What is a Bunion?

Dr. Randal Contento Shows How A Bunion is Formed.

For All Your Bunion Questions! 

Patients ask all the time, where do bunions come from?

To review, a bunion is a bump on the outside of your foot. It can cause pain in shoes and it can cause pain with range of motion of the joint. When evaluating somebody for a bunion, I look for flexibility. Flexibility is the main thing that will cause a bunion. If this joint is flexible, that means that when I move it up and down, there will be an excessive amount of motion. This patient does exhibit that excessive motion. Our foot shouldn't move this much. If our foot moves this much, that means that this bone will not end up doing its job.

When we put our foot down on the ground, our weight rolls on to the ball of our foot. The ground isn't going anywhere, so the ground is pushing up on the foot. This is the biggest metatarsal bone for the biggest toe. It should take about half of the weight as the ground pushes up on the foot. If this elevates, it's not taking its fair share of the weight.

That means there's two problems that will come the this.

The big toe joint is not taking the weight. Therefore, the second toe joint is going to take all of the pressure that the big toe joint is not. That's problem number one and some people can end up having pain underneath this joint with a bunion deformity.

The second problem is as the big toe gets pushed up, it locks the joint so there can't be any more bending at this joint. If it stays down, then you have great range of motion. Our feet are the length that they are depending on how much range of motion we get at this joint. For this size foot, you have to have range of motion to be able to walk normally. Your foot is just the right size, so if this joint is no longer bending our foot, it is too long to walk over. There are ways that we can compensate for having this problem. As we step down, our joint locks and we don't get this motion. We can't roll off of the tip of our toe; we have to externally rotate our foot in order to compensate for that. When that happens, we're no longer rolling off the tip, we're rolling off of the side. There's a big callus because this is where she is toeing off. Imagine that every single step that we take were rolling off of the side of our toe and this part of our foot is pushing up against the ground. Every single step, the toe just gets pushed again and again, over in that direction. Over time, a bunion will form because this toe will keep moving over in this direction. When this toe moves over, the first metatarsal bone stays where it's at or even worse, it can kind of move further out and that creates a big bump on the outside. That is how a bunion forms! 

if you have a bunion deformity and you want to have it examined, we offer same-day appointments.

Gaston Foot & Ankle Specialists

251 Wilmot Drive
Gastonia, NC 28054