What is a Big Toe Bunion?

A big toe Bunion is a bony prominence at the base of the big toe.

It is associated with the:

• Deviation of the big toe to the side. (Hallux Valgus)
• Increased space between the 1st and 2nd metatarsal bones.

Apart from the obvious aesthetic issue, it can also lead to big toe joint pain.

Bunion Exercises

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Table of contents

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A. Shoes

It is very important that your feet are comfortable and supported in your shoes.

Ill-fitting shoe wear can lead to the compression of the big toe which in turn, may lead to the formation of a big toe bunion.

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1. Tight shoes

Avoid shoes that are way too tight for you.

If you have to force and squeeze your foot into a shoe, it is most probably undersized or poorly designed!

There should only be a minimal amount of pressure around the toes.

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2. Narrow shoe box

Shoes with a narrow shoe box (front section of a shoe) will certainly squash your toes together.

To determine if a shoe is too narrow for you:

Shoe box test:

• Place your shoe on the floor.
• Place your foot on top of the shoe.
• Results: If any parts of your toes/feet lie outside the border of the shoe, then this shoe is way too narrow for you!

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3. High heels

Wearing high heels will shift the majority of your body weight onto your toes.

This will encourage the big toe (… and the other toes) to get squashed.

4. Wearing old shoes

Old shoes that have worn out on an angle at the heel may encourage you to place more pressure on the side of your big toe.

This side pressure is what causes the big toe to deviate to the side.

5. Lack of arch support

If you have flat feet and/or your foot tends to excessively pronate (roll inwards) as you walk, this will make your place weight on the side of your big toe.

B. The Big Toe

When it comes to fixing your big toe bunion, it is important for you to have a flexible and strong big toe.

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Big toe muscles

6. Release the Adductor Hallucis

These muscles pull the big toe towards the inside.

Release

Instructions:

• Locate the Adductor Hallucis.
• Place your foot on top of a massage ball.
• Position your foot so that the ball is covering the Adductor Hallucis muscle.
• Apply an appropriate amount of your body weight.
  • (Firm, but comfortable)
• Proceed to roll your foot on top of the ball.
• Continue for 1-2 minutes.

7. Stretch the Adductor Hallucis + Medial collateral ligament

Instructions:

• Place your ankle onto your other knee.
• Hold your big toe and 2nd toe with one in each hand.
• Proceed to pull the toes apart.
• Hold for 1 minute each.
• Continue the stretch with the big toe with each of the remaining toes.
• Aim to feel a stretch in between the toes.

8. Strengthen the Interossei

This muscle will help pull the base of the big toe back into the correct alignment.

Instructions

• Place a small object between your big toe and 2nd toe.
  • (I used a pen lid)
• Squeeze the object between the toes.
• Try not to flex or extend the toes as you do this.
• Aim to feel a contraction in the muscles between the toes.
• Hold for 5 seconds.
• Repeat 20 times.

9. Strengthen the Abductor Hallucis

This muscle will help pull the big toe back into the correct alignment.

Instructions

• Place your foot onto your other knee.
• Place your finger on the outside of your big toe.
• Whilst applying pressure to the big toe, try to resist the push with your big toe.
• Try not to flex or extend the big toe as you do this.
• Aim to feel a contraction in the muscles on the side of the base of the big toe.
• Hold for 5 seconds.
• Repeat 20 times.

Improve big toe extension

Without a sufficient amount of big toe extension during walking, the foot is forced to compensate by letting the foot roll inwards.

This places more pressure on the side of the big toe and can eventually result in the formation of a big toe bunion.

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10. Release the Big toe Flexors

Instructions:

• Locate the target muscles: (Use Google to find their location)
  • Flexor Hallucis Longus
  • Flexor Hallucis Brevis
• Place your foot on top of a massage ball..
• Apply an appropriate amount of your body weight.
• Proceed to roll your foot on top of the ball.
• Make sure to cover the entire big toe flexor.
• Continue for 1-2 minutes.

