Bunions and the Fitting of Children’s Shoes

The correct fitting of children’s shoes is crucial to the normal and natural development of the growing foot. That growing foot is malleable and easily deformed. There is some controversy around the use of supportive features in children’s shoes and care needs to be given when it comes to giving advice in that context. Some argue that the shoe should be minimal and not interfere with the foot’s development and others argue that there should be some support to encourage the foot to develop properly. This is not the place to get into this debate, as we focus here on bunions.

Which ever school of thought you are biased towards, there can be no doubt that the shoe for children must be wide and long enough in the forefoot to prevent any pressures that might increase the risk for bunions. The shoe must be checked and replaced at regular intervals as the child’s foot grow to prevent any problems developing.

Depression and Bunions

Who would have thought that something like a bunion or hallux valgus on the foot would affect your mental health status?

hallux valgus anddepression

Well it does. This study looked at 102 people and used the Beck Depression Inventory and measured the angle of hallux valgus and found the greater the ankle of the hallux valgus, the more depressed. Unfortunatly they did not include a group of people of a similar age, gender and body weight (etc) to compare them to, but never-the-less the results are interesting.

It is a chicken-and-egg situations. Did having the pain, discomfort, shoe fitting problems, embarrassment, etc contribute to the symptoms of being more depressed? Or is there a genetic risk profile for depression, that is also a risk factor for hallux valgus? Either mechanism is probably plausible. Either way, there are mental health issues involved and as part of the holistic management of any patient they need to be taken into account.

Overpronation and Bunions

Like ‘bunions’ there is so much misinformation on the web about this thing called ‘overpronation’. So much nonsense and so many myths are written about it. Unless you are familiar with all the issues, it can be hard to distinguish the good information from the bad information.

If you are on this site, then we assume you know what bunions are! ‘Overpronation’ is the term given to a situation when the ankle joint rolls inwards or medially too much. The problem with the term is that pronation is actually a quite normal motion and there is no consensus what is normal and what is over. This is why so much nonsense gets written on the web about it. Too much of the pronation is generally considered problematic (but not by everyone) and can increase the risk for foot and leg problems. One of those foot problems that it could be associated with is bunions.

What is the link between Overpronation and Bunions?

overpronation
“Overpronation”
bunions
“Bunions”

The potential for a link between the two comes about as there is good evidence that those with bunions or hallux valgus have more flat feet and those with flat feet (or overpronation) are more likely to have bunions or hallux valgus. There is a pretty reasonable theoretical mechanism how a flat or overpronated foot could lead to a bunion or hallux valgus, but that does not mean that the flat feet caused it. It could well be that people develop bunions and due to medial column weakness, the arch collapses. This could be the cause of the overpronation.

So it really is a ‘chicken or egg’ situation. Which came first? The pronation or the bunion (hallux valgus)? Some people think they know, but the don’t. there is no evidence one way or the other as to which one happens first.

Having said that, it is still important the the problem of any overpronation be addressed as pert of the management of bunions and hallux valgus. Clinical experience does support that there are better overall outcomes when it is addressed.

Why this site?

Bunions are so common and like so many other foot problems that are so common, there is so much misinformation being spread on the web about them. We thought it would be helpful to have an evidence based resource on the web that contained good science based information. We want to address those issues.

The cause of bunions is multi factorial, meaning many factors are involved. Its not just the shoes as there is an hereditary element to them. Bunions still do occur in those who do not wear shoes (but they are not as bad and not as painful in the shoe wearing populations). We want to address those issues.

When you get a bunion, there is no a lot that can be done to make it go away, except for surgery. There is not a lot that can be done to help the symptoms without surgery but they won’t help it go away. We want to address those issues.

So many issues and so little time. We will get to them all eventually.

In the meantime, check out:
The Bunion threads @ Podiatry Arena and the Bunions threads @ the Foot Health Forum.