Bunions in Runners: They’re Not the End of the Race

An athlete’s feet can be a source of greatness and joy – although when problems become severe, the opposite can be true. For runners, chronic foot problems can present a tough dilemma: it’s impossible to beat further milestones without pushing yourself. But push too hard, and you may need to stay off the track for much longer 

Do bunions affect running? Definitely! Far from an isolated problem in the big toe, bunions can result in generalized foot and ankle pain. But does this mean you should find a new discipline? Not at all. For athletes with bunions, the key will be to combine lifestyle adjustments with prevention measures and individualized podiatry care. 

What is a bunion?

A bunion (hallux valgus, as medical professionals call it) is a type of progressive foot deformity manifesting as a bony protrusion at the base of the big toe joint (the metatarsophalangeal joint). 

In their early stages, bunions may simply look odd, or cause your toes or toenails to rub uncomfortably against the inside of your shoes. However, as the bone continues to be pushed outwards, more severe foot conditions can develop. 

How do bunions affect runners?

Bunions may be easy to ignore at first. As the base of the big toe starts rubbing against the socks, it may create frequent blisters and corns. 

This may seem like a small nuisance – but often, trying to avoid extra friction causes runners to adjust their gait, which in turn may affect other muscles and tendons in the foot and ankle. As the bunion grows, so can the damage to the rest of the toes. Advanced bunions can cause more severe foot problems, including: 

• Hammertoes, when the middle joint of the affected toe starts to bend outwards. 
• Mallet toes, which affect the top joint of a toe (nearest to the toenails), bending it inward. 
• Plantar fasciitis is an inflammation of the fascia (the tissue that connects the muscles in your toes with your heel). 
• Bunionettes or “tailor’s bunions”, bend the pinky toe. 

Why do runners get bunions?

Bunions are a combination of genetic and lifestyle factors. In general, anyone who subjects their feet to repetitive motion and constant pressure on the toes will be more prone to developing bunions. 

Common culprits include wearing high heels (especially if pointy) or standing for long periods every day. Women are at further risk for bunion formation, as hormonal changes can often make joints looser. 

For runners, bunions often result from the repeated stress of hitting the pavement. Wearing shoes that are too tight, as well as having flat feet or overpronating feet can aggravate the problem. 

Preventing bunions in runners: It’s all in the shoe

People with loose joints or who have a family history of bunions are at an increased risk of developing bunions. Running – whether competitively or as a hobby – may also increase this risk. 

One of the best ways to compensate for this risk lies in shoe selection.  

Look for running shoes with a “zero drop” or “low drop.” A shoe’s drop is the height difference between where the heel rests and where the toes do when standing on both feet.  A pair of 3-inch heels will have a drop of 3 inches. Regular running shoes usually have a drop of up to 10 mm, while “shock absorption” models with lots of cushioning may have a drop of up to 12 or 15 mm. 

It may not sound like much, but even this slight “heel” counts in the long term. Higher drops place extra stress on your metatarsal joints, and may even shorten your Achilles tendon and the surrounding ligaments. 

Definitely steer clear of narrow or tapered toe boxes. These may make the shoe look “sleek,” but they’re far from ergonomic. 

If you’re at high risk for bunions or are already developing a slight bump on your big toe, don’t limit these rules to your training gear. Opt for a wide-toe box and avoid shoes with heels whenever possible. 

How runners can treat and manage bunions 

If a bunion has already started to develop, you should still have many fine athletic feats in your future. However, you will need to be vigilant to prevent the need for eventual surgery by balancing two priorities: first, as much as possible, keeping the bunions from worsening; and second, keeping the pain levels low and infrequent. 

 How to slow bunions down

A podiatrist or foot specialist can help design an aggressive bunion management plan, which may include: 

• Using orthotics or shoe inserts, both for training and for regular wear. 
• Toe taping: kinesiology tape and a toe separator will help you keep your toes in the right position during a run. 
• Wearing custom pads for extra arch support, especially if you have flat feet. 
• Using a bunion splint. 
• Paying attention to your posture throughout the day, because it affects the pressure you put on your toes. 

In addition, you can strengthen the foot muscles and ligaments through special exercises. Two that most athletes can do with minimal risk are: 

• Toe extensions: Sit on a chair with feet touching and flat on the floor. Then, bend the toes upwards for 30 seconds at a time. Do this at least three times a day. 
• Toe adductors: Sit on a chair with both feet on the ground. Then, spread your toes outwards. Focus on getting as much distance as possible between the big toe and the second toe, and hold the position for 5 to 10 seconds. Repeat this 10 times a day. 

Managing bunion pain

As bunions develop, they will have a larger impact on your gait and form. Eventually, even a short run may become painful for hours after a workout, or even keep you from your next scheduled run. 

Some effective tactics to lower foot pain include: 

• A professional foot massage. 
• A cold or icy compress on your bunion after a run. 
• Regularly scheduled foot care sessions to get rid of corns and possible ingrown nails. 
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, when the pain hits hard. 

If the pain becomes more frequent or more intense despite nonsurgical treatments, it may be time to go back to your podiatrist and discuss more invasive options. 

Can athlete bunion surgery help?

Bunion surgery can certainly provide effective relief. However, most foot specialists prefer to delay this step as much as possible. The reason is simple: even minimally invasive surgery will require some time off your feet. Afterward, you will likely have to take it easy for a while, as it may take a few months before you can go back to your previous activity levels. And like with any other surgery, there’s always the chance of a complication. 

The exact time it gets you to be “race ready” after surgery will depend on your body’s ability to heal from your specific surgery. 

For athletes, evidence shows that the two most successful procedures are: 

Chevron bunionectomy

A “Chevron osteotomy and bunionectomy” is one of the most widely used bunion surgeries nowadays. It works best for mild to moderate bunions and in people under 50. 

This procedure involves cutting into the affected joint, trimming any extra bone bits, and finally realigning the joint tendons around it. 

If you follow post-op instructions thoroughly, and you are healthy enough to bounce back quickly (most athletes are), you can expect to go back to a full range of motion after six weeks. However, it may take up to three months to return to your previous activity levels. 

Lapidus procedures

In more severe cases, surgeons may recommend a “Lapidus” procedure. This is a more complex surgery, as it involves fusing some of the bones in the toe, rather than simply realigning them. As a result, it often requires a longer recovery time. 

Choosing the right type of bunion surgery will require a frank discussion with a specialized foot surgeon. They will need to examine your pain levels, and will likely order an X-ray to see which bones and joints are affected. 

Fortunately, in the past few years, there have been great advances in this field. Now, both the Chevron and Lapidus procedures can be done using minimally invasive techniques. These use smaller incisions, cause less post-surgery pain, lower the risk of infection, and possibly cut the recovery time in half. 

Worried about bunions in runners? Come to the Bunion Institute

At the Bunion Institute of Los Angeles, our team of board-certified podiatrists and orthopedic surgeons specialize in every stage of bunion pain relief. 

Our goal is to work with each patient toward a solution that best aligns with their goals, comfort, and lifestyle. For bunions in runners, options start with careful non-surgical management, all the way into state-of-the-art minimally invasive procedures. 

To schedule a consultation, please call (855) 814-3600 or make an appointment now. 

The Bunion Institute is conveniently located throughout Southern California and the Los Angeles area. Our podiatrists and foot and ankle surgeons are available at locations in or near Santa Monica, Beverly Hills, West Los Angeles, Sherman Oaks, the San Fernando Valley, Manhattan Beach, the South Bay, LAX, Calabasas, Agoura Hills, Westlake Village, Valencia, Santa Clarita, and Santa Barbara.