11. Stretch the Big toe flexors

Instructions:

• Sit down on a chair.
• Place your ankle onto the other knee.
• Hold the big toe with your fingers.
• Pull it backwards.
• Aim to feel a stretch underneath your foot.
• Hold for 30 seconds.
• Repeat 3 times.

12. Strengthen the big toe extensors

To preserve the mobility of the big toe, it is important to strengthen the big toe in its newly acquired range of motion.

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Big toe lift

Instructions:

• Keep your foot on the floor.
• Lift up your big toe as high as you can.
• Do not move the other toes as you do this.
• Aim to feel a contraction of the muscles at the top of your big toe.
• Hold for 5 seconds.
• Repeat 20 times.
• Progression: Apply additional resistance with your finger in this end range position.

13. Strengthen the big toe flexor

Toe curls

Instructions:

• Place a tea towel on the floor.
• Place your foot on top.
• Proceed to dig and curl the tip of the big toe into the ground as to pull the towel under your foot.
• Aim to feel the contraction under the arch of the foot.
• Repeat 20 times.
  • (Reset the position of the tea towel if required.)

C. The Foot

Address excessive foot pronation

When walking – A foot that over pronates (rolls in) will tend to cause more pressure on the side of the big toe.

Over time – this can push the big toe towards the inside and result in the development of a big toe bunion.

If you would like a complete guide on fixing your foot over pronation, please feel free to …

14. Release the peroneal

The peroneal muscles are located on the outside of your lower leg.

If tight, this muscle can cause your arches to collapse.

Instructions:

• Locate the target muscles: Peroneal.
• Place the outside of your lower leg on a massage ball.
• Apply pressure over the ball.
• Make sure to cover the whole outer side of the lower leg.
• Draw circles with your ankle to increase release.
• Duration: 1-2 minutes

15. Stretch the lateral structures

Instructions:

• Whilst sitting, place your ankle on top of your other knee.
• Place one hand on top of the ankle and the other on the forefoot.
• Whilst anchoring the ankle joint down, pull the fore foot towards you.
• Aim to feel a stretch on the out side of the ankle.
• Hold for 30 seconds.

16. Strengthen muscles that support the arch

(Tibialis posterior/anterior, plantar muscles)

Short foot exercise

• Stand with your feet facing forwards and shoulder width apart.
• Whilst keeping your toes relaxed, proceed to scrunch the under-surface of your foot.
  • Drag the base of your big toe backwards towards the heel.
• Push the base of the big toe into the ground to prevent this area from lifting.
• If performed correctly, you should be able to feel the strong contraction of the muscles underneath your foot.
• Hold this for 5 seconds.
• Repeat 20 times.

D. The Ankle

Improve ankle dorsiflexion

Ankle dorsiflexion is the movement of the ankle when you move your toes back towards the shin bone.

Any limitation in this particular movement can lead to:

• overpronation of the foot during walking
• increased pressure on the side of the big toe
• deviation of the big toe to the side
• … a bunion!

If you would like more information about increasing your ankle dorsiflexion, please feel free to…

17. Release the calf muscles

Instructions:

• Sit on the floor with your legs straight in front of you.
• Place one leg over the other.
• Place the calf of the bottom leg on a foam roller.
• Apply a downward pressure.
• Roll your leg up/down the entire calf.
• Duration: 1-2 minutes

18. Stretch the Gastrocnemius

Instructions:

• Stand on the edge of a step.
• Keep your knees completely straight.
• Lower both of your heels.
• Do not leg your foot arch collapse.
• Aim to feel a stretch in your calf muscle.
• Hold this stretch for 30 seconds.
• Repeat 3 times.

19. Stretch the Soleus

Instructions:

• Assume the lunge position.
• Sink your body weight on top of your back leg.
• Think about getting your shin bone as close to the floor as possible.
  • Do not lift your heel!
• Aim to feel a stretch in the back of your calf.
• Hold for 30 seconds.
• Repeat 3 times.

