Bunion surgery and running
February 19, 2014 11:34 AM   Subscribe

Runners of MeFi, have any of you had bunion surgery? If so, what were your outcomes, running-wise? What was your recovery like? How soon were you able to get back to normal training or even maintenance training? Did you experience the hoped-for reduction in pain? Did you have any issues with your form or balance afterward?

Background: I'm a 35-year-old marathoner with a moderate bunion on my right big toe. I've had cortisone injections, and I run in orthotics. It's gotten more and more painful over the last year. It's time to get serious about this bad boy; thing has its own ZIP code.

Thanks in advance for your help!
posted by Flipping_Hades_Terwilliger to Health & Fitness (12 answers total) 4 users marked this as a favorite
Do you only want to hear about surgery or are you also interested in non-surgical treatment?
posted by medusa at 11:51 AM on February 19, 2014

tough one. My mom has the same foot appearance, and had surgery. It didn't help her, and she has had long-term foot pain since. So, I opted against surgery. Yet, orthotics did not help.

What helped me (run a marathon, and has kept me running steady for the year since) was using a second shoe liner to build up height in both shoes, and cutting out a slice of my orthotic and the liner underneath the problem big toe and enough of the toe joint so the toe naturally slides and spreads into that space as the foot hits ground.

This has created much more space and comfort than the orthotics alone ever did. Less residual stiffness, and no taping! This was my physical therapist's idea.
posted by iiniisfree at 12:53 PM on February 19, 2014 [1 favorite]

@ medusa: I've had some experience with non-surgical treatments (e.g., orthotics, rescue cortisone). The orthotics help manage the pain and correct mechanical issues while I'm running. The cortisone helps calm down flare-ups, which helps me avoid changing my gait and ending up with issues further up the kinetic chain. From what I've heard and read, non-surgical options can help with management, but can't reduce the size of a bunion, or correct any resulting deformities. I'd appreciate your perspective, though. Every bit of info is helpful.
posted by Flipping_Hades_Terwilliger at 12:55 PM on February 19, 2014

@iinisfree - what an interesting idea! No chafing from the edges of the cutout?
posted by Flipping_Hades_Terwilliger at 12:56 PM on February 19, 2014

Anecdotally, my physical therapist said that the only bunion-related surgery she has considered "successful" was a complete toe joint replacement. (The recipient had to search high and low to find a surgeon who could do this and tries not to run too much on it.) Otherwise, she has said they always result in loss of mobility. :(

(Apparently I'm starting to develop a bunion so I'll be continuing my bunion conversations with her to do everything I can to stop or slow it down.)
posted by purple_bird at 1:22 PM on February 19, 2014

Dancer, not a runner, but I did have major bunion surgery in my early 20s. Like purple_bird says, there has been permanent loss of mobility. The pain in my foot increased; for several years afterward I had debilitating muscle spasms in my arch. They still happen now (almost 10 years later), but are much less severe. I also developed arthritis, as a result. Meaning I'm stuck wearing mostly flat, dowdy shoes, even when I dance, as heels force my foot to bend in a way it doesn't want to go.

As a runner, you should really consider all options before going the surgery route. It could potentially have a significant effect on your performance. However, I hope the surgeon you consult with, if you go that route, is more competent than mine was.
posted by Miss T.Horn at 2:10 PM on February 19, 2014

no chafing at the edges- but mine are very soft foam up at the toe. I snipped out a small piece (about 1" by 3" to start, and gradually cut it larger until I felt my toe (only) was spreading into the divot. I was shocked at how well its worked out for me... (deformity remains but I am gambling I can do more running this way than if I had residual pain from surgery).
posted by iiniisfree at 2:14 PM on February 19, 2014

oh- also, I was very nervous to snip into my expensive orthotics (were they 500$?? I can't remember- I've blocked it out)... so I first experimented cutting into some 50$ smartfeet/smartfoot? inserts. I liked the effect so much I leave the smartfeet in my regular shoes, and my expensive orthotics in my running shoes. I try to wear something with the cutout at all times.

I've been tying to minimize the number of times I pull the orthotics in & out of the shoe to minimize wear or slippage of the cut edge, but I don't know that it makes much of a difference). Lastly, I can't say for sure that second liner (for height) underneath my orthotics actually makes much of a difference- the divot cut into the orthotic alone might be enough to keep the foot spread out. -Good luck!
posted by iiniisfree at 2:23 PM on February 19, 2014

I started getting a bunion a few years ago that was bothering me more and more. I went to a podiatrist who said not to have the surgery until I couldn't bear the pain for even one more minute—he said apologetically that it's a "barbaric" procedure. Meanwhile, my chiropractor has worked miracles with it—it is noticeably smaller, I don't need my little gel toe spacer thingy anymore, and I no longer wake up in the middle of the night feeling as though someone is thrusting a fire poker through my instep.
posted by wisekaren at 2:44 PM on February 19, 2014

FHT, like you I had worsening bunion pain and was considering surgery. However it didn't seem that the surgery actually works very well. Then I came across the book "Born to Run" and started reading barefoot running propaganda, some of which claims that barefoot training can reverse bunions. That sounded overblown, and there aren't really data on this, but I figured that going barefoot to strengthen my foot muscles didn't seem insane and I was willing to try something weird if I might avoid surgery.

I got some vibram five fingers and slowly built up walking and then running in them, very gradually to avoid injury. I also use them at the gym. I don't run long distances in them, I have some more substantial but still fairly minimal running shoes for that. My bunions haven't gone away, but the pain has gone away and I no longer need orthotics. It's been a huge change, and I no longer think I'll need surgery.

So that's my anecdote. May not work for you, but perhaps worth a try. And barefoot-style shoes are really fun to wear and run in, so there's another bonus.
posted by medusa at 2:49 PM on February 19, 2014

Not a runner, but my mom had bunion surgery and has been in pain/reduced function ever since. If you must get the surgery, I would recommend doing some pretty intense consulting with the doctor first about their anticipated outcomes. I would also shop around and see if I could find a surgeon who people had had good experiences with getting this surgery. And I would definitely give other options (barefoot shoes, cutting through shoe liners as described above) a shot before going the surgical route. Good luck!
posted by feets at 4:57 AM on February 20, 2014

I opened an account just so I can reply to this question.

Got double bunion surgery at 25 (that was 10 years ago). Followed the recovery instructions to a "T" : avoid using crutches and bear weight on both feet as much as possible. It was painful at the time but am grateful for that advice as I recovered very well, being able to walk normally in about 3-4 months post-surgery. Five years later, in my 30s I took up running and have now completed a full marathon and many half marathons. I run regularly pain free. I've never regretted getting the surgery done as it has improved my life in many ways. The only horror recovery stories I heard were from those that stayed immobile in bed 1-2 months after surgery and took a long time to get back to normal walking afterwards.

Good luck!
posted by Karotz at 8:36 PM on February 21, 2014

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