Crooked feet are not random

Although misaligned toes and bunions are fairly common, there are numerous misconceptions about such deformities. Many people fail to realize that their crooked, calloused feet and their ankle and foot issues like achilles tendonitis and plantar fasciitis go -ahem- hand in hand.

My patients often look down at their feet and blame their stuctural condition on one of their parents. But bunions and drifting and overlapping toes are not random occurances like a cyst or a plantar wart. They are the body's typical response to mechanical forces. What's inherited is not the bunion itself, but a faulty foot or lower leg structure and gait pattern that make a person prone to developing a bunion.

This may seem like trivial information. But it's important when deciding the best way to treat such problems. Seeing callousing and bunions primarily as cosmetic issues that need to be addressed at the spa or surgically will produce a far different outcome than seeing them as biomechanical problems in need of biomechanical correction away from the actual bunion.

For example, treatment for someone with a mild to moderate bunion and/or hallux valgus (first toe migration) may include:
  1. Placing a splint or spacer between the first and second toes.  
  2. Appropriate width footwear that doesn't perpetuate the pain and sensitivity by putting pressure on the area.
  3. Custom or semi custom orthotics that correct for structural misalignment in the midfoot or rearfoot and allow for more normal forces as the patient rolls off the ball of the big toe.
  4. Stretching and select strengthening of the foot, and more likely, the ankle and the hip, which promotes more normal motion elsewhere and unloading of the areas taking a beating.
  5. Gait training aimed at forming a "new groove" of walking that places more normal forces at the hip, knee, and foot and again, minimizing the biomechanical forces which cause the deformity. 
Pain relievers help relieve pain and surgical correction is absolutely needed at times. But can you see how a toe splint and anti-inflammatory drugs are a short sighted fix for something that may be due to biomechanical forces all the way up at the hip? Orthotics and surgery are even of limited benefit if you walk like Donal Duck.

Donald seriously needs some hip internal rotation mobilization.

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