20. Release the Achilles tendon

Instructions:

• Sit on the floor with your legs straight in front of you.
• Place the back of your Achilles tendon on a ball.
• Apply a downward pressure.
  • You can apply additional pressure by placing your other leg on top.
• Rock your foot from side to side.
• Duration: 1-2 minute

21. Ankle dorsiflexion grooving

Instructions:

• Attach a band to a stationary object behind you.
  • (Make sure it doesn’t move!)
• Lace a resistance band around your ankle.
  • Make sure the band is below the bumps on side of the ankle.
• Assume the lunge position with your ankle on a bench. (See above)
• Make sure there is a firm amount of tension on the band.
• Lunge forwards
  • Do not let your foot arch collapse as you move forwards.
• Repeat 30 times.

22. Strengthen Tibialis anterior

Seated Dorsiflexion holds

Instructions:

• Whilst sitting, slightly slide your foot underneath you whilst keeping your foot flat.
• Lift the front part of your foot off the floor.
• Aim to feel the activation of the muscles in the front of your shin.
• Hold for 5 seconds.
• Repeat 20 times.

E. The Lower limb

Big toe bunions may be associated with other postural dysfunctions of the lower limb.

To completely fix your bunion, you may need to address the following issues as well.

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23. Duck feet posture

The out turning of the feet can lead to more weight being placed on the side of the big toe as you walk.

As there are many reasons why you might have Duck feet posture, I highly recommend that you check out the following blog post:

24. Knee valgus

In this position: The knees collapse inwards, the feet point outwards (Duck feet posture) and the feet roll inwards (Flat feet).

This causes more pressure to be placed on the side of the big toe during walking.

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25. Rotated pelvis

If your pelvis tends to be rotated to one side, it can influence how your big toe interacts with the ground as you walk.

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26. Tight hip flexor

As you are walking, there should be an adequate amount of hip extension before the toe lifts of the ground.

If the hip flexor is tight, this can cause the:

• Hip to externally rotate and
• Pelvis to rotate away from the tight side.

This will result in more pressure on the side of the big toe.

Hip flexor stretch

Instructions:

• Assume a deep lunge position. (See above)
  • The target side will be the hip of the back leg.
• Perform a posterior pelvic tilt
  • “Tuck your tail bone underneath you.” 
  • Keep your glutes contracted.
• Lean your torso away from the side of the back leg.
• Aim to feel a pulling sensation at the front of your hip.
• Hold for 30 seconds.
• Repeat 2-3 times.

F. Function

The next step is to regain the complete control of your foot and toes. (especially as you walk)

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Improve toe control

27. Toe push + drag

This is a great way to move the big toe out of the deviated resting position.

Instructions:

• Perform this exercise whilst standing.
• Push the tip of the big toe into the ground.
• Whilst keeping the big toe anchored, move the rest of your foot away.
  • This is to create a gap between the big toe and 2nd toe.
• Repeat 20 times.

28. Heel raises

Instructions:

• Whilst standing, perform the push toe push and drag technique. (See Tip #27)
• Once you have achieve a good alignment of your big toe, perform heel raises.
• Make sure to push into the tip of the big toe.
  • Do not let your weight go to the side of your big toe!
• You can support your body weight by holding onto a stationary object if required.
• Only go as high as you can control your big toe.
• Perform 30 repetitions.

29. Big toe strap with Extension/flexion

Instructions:

• Apply a strap around the big toes.
• Pull the feet away from each other as to pull the big toe out of the squashed position.
• In this position, practice moving the big toe up and down without letting it go back to the squashed position.
• Repeat 20 times.

30. Toe squeeze

Instructions:

• Squeeze yours toes together.
• Try not to flex or extend the toes as you do this.
• Aim to feel a contraction in the muscles between the toes.
• Hold for 5 seconds.
• Repeat 20 times.

31. Toe spread

Instructions

• Spread your toes as far as possible.
• Do not flex or extend your toes as you perform this exercise.
• Hold for 5 seconds.
• Repeat 20 times.

