A bunion is not a growth, not a disease, not a fungus, and certainly nothing to be ashamed of. If you don’t have a bunion, consider yourself lucky. If you do have a bunion (or two) you owe it to yourself to understand what’s going on.
While it’s one of the most common foot problems today, the condition is still not well understood, and therefore approaches to treatment, surgical correction in particular, are far from standardized. Doctors and online medical resources offer differing views because there is still no official consensus on the actual pathology, or specific reason for bunions to develop. We believe this situation needs to change.
Validated by 35 years of successful outcomes, we offer a direct diagnosis, and therefore a true pathology for bunions.
The word ‘bunion’ comes from the Greek word for turnip and is the common name for that annoying and sometimes painful protrusion on the side of your big toe joint. Medically, your bunion is called a hallux valgus deformity, which means an outward tilting of the big toe. What you see on the surface, however, does not tell the whole story.
Doctors have long hypothesized different failure scenarios: “Is it the bones, joints, ligaments, muscles or tendons? What is the primary underlying reason for an otherwise anatomically normal foot to become so deformed later in life?” Simply put, the bones in the inner-side of your foot, or the medial column, have fallen apart.
The real culprits are incompetent ligaments. Drifting bones and joints are innocent bystanders. Displaced tendons and muscles only become accomplices after the fact.
Bunions are a progressive condition that slowly reveal themselves over many years and through a complex sequence of events.
A network of ligaments around the medial column begins to fail, particularly around the first metatarsal bone. Without this critical support, the bones in the medial column are allowed to drift apart.
Under the stresses of daily activities, the first metatarsal’s head is slowly pushed away from the rest of the forefoot. At the top, the big toe caves in. The entire medial column rotates inward, and the sesamoid bones gradually drift outward.
A layered network of tendons and muscles connect the big toe to the rest of the foot. The tendon-embedded sesamoids act ingeniously as a pulley system to power big toe function. As the sesamoids dislocate, the entire medial column is rendered unstable and weak.
When this critical walking mechanism is compromised, the foot naturally compensates. Weight-bearing force is transferred from the inner-side of the foot to the outer-side. The gait changes, and sooner or later secondary problems appear.
Indeed, bunions are rarely a singular issue, and often cause secondary problems:
80% of bunion sufferers claim a family history of bunions.
90% of bunion sufferers are women.
Nearly one quarter of the global adult female population suffer from bunions. Although high heels are infamously blamed, studies demonstrate these weakened ligaments are primarily related to the female estrogen hormone and heredity.
The female body has specifically evolved to be more flexible than the male body. During pregnancy, an increase in estrogen allows further loosening of the ligaments around pelvis to prepare for childbirth. This same hormone is also partly responsible for the loosening of ligaments in female bunion feet.
Heredity also plays an important role, with 80% of bunion sufferers claiming a family history of bunions.
Furthermore, variable lifestyles contribute to the speed and severity by which bunions develop. High heels, pointed and tight shoes may precipitate an earlier onset and accelerate bunion progression to vulnerable feet, but there is no evidence that high heels primarily cause bunions.
Other Bunion Myths
While it's too late to change your parents or gender that may be responsible for your bunions, you can minimize pain and maximize function through conservative measures. Surgery should only be a last resort.