Most people who have bunions have a hereditary genetic condition called overpronation. This means that when you're standing or walking, your feet have a tendency to roll inward toward the big toe joint. Over time, the toe joint deforms, causing a bunion.
While both men and women can develop bunions, women develop them more often because of their choice in footwear, explains Dr. Hartley Miltchin, a Toronto-based podiatrist. Not surprisingly, high heels are the major cause.
"We're meant to walk on flat feet so that our body weight is distributed equally between the ball and the heel of the foot," says Dr. Miltchin. "When we wear heels, 90 per cent of the weight is on the big toe joint."
But even flip-flops and ballet flats can cause bunions. "Any shoe without proper support for your feet can cause them to roll inward." Pointy shoes – where toes are squeezed into a cramped space – can cause bunions not only on the big toe joint, but also on the small toe (aka a "bunionette").
How to prevent bunions
It's never too late to prevent bunions from forming or getting worse. Here are some tips to keep you bunion-free:
• Make an appointment with a podiatrist. Most people have mild signs of bunions before they notice any discomfort. Foot problems can often be identified – and prevented – before the age of six, so if you're a parent, now is the time to take your kids for a check-up if you have bunions in your family. You don't need a physician's referral to visit a podiatrist and the initial consultation is often partially covered by provincial and extended health care plans. During an initial visit, the podiatrist will take several X-rays of your feet to see if there's been any shift in your toes. Then, he will identify ways to prevent bunions. Many insurance plans also cover follow-up visits, orthotics, custom footwear or surgical fees (if required).
• Wear lower heels. Swap your four-inch heels for less-than-two-inch heels. Opt for a wedge or a chunky heel over stilettos, which will give you more support. And choose a round-toe pump over a pointy-toe shoe, which will give your toes more wiggle room.
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• Commute in comfy shoes. Instead of walking to work in heels, channel Melanie Griffith in Working Girl and commute in cute sneakers, then change into your heels at the office. "If you have a desk job and only walk to get a coffee or use the printer, wearing heels in the office isn't going to worsen your bunions," says Dr. Miltchin.
• Buy custom orthotics. Like your eyes, no two feet are identical, so buying off-the-shelf orthotics may not prevent bunions. "The success rate for an off-the-shelf orthotic is low because it's not formed to your foot," says Dr. Miltchin. While custom orthotics aren't cheap (most range from $500 to $700), they will last many years. Though no orthotics will fit in every pair of shoes you own, they will fit in most – including sneakers, golf shoes, low heels and flats. Tip: Bring your orthotics with you when trying on new shoes to make sure they fit.
• Switch up your exercise regime. "Running is one of the worst exercises – not only for your feet, but also for your knee and hip joints," says Dr. Miltchin. If you're a runner, try alternating running days with a low-impact sport such as biking, swimming, speed walking, yoga or Pilates. When you run, wear an orthotic that will absorb the shock of impact your feet would otherwise take.
• Minimize the pain. If your bunion is already causing you pain when you're wearing shoes, you can apply bunion cushions before slipping into your shoes to relieve friction and pressure. In the evening, apply an ice pack to reduce inflammation. Once a bunion becomes too painful to bear, unsightly or prevents you from wearing shoes you love, ask your podiatrist about minimal incision bunion surgery.
• Exercises for high-heel wearers
• What you should know about podiatry
• 7 steps to happy feet
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