32. Alternate toe lifts

Instructions:

• Position 1: Lift up your big toe whilst pushing the other 4 toes into the ground.
• Position 2: Push your big toe into the ground whilst lifting the other 4 toes.
• Transition smoothly between these 2 positions.
  • Keep your foot still. Your toes should be the only thing that is moving.
• Repeat 30 times.

33. Big toe side tap

Instructions

• Lift up all of your toes.
• Move your big toe to the side and place it back on the ground.
• Return to starting position.
• Repeat 20 times.

Walking mechanics

34. Short foot + step (mid stance)

Instructions:

• Have your feet in a staggered position.
• Position 1: Activate short foot in your leading leg. (see tip #16)
• Position 2: Whilst maintaining short foot on the leading leg, step forward with the back leg.
  • As the swinging leg is about to land on the ground, push off from the tip of the big toe.
• You should feel a contraction in your arch through movement.
• Return to starting point.
• Repeat 30 times.
• Progression: Instead of stepping to the front, try stepping in different directions whilst maintaining a strong short foot contraction.

35. Big toe activation in lunge position

Instructions:

• Assume a lunge position. (see above)
• The foot at the back will be the side targeted.
• Push the tip of your big toe into the ground and spread the toes. (See Tip #27)
  • This is to anchor your big toe into a better alignment.
• Raise your heel of the leg at the back so that your weight is on the toes and ball of the foot.
• Push your big toe into the ground as you place your weight onto the tip of the big toe.
  • (Think of how a ballerina does a point.)
  • Place as much of your body weight onto the back leg that you can comfortably tolerate.
• Return your weight back to the ball of the foot.
• Repeat 20 times.

G. External devices

If your big toe bunion is mild/moderate in nature, you may need to consider wearing tape, brace and/or spreaders to encourage the big toe into a better position.

How long do I wear it for?

• Start off with 1-2 hours/day and slowly increase as appropriate.

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36. Taping

Use taping if you have a mild bunion.

Instructions:

• Apply anchor tape:
  • Around the Forefoot (1)
  • Around the Big toe (2)
• Pull and correct your big toe alignment
• Whilst holding this position, apply and firmly pull tape from the big toe to the anchor point on the forefoot. (3,4,5)
• Re-apply lock in strips:
  • Around the Forefoot (6)
  • Around the Big toe (7)

37. Toe spreaders

Use a toe spreader if you have a mild big toe bunion.

38. Bunion corrector brace

Use a brace if you have a mild/moderate big toe bunion.

39. Orthotics for flat feet

If you have flat feet, you can consider using an orthotic insert.

(Keep in mind – I would advise that you do not use this in the long term.)

H. Surgical intervention

40. Bunionectomy

a) What happens in the surgery?

The surgeon will cut a portion of the big toe bone (metatarsal and/or phalange bones).

The bone will then be re-aligned and fixated with the use of pins.

b) Who should get it?

Surgical intervention should never be the first option to consider!

Consider surgery if you have:

• Trialed conservative management for at least 6 months.
• A moderate to severe case.
• Other areas of the body being negatively affected by the big toe bunion.

c) Do I still need to do exercises after the surgery?

If you opt surgical intervention, it is highly recommended that you still perform these exercises.

… Why? (see below)

d) Can the big toe bunion come back after surgery?

Unfortunately – it can!

The reason behind this is that surgery does not address the underlying cause as to why the original bunion developed in the first place.

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I. Questions that you may have:

1. “I’ve had my big toe bunion for (insert number of years), is it still possible to improve?”

Yes.

However – the general rule being: the longer that you have had the big toe bunion for, the longer it will likely take to get better.

2. “This post has 40 tips! Do I need to do them ALL?”

No.

Not all of these tips will apply to you.

Focus on the ones that make sense to you and are relevant to your individual presentation.

3. “How long will it take?”

This is definitely one of the most commonly asked question I get.

.. and it is a very difficult one to answer!

Everybody is different! It would be impossible for me to tell you.

My advice: Focus on consistent small improvements over a long period of time.

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