A Bunion (or Hallux Valgus) appears as a bump on the side of the great toe. It is due to an angular deformity at the 1st MTP joint (at the base of the great toe). As a result, the great toe then pushes against the second toe. Bunions often occur in both feet and women make up the majority of cases. Bunions can occur at any age and tend to worsen over time.
Bunions are thought to occur due to an imbalance between your ligaments and muscles in the foot. It is partly an inherited condition but footwear such as tight or high heeled shoes also contribute.
Patients may experience painful rubbing over the Bunion causing difficulty finding comfortable footwear or pain elsewhere in the foot. In rare cases, it can lead to a skin breakdown over the Bunion. A Bunion will often lead to issues around the second toe being painful and deformed (claw or hammer toe).
When to consider having a discussion with a Surgeon for your Bunions:
Plain ‘weight-bearing’ x-rays must be obtained to accurately assess the deformity.
There is no non-surgical treatment that can permanently correct the deformity or prevent it getting worse. Wider shoes can accommodate the foot and limit rubbing. An Orthotist or Podiatrist should be able to provide you with a Bunion splint to hold the toe in a corrected position.
Surgical treatment is the most reliable way to correct your Bunion. Most patients achieve a successful outcome after Bunion surgery.
Mr Goldbloom prefers minimally invasive surgery for Bunion correction. Through 5mm incisions, specialised instruments (such as irrigated burrs) are used under x-ray guidance to re-align and stabilise the bones and joints.
Small incisions used for minimally invasive bunion surgery
There are certain cases where minimally invasive surgery for Bunion correction may not suitable for your foot. In this situation, Mr Goldbloom will discuss other surgical options such as:
|Week||Exercises||Boot||Weight bearing||Returning to Pre-Surgical Function||Other|
|0-2||Ankle circles Foot and lower leg massage.||Post-op shoe||Weight bearing as tolerated||Staying home with the foot elevated above heart level for 23 hours a day|
|2-4||Light ROM “fairy fingers” for dorsiflexion and plantarflexion exercises. Seated low force toe raises and heel raises. Working towards 30 mins walking.||Post-op shoe||Weight bearing as tolerated||Never pushing the joint to end ROM- no sprinting off blocks or extreme DF for 12/12|
|4-6||Calf stretching. Physio guided 1st toe mobilisations Hip, knee, ankle band resisted exercises. Resisted seated heel and toe raises, feet tapping, short foot and arch lift exercises. Continue exercises a/a. Start DL heel raises, progressing to SL.||Full weight bearing||Return to work – sedentary occupation.|
|6-8||Patient guided 1st toe flex and ext mobilisations, toe ball squeeze, toe squeeze and spread. Physio guided gait and balance training||Walking as tolerated. Return to light duties – labour intensive occupation|
|8-10**||Increase walking distance. Progress exercises a/a with physio guidance|
|10-12*||Physio guided, gradual return to pre-surgery activities eg. running, cycling.|
|12+||Return to sport training for higher level functioning patients.|
If you have any questions please do not hesitate to contact Mr Goldbloom’s rooms on 03 9928 6188.
This rehabilitation plan was developed by Mr Goldbloom in conjunction with Physiotherapists Brodie Leonard-Shannon and Brendan Mason from Back in Motion, Aspendale Gardens.
Any surgical or invasive procedure carries risks. The information provided here is for general educational purposes only. Please contact Mr Goldbloom's rooms to discuss if surgery is appropriate for your situation.