How Can I Prevent Bunions?

All of the women in my family have horrible bunions. Are there any exercises that can ward off or help bunions?

A bunion is an irregular bony prominence (a bump) on the joint where your big toe meets the main bones of your foot. The bunion causes the end of the big toe to bend toward the other toes and crowd them, while the bone at the base of the toe where it meets the foot moves outward beyond the normal limits of where the bone should be. Pain is caused by inflammation and the bone pressing against the shoe. Bunions are more common in women, as you report, and are caused by a number of reasons, including shoes that are too tight, years of abnormal motion (like dancers on point), poor foot mechanics, bone deformities, flat feet, and arthritis.

Treatment usually includes shoes with a roomy toe box (you should be able to wiggle your toes; the toe box should be wide enough to accommodate the bony prominence), padding, over-the-counter arch supports, orthotics, and taping by a physical therapist or doctor. Surgery is an option when conservative treatment fails and you have chronic pain.

As for exercises, keeping your feet strong and building up the arch might help (particularly if you have flat feet). Although there isn't a lot of evidence for strengthening feet as an effective treatment for bunions, it's certainly worth a try. Here are some exercises to strengthen your feet. Do 10-15 repetitions of each, two to three sets, every other day.

• Towel pull. Sit in a chair barefoot with your toes on the edge of a towel. Start flexing (curling) your toes and pulling the towel to draw it up under your toes.
• Big toe pulls (barefoot). Wrap a thick rubber band around both big toes and pull them away from each other. You can keep heels together if you like but it's not necessary. Hold each repetition for two to three seconds.
• Marble or pencil grab (barefoot). While sitting or standing try to pick up marbles or pencils with your toes.

I recommend that you consult with your doctor or a podiatrist if you have not already done so.