How Bunions Affect Stability and Gait

The medical world is a hotbed for debate, and there are few things in it which go undisputed. However, two concepts which go widely accepted in the medical world include:

1. Bunions (Hallux Valgus) are a progressive condition which typically gets worse (not better) with age
2. As people’s age increases, the probability of them falling – and the concern of illness, injury, and mortality associated with those falls – also increases with age.

These two concepts beg a question which affects many bunion sufferers: How do bunions affect the stability and gait of otherwise healthy adults? If you’re someone afflicted by both a bunion and the unfortunate side effect of life which is aging, then read on. It’s important to know how your bunion’ effect on your health may change as time passes.

According to the research from nine studies and 589 participants published in the Journal of Foot and Ankle Research, Hallux Valgus (HV) patients often demonstrated reduced ankle and rear foot motion while standing. They often also experience difference in muscle activity surrounding the ankle. These same studies revealed that those suffering from bunions also experienced reduced walking speed, reduced step length and less stable gait patterns during walking.  These findings support the belief that bunions can often significantly impact a person’s quality of life as well as put the elderly at a higher risk for falls due to instability.

Enlargement of the metatarsophalangeal joint (also known a the MTPJ, or the big toe joint) can often result in excessive foot pronation, muscle imbalance around the MTPJ, and a change in the way the body weight is transferred during the later stage of the gait.

One study stated the following about its findings:

“Findings of this systematic review indicate that individuals with HV differ to healthy controls on particular gait parameters. Reduced ankle dorsiflexion and less rear foot supination during terminal stance have been observed in individuals with HV. Early onset of intrinsic muscle activity at heel strike may occur in those with HV compared to controls. Patterns of altered loading under the hallux and medial metatarsal heads are apparent, although studies report inconsistent findings. Older individuals with moderate to severe HV may exhibit slower, less stable gait patterns with a shorter stride length, especially when walking on irregular surfaces.”

The restricted or compromised ankle movement to which this study referred may also contribute to HV development due to increased forefoot loading. This restriction may also result in externally rotating the foot to compensate, which can subsequently increase the forces on the big toe.

The primary findings from this study show that those with bunions (HV) experienced a reduction of muscle activity at the heel strike earlier than those without HV did. It also showed that conservative interventions which target foot function during gait could be quite beneficial. Retraining muscle activation patterns is relevant and performing stretches focused on the ankle may improve stability while standing.  Clinical trials will be needed to confirm any findings.