Big toe deviation
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The foot is roughly divided into three sections: the hindfoot or heel, the midfoot and the forefoot & toes. The function of the toes, especially the big toe, is to help us balance, and to propel us forward during walking or running. The 14 bones of the toes are among the smallest in the body, and, not surprisingly, things can and often do go wrong. Some problems begin in childhood and may go unnoticed. Others begin later on in life, perhaps as the result of injury or the added pressure of incorrect footwear.Bunions
What are bunions?
What most people call a bunion is actually known as "Hallux valgus". Hallux valgus refers to the condition in which the big toe is angled excessively towards the second toe – and a bunion is a symptom of the deformity. “In a normal foot, the big toe and the long bone that leads up to it (the first metatarsal) are in a straight line,” explains podiatric surgeon Trevor Prior. “However, Hallux valgus occurs when the long foot bone veers towards your other foot and your big toes drifts towards your second toe.” A bunion actually refers to the bony prominence on the side of the big toe. This can also form a large sac of fluid, known as a bursa, which can then become inflamed and sore.Is it serious?
“Some people have massive bunions that aren’t that painful but cause difficulties with shoes, while others have relatively small bunions that are very painful,” says Trevor. However, just because you have Hallux valgus doesn’t mean you’ll get the bursa. Pressure from the big toe joint can lead to a deformity in the joint of the second toe, pushing it toward the third toe and so on. Likewise, if the second toe and big toe cross over, it can be difficult to walk. “Once the big toe leans toward the second toe, the tendons no longer pull the toe in a straight line, so the problem tends to get progressively worse,” explains Trevor. This condition can also encourage corns and calluses to develop.Who gets them?
“Women tend to get bunions more than men,” says Trevor. “This could be due to the more restrictive footwear they wear, (such as high heels or narrow toe boxes which force the big toe towards the little toes) but women also tend to have looser ligaments, making them slightly more prone.” You’re also more likely to get bunions if your parents or grandparents have them.What causes bunions?
“No one single cause has been proven,” explains Trevor. “There are a number of causes, and though shoes can exacerbate the problem, bunions do occur in societies that don’t wear them.” Michael Ratcliffe, a registered podiatrist who specialises in podiatric clinical biomechanics, explains that we walk on the same type of ground all the time, whereas the human foot was actually designed to adapt to varying terrains. In a sense, a bunion is a type of repetitive strain injury. And like repetitive strain injury, some people are more prone to it than others. One theory - though it remains unproven - is that bunions are caused by one or both of the following:1) Because the foot wasn’t designed to constantly walk on a level surface, the ball of the big toe is slightly lower than the ball of the rest of your foot. When your foot meets the ground, the ball of the big toe is pushed up, and the big toe joint can’t bend as well as it was designed to. In order for the big toe joint to bend fully as you walk, your foot rolls slightly over to the side (this is also why people with hallux valgus often get hard skin).
2) Also, if your midtarsal joint tends to move from side to side more than it does up and down, the arch in your foot collapses as your foot rolls in. This also makes you more prone to developing bunions.
Such problems can be exacerbated by tight footwear. “Slip-on shoes can make matters worse,” says Trevor. “Because they have to be tighter to stay on your feet, you automatically have less room for your toes. And with nothing to hold your foot in place, your toes often slide to the end where they’re exposed to lots of pressure. Likewise, high heels throw more weight onto the ball of the foot, putting your toes under further pressure.” If you haven’t got a bunion by adulthood and you later develop one, there could be some underlying arthritis.
