Proper stretching can help with leg cramps

By Dr. Lou Pack

“Do shoes cause bunions?”

Bunions are the bumps seen at the big toe joints of the foot. They can also occur on the sides of the foot (just behind the little toe), where they are referred to as “Tailor’s Bunions.”

Although thought to be bony enlargements (and at times this can be a component), bunions are actually a dislocation of the big toe joint caused by pronation or a flattening of the foot, which results in a dislocation of the joint.

In some cases, the joint jams instead of actually dislocating, causing severe arthritis with bone spurs and a limited range of motion at the big toe joint. This can cause the individual to walk abnormally resulting in painful symptoms in their knees, hips and low back.

Often thought to be a problem of just older people, we sometimes see bunions developing in children. Because of this, many people think that bunions are inherited. But what’s really inherited is the excessive flattening of the foot, which in turn causes the bunion, and not the bunion deformity itself.

Most people do pronate to some degree. And this same force that causes bunions, can also damage the weight bearing joints of the knees, hips and back as well. Stand in front of a mirror and let your right foot flatten (rolling inward, towards your left foot), and notice how much your knee turns in too. That’s why knee pain is so common.

Bunions are therefore a result of improper structure and not shoes, although shoes can accentuate the problem. And if this structural problem is not corrected, bunions can recur (even after surgery), and problems in the weight bearing joints the foot supports can increase.

But for the most part, bunions are preventable. A simple exam to evaluate abnormal structure and function can go a long way in not only preventing this problem, but in preventing arthritic changes in the ankles, knees, hips and back. And if you have bunions, remember to have your children checked as well, since as I’ve mentioned, they may have inherited your structural problems.

A former reconstructive foot and ankle surgeon and past clinical instructor of Medicine at Emory, Dr. Pack practices at MCG in Greensboro. He works with patients who have arthritis and wish to decrease joint symptoms and remain active without medication or surgery. Dr. Pack also treats athletes at all levels. In the 2004 Olympics he had a silver and gold medalist, and helped the UGA Golf Team (2005 NCAA national champions). For further information please see www.drloupack.com, drloupack.blogspot.com or contact him directly at (706) 454-0040.