jospt perspectives for patients

Bunion
Strengthening Foot Muscles to Reduce Pain and Improve Mobility
J Orthop Sports Phys Ther 2016;46(7):606. doi:10.2519/jospt.2016.0504

F
oot pain discourages physical activity, and less activity
harms overall health. Bunion, extra bone and tissue at
the base of the big toe, is a frequent cause of foot pain.
More than 64 million Americans have bunions that can
lead to painful walking. Bunions affect some 35% of
women over the age of 65. Bunions can be removed by surgery,
which can reduce pain and improve your ability to walk and ex-
ercise, but up to 15% of bunions return. Weak muscles may play a
role in bunion-related pain and movement problems. In a review
of prior research and commentary on this topic published in the
July 2016 issue of JOSPT, the author identifies muscle-strength-
ening exercises that may help people with bunions.

A NEW INSIGHTS
The author of the review and commentary identified
3 key muscles in the foot and 2 muscles in the calf
that, when strengthened, have the potential to lessen
the pain and improve the movement of patients
with bunions. These 5 muscles help support body
weight and forward motion. They also stiffen the
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arch of the foot and help keep it from rolling inward,

B better supporting the big toe. The author found that
people can effectively reinforce these muscles using
3 simple exercises. The exercises—short foot, toe
spread out, and heel raise—are easy to do at home
and can strengthen these key foot muscles. Stronger
feet may help decrease bunion-related pain and its
impact on movement.

PRACTICAL ADVICE
After your physical therapist evaluates your feet and
C
how you walk, the therapist may prescribe these
3 exercises, additional hip- and leg-strengthening
J Orthop Sports Phys Ther 2016.46:606-606.

exercises, and possibly arch supports. The exercises to

strengthen your feet are easy to perform. If you have
trouble with them, though, your physical therapist
may add electrical stimulation to help you learn which
muscles to contract. Your physical therapist can also
guide you on proper shoe selection to improve your
ability to walk and exercise without discomfort. While
they may decrease pain and improve movement,
these exercises likely won’t change the look of your
bunion. More research is needed to determine whether
these exercises can help you avoid surgery. For more
EXERCISES TO STRENGTHEN FOOT MUSCLES. (A) Short-foot exercise: shorten your foot while keeping your heel and information on nonsurgical options for treating
the front of your foot on the ground. Do not curl your toes. (B) Toe-spread-out exercise: lift and spread your toes while bunions, contact your physical therapist specializing in
keeping your heel and the front of your foot on the ground. While your toes are spread out, push your little toe down and orthopaedic and sports-related injuries.
out to the floor. Then, push your big toe down toward the inside of the foot. (C) Heel-raise exercise: stand with your knees
This JOSPT Perspectives for Patients is based on an
bent. Elevate your arch while keeping your heel turned in. Then, raise your heel off the floor while keeping pressure on
article by Glasoe, titled “Treatment of Progressive
your big toe. Perform all exercises barefoot. Hold each repetition for 5 seconds. Repeat each exercise until you feel the
First Metatarsophalangeal Hallux Valgus Deformity:
muscles becoming tired. Exercises are progressed from sitting, to standing on both feet, to performing the exercises
A Biomechanically Based Muscle-Strengthening
standing on just 1 leg. Perform exercises daily.
Approach” (J Orthop Sports Phys Ther 2016;46(7):596-
605. doi:10.2519/jospt.2016.6704).
This Perspectives article was written by a team of JOSPT’s editorial board and staff. Deydre S. Teyhen, PT, PhD, Editor,
and Jeanne Robertson, Illustrator.

JOSPT PERSPECTIVES FOR PATIENTS is a public service of the Journal of Orthopaedic & Sports Physical Therapy®. The information and recommendations
contained here are a summary of the referenced research article and are not a substitute for seeking proper health care to diagnose and treat this condition. For
more information on the management of this condition, contact your physical therapist or other health care provider specializing in musculoskeletal disorders.
JOSPT Perspectives for Patients may be photocopied noncommercially by physical therapists and other health care providers to share with patients. The
official journal of the Orthopaedic Section and the Sports Physical Therapy Section of the American Physical Therapy Association (APTA) and a recognized
journal of more than 30 international partners, JOSPT strives to offer high-quality research, immediately applicable clinical material, and useful supplemental
information on musculoskeletal and sports-related health, injury, and rehabilitation. Copyright ©2016 Journal of Orthopaedic & Sports Physical Therapy ®

606 | july 2016 | volume 46 | number 7 | journal of orthopaedic & sports physical therapy

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