Bodyworks: Bunion (Hallux valgus)

Symptoms
You’ll feel tenderness over the inner side of the joint between your first metatarsal (MT) and big toe, or hallux, and notice that the end of the toe starts to point outwards, forming an angle of up to 90 degrees with the MT. Pressure of any sort over the joint can cause both redness and pain.

Signs
The deformation is obvious, and underlying this will be wear and eventual arthritis of the first metatarso-phalangeal (MTP) joint. The space opened out by the splitting of the joint is filled by a thick-walled bursa – the bunion. Bunion-sufferers often lose their transverse arch under the metatarsal heads, which exaggerates the problem.

Medical investigations
An x-ray is unnecessary, and blood tests will only exclude differential diagnoses.

What else could it be?
Gout, and occasionally other rheumatic conditions, may arise within the first MTP joint.

Self-treatment
Correcting the loss of the transverse arch with a metatarsal pad, or wedging the first and second toes apart with cotton wool will delay the progression of the condition. Protecting the bunion with felt or foam pads, if your shoe is large enough to permit it, will ease your pain.

Medical treatment
The worst bunions can ultimately be corrected only by surgery. Various operations have their proponents; none prevents some disability in terms of mechanical efficiency, but all should leave you pain-free! Meanwhile, anti-inflammatory drugs, cortisone injections, mobilisation and exercises will give some relief.

Can you run through it?
Running through bunions without podiatric modifications is possible, though you will probably feel some pain, which is likely to progress over the years.

Recovery time
After surgery, you should be able to begin light training after six to eight weeks, and be on the road in 12.