Almost every runner has dealt with sore or achy feet at one time or another. In fact, according to research evaluating the incidence of musculoskeletal injuries in runners, anywhere from 5.7% to 39.3% of runners experience foot injuries.
From blisters to plantar fasciitis, bruised toenails to extensor tendonitis, foot maladies are among the most common complaints from runners due to the fact that our feet take the brunt of the impact and are the site of initial landing and ground contact for every single step of every mile we run.
Some runners have an even more aggravating cross to bear when it comes to their feet and running: a bunion. Running with bunions can be painful and can potentially increase your risk of other foot pain while running.
However, it’s definitely possible to run with a bunion. Given how common bunions are, many of the same runners you pass on your usual neighborhood runs might also be out there running with bunions.
In this guide, we will discuss running with bunions to help minimize the nuisance of this condition and keep your feet as healthy and happy as possible.
We will look at:
- What Is a Bunion?
- What Does a Bunion Look Like?
- How Do Bunions Form?
- What Causes Bunions In Runners?
- Preventing Bunions In Runners
- Running With Bunions: How to Deal With Bunions When You Run
Let’s get started!
What Is a Bunion?
A bunion, referred to as hallux valgus, is a foot deformity wherein the first metatarsophalangeal joint (MTP) of the big toe juts inward (medially), and the toe itself points outward toward the second toe.
This causes a prominent protuberance on the inner surface of your foot and alters the alignment and force that occurs during push-off when you run.
The bunion can be painful as it can chafe, rub, or be squeezed by the standard toe box of your running shoes because the migration of the MTP joint makes the ball of your foot abnormally wide.
Research suggests that approximately 23% of adults aged 18 to 65 years and around 36% of adults above the age of 65 deal with hallux valgus (a bunion) on one or both feet.
Prevalence is particularly high in women and those who wear high heels or shoes relative to barefoot populations, pointing to the fact that footwear can increase the risk of bunion formation.
What Does a Bunion Look Like?
The most obvious sign of a bunion is a visible, knobby protrusion at the base of your big toe on your foot’s medial or inner surface. Like your ankle bones (malleoli), a bunion looks like a hard, round bump.
You might also see the tip of your big toe pointing outward toward your other toes rather than straight ahead.
The bunion might appear red or chafed, depending on if it rubs on the inside of your shoes, particularly if you’re running with a bunion in standard-width running shoes.
How Do Bunions Form?
Bunions are thought to primarily be a result of an imbalance between the extrinsic and intrinsic muscles of the foot, with some contribution from the ligaments as well.
Under normal conditions, the proper alignment of the first MTP joint of the big toe is maintained by the peroneus longus laterally. The abductor hallucis muscle medially with collateral ligaments maintains alignment from a rotational standpoint.
If tight shoes place pressure on the head of the big toe joint, the metatarsal starts to move such that the toe points towards your second toe and the base of the toe juts inward.
When this happens, it changes the angle of pull of the muscles that generally align the big toe forward.
A vicious cycle is created such that the more the toe begins to shift, the more the muscles pull it out of position because the mechanical advantage of the two opposing muscles becomes increasingly imbalanced.
The muscle that pulls the base of the toe to protrude into the inner surface of your foot gets into a better and better position to do that, while the muscle that should be opposing this migration gets into a worse position to maintain proper alignment.
Additionally, this pull strains the medial collateral ligament and the medial capsule over time until they eventually rupture.
Since these structures typically provide support along the medial surface of the foot, without them intact, the lateral structures (adductor hallucis muscle and collateral/lateral joint capsule ligaments) remain unchecked, exacerbating the bunion.
What Causes Bunions In Runners?
While any shoes can contribute to bunion formations and non-runners can undoubtedly deal with bunions, runners are often at an increased risk of bunions, given the nature of most running shoes.
Many running shoes have a relatively tapered toe box, much like the shape of a women’s flat or high heel, in that the shoe gets visibly narrower at the toe. This restricting shape puts pressure on the MTP joints and can start to force the big toe to point toward the other toes and conform to the tapered shape of the shoe.
Mile after mile of running, especially when your feet swell, can lead to the formation of a bunion.
Moreover, most running shoes have a heel drop, meaning the heel is slightly elevated relative to the forefoot. Unless you’re running in zero-drop shoes, this heel drop contributes to more pressure and force on the forefoot, which exacerbates MTP joint stress.
A heel drop also shortens the Achilles’ tendon, which causes a compensatory flattening of the arch of your foot. It further adds pressure and stress to the big toe and alters the alignment of forces going through your foot when this happens.
Preventing Bunions In Runners
The best way for runners to prevent bunions is by selecting footwear that encourages the natural splay of the foot upon weight-bearing.
Most conventional running shoes have a narrow or tapered toe box and a 2:1 ratio of the heel to the forefoot in the heel drop. Both of these design features can increase the risk of bunion development.
Instead, try zero-drop running shoes with a wide toe box that permits the natural splay of your toes when you run.
When you aren’t running, wear wide or open-toed shoes or go barefoot around the home to allow your feet to splay normally without pressure on the metatarsals. Do not wear high heels.
Strengthening the intrinsic muscles of the foot can also help prevent bunions. Exercises, like picking up marbles with your bare feet and scrunching up a towel and squeezing it in your toes, can help maintain strength in the feet.
Running With Bunions: How to Deal With Bunions When You Run
It is possible to run with bunions if you do not want to get them removed or treated medically. Here are some tips for running with bunions:
#1: Switch Your Running Shoes
Again, it’s crucial to switch to running shoes with a wide toe box and a minimal heel drop. You can also consider wide-width running shoes.
#2: Wear Recovery Shoes
Recovery sport slides or barefoot walking after your workout can give your feet a much-needed break from bunion pressure.
#3: Use Moleskin Pads
Moleskin or gel pads can reduce chafing on a protruding bunion.
#4: Ice Your Bunions
If your bunion is hurting after a run, ice the area for 10-15 minutes to reduce swelling and discomfort.
#5: Try Orthotics
Orthotics can help support the arch and align the foot, reducing some of the pressure on your bunion.
#6: Wear Toe Spacers
Toe spacers or toe separators improve the alignment of your toes and can help restore the balance between the muscles controlling the direction of the big toe. Runners often do well with Correct Toes.
#7: Do Toe Yoga
Exercises like big toe lifts and pointing and stretching the big toe can increase mobility and strength in the big toe.
#8: Massage the Bunion
Massaging the arch and soft tissue around the bunion can ease some discomfort after running.
#9: Consider Surgery
A bunionectomy or bunion removal surgery can correct the deformity and resolve your bunion pain.
Do you have bunions? What are your tips and tricks for running with bunions?
For more information on foot strengthening exercises and preventative measures you can take to lower the risk of foot injuries, check out the following articles:
10 Foot Strengthening Exercises For Runners