Bunions…A Runner’s Nemesis

By: Elise Yanover

A bunion for those of you who do not know is defined according to Wikipedia as:

“A deformity characterized by lateral deviation of the great toe, often erroneously described as an enlargement of bone or tissue around the joint at the head of the big toe.”

In layman’s terms it is that unsightly bony thing sticking out of the side of the big toe! It can be painful, or not (just ugly!). It makes shoe purchasing difficult and limited, as one must find shoes that accommodate these protrusions.  Pain in the area occurs from pressure on the shoe, as well as a result of the poor joint alignment. I have yet to meet a runner who has stopped running because of bunions, but have met many who complain about having them. It is one of those things we “live” with if we happen to be blessed with them. Bunions are both a factor of heredity (yes it is one of those things you can blame your parents for!) as well as biomechanics. If you tend to have flatter feet or overpronate in your run stride, you are more prone to bunions as this motion causes an increase of outward motion to the big toe joint.

I have had bunions for most of my adult life. My mother has horrid bunions, her father’s were even worse , and both of my sisters and my niece also have bunions. So I knew I was up against some pretty bad genes. For many years my bunions were not painful and I said I would NEVER have surgery on them until they limited what I wanted to do. Well, that day came about 5 years ago. I recall the moment I was out for a run in a pair of shoes that had changed their design (these were not Mizuno shoes) and were slightly narrower than their previous version. I felt a sharp pain in my big toe and from that day forth, my running was never the same. It got to be so painful, that I had to cut holes out of my running shoes to take the pressure off of the bunion. I had to wear mens running shoes for the width (and for someone who loves girlie colors, this was not enjoyable). Those cut outs in my shoes were fine in the summer, but in winter, and snow…no one needs air conditioning for a Canadian winter!  Running was tolerable, but not as enjoyable as I would have liked and so I reduced my distances considerably

Recall I said I would NEVER have surgery unless it interfered with my life. Eventually it really started to interfere with my life. Not just for running but everyday. I could only tolerate open Birkenstock shoes. Enough said. Having worked at a sports clinic at the time, I was very lucky to have easy access to an orthopedic surgeon who would operate on me.  Almost three years ago last month I had it done. He did both at the same time. I had heard from many people that doing one at a time usually means you don’t want to go through it a second time and so having both done was a good way to only have the recovery process once (however many surgeons will not do this). It was a long recovery. I won’t lie and say it was not painful, but I knew if I was patient the end result would be positive. My surgeon was so exact with my recovery timelines that it made it easier to accept. Unlike an overuse injury when you really have no clue when you will be better, or back to your activity at it’s full capacity, surgery usually has a much more definitive timeline.

For the first two weeks, I could only walk on my heels and could only get up to go to the bathroom. Let’s say I made myself go to the bathroom a lot! excuse  I did a lot of floor work while recovering especially those first two weeks. Plank from my knees, leg lifts, arm weights, bridging from my heels. For someone like me, being told not to move was torture! However on the flip side I took it as a break from the everyday and actually started to enjoy it.

Fast forward 3 months later and I was able to start to run again. I did a very conservative walk/run program (actually the day I got the go ahead, I went out!). It took me 2 months to run about 30-35 minutes.  I was biking again within 6 weeks of surgery and swimming about 9 weeks after (he told me that I could after 6 weeks, but kicking did not feel great). I could also do a good amount of strength work and found TRX to be a great way to get in strength without stressing my feet.

Three years later the following has happened:

• I have no pain in my feet when I run and I am back to running half marathon distance (and faster than pre-surgery!).
• I actually understand how women love to shoe shop!
• I can wear women’s running shoes! This is most exciting!
• I transitioned out of my orthotics.

However, my feet are starting to change a little mostly as a result of my inherent biomechanics and hypermobile foot joints. They are not nearly as severe as they were in terms of angulation and I hope they won’t become that way. With bunion surgery there is never a guarantee and so much of it is dependent on your biomechanics. If you are struggling with bunions or considering surgery, I suggest the following:

• Make sure you wear properly fitting shoes for running. Consider a wider model if need be, or if you are female, consider mens shoes. Slice a small hole near the bunion area to let the area free up if a wide shoe is still too narrow.
• Run with good forefoot to mid foot mechanics to avoid excessive pronation in the mid-stance phase of your gait.
• Get a referral to an orthopedic surgeon who treats bunions. This process MAY    take up to 2+ years so if you are even considering it, get on the list now! I do know that some podiatrists do the procedure in office, however this is not covered by OHIP and can be very pricey.
• Don’t think about how much it may require of your patience and pain tolerance post surgery, think of the outcome at the end.

Here is a photo post surgery bandaged:

And now I can run in these:

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Elise is a long time competitive amateur triathlete and Physiotherapist with 20+ years experience treating runners and athletes of all kinds. She also has an online coaching business for runners and triathletes looking to reach that next distance goal or PB.  She is very passionate about biomechanics in running and does gait analysis and shoe recommendations as part of her practice.  Elise also has a self admitted running shoe and apparel fetish. She is mom to an active 10 year old girl and is married to a man who also runs and races.