Bunions are one of the most common foot injuries in dancers. They can be incredibly painful, making it nearly impossible to go on demi-pointe, land a sauté, or perform a pirouette. Hallux valgus, more commonly known as bunions, is a deformity of the 1st metatarsophalangeal (aka MTP) joint causing the big toe to deviate towards the other toes. It can often lead to swelling, inflammation and bony growth on the inside of the big toe. There are certain risk factors for developing bunions that are out of our control. These include being female, older age, genetic predispositions, and having a longer 1st metatarsal bone.
Luckily, there are certain risk factors that we can control:
Practicing proper turnout technique: Insufficient turnout at the hip can cause hyper-pronation or ‘rolling in’ at the feet. This places more pressure on the inside of the big toe, pushing the big toe towards the other toes and leading to bunion development.
Avoid wearing ill-fitting shoes: Constrictive shoes can contribute to development of bunions. While this goes for all shoes, wearing worn out or ‘dead’ pointe shoes also increases the risk as the shoe may no longer provide adequate support. Dancers should get their shoes properly fitted by their local dance shoe expert to avoid problems with bunions down the road.
Strengthen foot arches: Fallen arches are often the result of weak intrinsic foot muscles and can increase the stress to the inside of the foot including the big toe.
Avoid leaning on the big toe: Although a winged foot is a desirable look, be careful to avoid bearing weight and putting significant pressure through the big toe, especially in classical position or positions in derriere.
How Do We Treat Bunions? When it comes to treating bunions, research suggests that a multifaceted approach is best. When treating conservatively, this includes:
Correction of improper technique and alignment with the focus on proper turnout technique at the hip and proper weight distribution over the foot
Use of toe spacers can assist with big toe alignment and help reduce pain
Joint mobilization of the foot, ankle, knee and hip, depending on specific joint restrictions
Strengthening of the big toe muscles as well as the little muscles in the foot to help manage symptoms and slow progression of bunion formation
Surgical management is an option but should be the last resort and delayed as close to retirement as possible, generally speaking. The flexibility and mobility of the big toe can be impaired and difficult to regain fully after bunion removal.
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