The word ‘bunion’ is from the latin, meaning an enlargement of the joint (a lump of bone) at the base and side of the big toe. Hallax Abducto Valgas (HAV) is the medical term for the bunion. HAV may have experienced in 3 stages; Primary & Secondary stage bunions can be treated with orthotic therapy to prevent further development of the bunion. The tertiary (3) stage generally requires surgery to straighten the toe.
Cause
Bunions are not hereditary – but, inherited bad mechanics are and underlying cause. A short 1st metatarsal, combined with excess pronation is the general causation of a bunion. As the metatarsal deviates to the midline of the body, excess pronation assists the big toe into abduction (towards the 2nd toe) during the propulsive phase.
Symptoms
Pain may be felt in the 1st MTPJ together with a lump that enlarges with age. Left untreated the hallux (big toe) will increasingly deviate until it reaches the tertiary stage (3), in which the big toe either overlaps or underlaps the 2nd toe – making it difficult to obtain comfortable fitting footwear. Pain discomfort and difficulty wearing shoes may be experienced due to the deformity – arthritis and stiffness in the joint can also develop.
Treatment
Primary and secondary stages can be successfully treated with correctly fitted orthotics to realign and control the foot. Orthotics when moulded to STJ neutral limit the effects of pronation and prevent development of the bunion. Surgery may be required for tertiary stage. Post surgery orthotics should be fitted to prevent bunion reoccurance.
