What is a Bunion?
A “Bunion” ( Hallux Valgus) is a deformity where a bony bump forms at the side of the Big toe (Hallux). It occurs when the Hallux is pulled over to the lesser toes causing the joint (Metatarsal head) of the big toe to stick outward. The bunion can become painful, red and swollen and become very stiff and have reduced movement. It may also contribute to arthritis.
Bunions usually get worse over time and they can then impact and affect the smaller toes contributing to hammertoes, claw toes and metatarsalgia. Factors that influence them may be ill or tight-fitting shoes, high heels, inherited foot type but the causes are unknown. Once the pain becomes worse then surgery is required to help correct this.
What Treatments can I do? will I need Surgery?
If you have a Bunion we would advise that you see an expert Physiotherapist to help improve your foot strength, stability, joint mobility and control of the foot. By undergoing the appropriate rehabilitation for your foot then you may find that you help reduce the progression of other dysfunctions and reduce your pain.
Other interventions can be Podiatry referral for orthosis to help pain and gait. Home treatments that may provide pain relief and prevent symptoms from getting worse can be Toe Spacers and Wide fitting shoes and Bunion pads. These can give you some protection from the pressure of your shoes and reduce pain. These can all help, however most likely over the long term you may still end up requiring surgery. There are many types of surgical procedures such as Scarf, Akin Osteotomy and Minimal invasive.
What can I expect after the operation?
The main objective with Bunion surgery or a Bunionectomy is to remove the bunion prominence and realign the toe so that it's straight and stays like that. You will have pain after the operation and this is expected. There will be swelling and bruising and It is important to manage your pain well by taking the medication prescribed by the hospital or your GP
For the first 7-14 days you will have to keep the foot elevated most of the time and will be given a surgical shoe so you can put weight through the heel. You will also be using crutches. Most commonly you can drive after 4-6 weeks, and walk comfortably in 3-5 months. Remember you may have to wear wide fitting shoes for the first 3-6 months. Many times people are back running after 5-6 months. Overall it may take 9-12 months for a full recovery.
How do I recover?
Following your Bunionectomy and you are discharged it is important to follow the guidance and post-operative instructions. These will be keeping foot elevated and protect it well. Take the medication prescribed by your consultant and GP to help manage your pain.
As an expert Foot and ankle Physiotherapist, I will perform manual therapy to help your big toe joint move better to prevent long term stiffness and also help muscle tightness and swelling. I will prescribe a bespoke exercise programme for you and your Bunionectomy. This will help increase your mobility, strength and daily activity. I will advise in all areas from self home care, walking, stairs, and how to progress your mobility, strength and exercise tolerance. This is also with the guidance of your surgeon. As you progress I will instruct you on how to increase your fitness, exercise, recreational activities and return to sport if you wish.
My objective is to help you in achieving your goals 100% of what you expect from your Bunionectomy. As I have seen 100's of bunionectomy and worked with the leading Foot and Ankle surgeons in the Uk I can safely guide you back to normal function. Pop in and see me in the Edinburgh Physio clinic for guidance and assistance.
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