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Bunion (Hallux Valgus) Physiotherapy



A bunion (hallux valgus) is a large bump on the side of the foot that develops at the base of the big toe (refer to image; take a look at your big toes, and then follow the line on the inside part of the foot - it's the joint just below the big toe).

Unfortunately it is common for a bunion to become inflamed and swollen, causing foot pain.

Although anyone can develop a bunion, this painful bunion condition occurs most of the time in

  • women and
  • older adults

Over time, the bunion joint may become

  • enlarged
  • stiff/tight
  • painful

and this causes problems with shoe fit, pain, and even difficulty walking.

What our senior physiotherapists do to help patients with (painful) bunions is to

  • improve the angle of the big toe
  • improve their muscle strength
  • improve their walking ability and
  • reduce their pain

first of all, What is a Bunion?

A bunion is a bump on the side of the foot that develops at the base of the big toe when the toe deviates (points/moves) inward.

Also, there are four classifications of the severity of a bunion: mild, moderate, large, or severe, depending on the size of the measured angle at the toe. An angle of 20° or greater is considered abnormal.

There are several factors that may cause bunions, including:

  • Heredity
  • How the foot is shaped
  • Flat arches
  • Joint laxity (too much flexibility in the joint at the base of the big toe)
  • Osteoarthritis

Tight footwear has often been blamed for bunions, but recent studies and research are saying that footwear may not be a large (if any) factor in their development. That being said, inappropriate and tight footwear can irritate a bunion by rubbing on the tissue at the joint, and this leads to more swelling, inflammation and pain.

How Does a bunion Feel like?

How a bunion feels really depends and varies with each individual.

There is no relationship between the severity of a bunion and the symptoms experienced (this means some really bad bunions can be not painful, and some mild bunions can be really painful). Not all bunions cause symptoms; however, people with bunions report mild to severe symptoms, including:

  • Pain and swelling in the big toe joint that worsens with standing and walking
  • Gradual enlargement of the bump on the side of the foot, which can become inflamed and swollen causing foot pain
  • Pain when wearing shoes, making it difficult to find comfortable or stylish footwear
  • Changes in how you walk
  • Increased difficulty walking
  • Changes in balance, increasing the risk of falling, particularly in older adults
  • Crossing of the big toe and lesser toes, causing crowding of the toes, and possibly causing additional deformities and pain
  • Reduced quality of life related to foot pain

Signs and Symptoms of bunions

If you see our senior physiotherapists first, they will ask you about

  • your medical history
  • how your symptoms developed and
  • how they are currently affecting you

They will observe your walking pattern, particularly how you bear weight on the affected foot with the bunion, and willexamine the foot and the big toe to observe any swelling, deformity, or tenderness.

They will test the strength of your foot and big toe, and measure your foot's flexibility and range of motion, and will check your footwear for proper fit, and for wear patterns.

If your bunion is classified as severe, they may recommend a consultation with an orthopedic foot surgeon (we can refer you to our medical network as well).

How Can our senior PhysioTherapists Help?

Our senior physiotherapists will treat your bunion symptoms with

  • pain management
  • exercise
  • gait training and
  • education regarding proper footwear and self-care for symptom management

The key focal goals of our senior physiotherapists treatment is to

  1. improve the angle of the big toe
  2. improve muscle strength and
  3. reduce pain (pain relief)

Physiotherapy bunion treatments may include:

Manual Therapy. We may use manual (hands-on) therapy to help improve the position of the big toe . We will gently move your big toe and ankle to reduce joint tightness and any stiffness of the surrounding tissues, and increase the big toe's bending range of motion.

Exercise. You will be taught range-of-motion, stretching, and strengthening exercises to improve the alignment of the big toe when standing, and improve your walking pattern. We will design an individualized exercise program based on your specific needs.

Balance Training. To help reduce the risk of falling, we will teach you standing and walking exercises to improve your balance during movement.

Symptom Management. You will learn how to use intermittent

We may also apply specialized taping of the big toe to improve the big toe's alignment, and reduce pain.We will recommend the best footwear for your condition.

Orthotics and Devices. We may recommend the use of splints, foot orthotics, or assistive devices, depending on your condition, and will train you in their use. They may include:

  • Splints and toe separators to reduce pain and pressure on the big toe.
  • Custom arch supports (foot orthotics) to help keep the foot and ankle in a midline position during walking.
  • A cane, walker, or crutches (assistive devices) to reduce pain and improve walking ability.

physiotherapy After bunion Surgery

If your bunion pain level and deformity worsens to a point where you cannot find comfortable footwear, or walking becomes difficult, you may choose  to consider bunion surgery to correct the position of the big toe.

Our senior physiotherapists can help after your bunion surgery to

  • restore the strength of the big toe
  • restore the flexibility of the big toe
  • reduce pain and
  • improve your walking ability

Physiotherapy is different and varies with each patient, because it's based on their condition and the type of surgical procedure performed. After most surgeries, you will wear a special postoperative shoe to protect your foot, and avoid putting pressure on the surgical area for about 4 weeks.

A hospital physiotherapist will teach you

  • how to walk with a cane, walker, or crutches to avoid putting weight on the surgical area
  • to help ensure that the bones will heal well
  • the use of cold therapy and leg elevation to control pain and swelling

Post bunion surgery physiotherapy with our senior physiotherapists usually will begin 3 to 4 weeks after surgery, and continue for 4 to 8 weeks. Treatments will include the elements listed above.

The first session will focus on pain relief and swelling management with the use of mild ankle range-of-motion exercises, cold therapy, and gentle retrograde massage. You will begin gait training with specific instructions from us, and perform exercises in the clinic and at home.

Postoperative physiotherapy will emphasize walking and learning how to push off of your big toe properly to restore normal walking ability. It will also include exercise to strengthen the big toe and ankle, and movement to restore better bending of the big toe.

Do note that it is important to regain strength and bending in the big toe to restore your full walking ability. You will be encouraged to perform a home-exercise program between physiotherapy treatment sessions as well as after the visits are completed, to help you return to your job, leisure, or sport activities.



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All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).

See our entire team here with introductions and their specializations.

At the first session, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover as well as provide treatment in the same session.

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