What is a bunion/adolescent bunion?
While bunions are more common in adults, they can occur in children and teenagers too. Bunions, medically called hallux valgus, arise when the great toe (hallux) moves towards to the 2nd toe, creating an angle and a bony bump on the side of the great toe joint (known as the metatarsophalangeal joint). Bunions tend to worsen over time and can become arthritic and painful if left untreated.
Why do they form?
Bunions in children should be assessed and treated as early as possible. Often, adolescent bunions are related to genetics. Children aren’t born with bunions, but they can develop a foot type and structure according to their genetics that can make them more prone to bunions developing. Flat feet and hypermobility (floppy and loose joints) commonly predispose bunion formation. While we can’t change genetics, we can help to reduce and redistribute the force that contributes to the bunions forming.
How can we treat them?
Treatment options include:
- Orthotics: orthotics help to support correct foot alignment and reduce deforming pressures around the big toe joint. This can help to reduce pain and prevent progression of the bunion.
- Footwear: children and adolescents should avoid tight-fitting and narrow shoes as these apply pressure around the ball of the foot and toes and encourage the bunion angle to increase. Shoes should have a wide enough toe box to accommodate the ball of the foot and toes. This reduces pain and irritation of the bunion and helps to prevent progression of the bunion. It is also important to make sure children are wearing the correct sized shoes – tight shoes apply too much pressure and loose- fitting shoes cause the feet to over-exert and don’t provide enough support.
- Night splints: a corrective splint around the bunion worn over night can help to correct joint alignment and offload and gently stretch the surrounding soft tissue.
- Exercises: bunions can form if the surrounding muscles aren’t strong enough to hold the big toe joint and bones in the correct alignment. Exercises to strengthen the surrounding musculature can therefore help to reduce the progression of bunions.
- Surgery: surgery may be necessary to correct the bunion, but it’s usually the last option and considered if conservative treatment doesn’t work.