I don’t talk about bunions much as I don’t have a massage therapy technique that directly addresses them. (For that matter, I’m not currently taking appointments, as Travis County is once again in Stage 5, and test positivity has topped 30%.) However, as a structural therapist, I take great satisfaction in helping people improve their structural balance for reduced pain, improved balance, and better facility in doing whatever we want to do; even if it doesn’t directly benefit me. So I thought I’d share a little something I’ve found along the way for bunion pain.
When I was in massage school, the understanding I was taught was that bunions are a function of compromised integrity of joints of the foot other than the one that is painful. Besides the arch of the foot that we think of most often, there are two, or possibly three other arches, and I’d venture to guess that it’s unlikely that there is ever a collapse of only one of them; they all work together to support the weight of the body in standing, walking, and other weight-bearing movement. So the treatment for any bunion was said to be to provide effective support of the arches, typically in the form of custom orthotic inserts into the shoes.
Many mass-produced shoes and other kinds of arch support devices only support the medial longitudinal arch, which is the one that runs from the heel to the ball of the big toe. Even Birkenstocks, famous for being supposedly good for the feet, have zero support for the transverse arch, which runs across the foot from the ball of the big toe to the ball of the little toe. Janet Travell, the physician who recommended that President Kennedy alleviate his back pain by rocking in a chair with a rocking ottoman, went on to popularize Trigger Point Therapy, and once made an instructional video in which she cut away the part of an insole that supports the ball of the big toe, thereby elevating the rest of the transverse arch.
After the foot changes that came from having two babies and living over 40 years, I began noticing occasional pain in the joint of my big toe. It was worst with whatever shoes were my favorite at a given time. I couldn’t bring myself to throw out my shoes every 6-12 months. Upon examination, I found that the most painful shoes always had some heavy wear right under the ball of my big toe, so that that part of my foot was lower than the rest. Ignoring Travell’s recommendation, I decided to elevate it, at least to level it out with the balls of the other toes.
It was months after Valentine’s Day, but face it, sometimes things get left around the house for a while. In this case, there was a box of adhesive foam valentine decorations. They turned out to be a perfect size and thickness to fix my shoes. I stuck them in several shoes, right where they had worn the lowest, and I found that the best sticker was the one shaped like a cupcake. There were some larger hearts that worked well, too. There were also little squares that I could place in clusters underneath the cupcake for added height.
One pair of sandals with a molded footbed didn’t have the same wear pattern, but I felt the transverse arch needed support, so I put a heart under the balls of the middle toes. When I was unsure where exactly I needed to place them, I started with one or two little squares, then added around them until they felt right. Then I covered the cluster with a big heart.
There are countless people who offer a million ways to alleviate bunion pain, some surgical, some bodywork, some by devices that you wear on your foot. They might be fine products and treatments, but I haven’t needed to try any of them. Sometimes it’s enough to keep it simple and inexpensive with good arch support, and a cupcake in your shoe.
Rachel Creager Ireland, LMT 