Do Your Shoe Choices Cause Bunions? - Jeffrie C. Leibovitz, DPM

Can’t Believe Everything You Hear: Shoes DON’T Cause Bunions!

For as intelligent as we consider ourselves to be, people are sometimes a bit too quick to believe everything we hear and read.

To support that, here are just a handful of very popular misconceptions:

  • Energy drinks contain special alertness-boosting ingredients. People think that the vitamins and extraneous supplements somehow boost mental performance and improve your focus. The truth of the matter is that the only benefit they offer is the same one you can find in a simple cup of coffee: caffeine.
  • Bottled water is better for you than tap water. Sure, this doesn’t hold up in cases of disaster (Hurricane Katrina) or morally reprehensible irresponsibility (Flint, Michigan). Otherwise, tap water in almost all American municipalities is completely healthy. If we take environmental consequences into account, bottled water may actually prove to be considerably more detrimental to human (and ecological) health in the long run.
  • We only need sunblock on sunny days. Yes, a trip to the beach on a cloudless summer day can be a real disaster for your skin if you go sans sunblock. At the same time, you should be diligent applying sun protection to exposed skin whenever you spend extended periods outside—even when there is ample cloud cover. As an ex-red head with Casper (the friendly ghost) like skin I never leave home without a minimum 60 SPF sunscreen.

(Sun damage—including down in your feet—is a serious matter!)

  • 10,000 steps is some kind of “magic number” for physical activity. This is certainly an admirable goal—one that has certainly gained popularity thanks to Fitbit—and we applaud anyone taking effort to improve their health. That said, 10,000 is an arbitrary number. More important is to create a sustainable exercise program where you elevate your heartrate 3-4 times per week for at least half an hour at a time. My office record for the most steps on a daily basis goes to Amazon warehouse workers that log 25,000 – 30,000 steps. That is an exercise program that pays while you do it.
  • If we stop weight training, our muscles turn to fat. If this isn’t true, then where did all that muscle tissue go? Well, nowhere. The muscles are all still where they’re supposed to be—it’s just that they’ve shrunk in size. A decrease in physical activity also comes with a decrease in calories burned AKA more fat put into storage. Plus, dietary habits tend to change when people stop exercising … and it is rare for that change to be positive! So do your feet think you are fat??

Of course, those aren’t the only misconceptions—coffee “beans” are actually seeds, peanuts aren’t really nuts, etc.—and we certainly have our fair share in the field of podiatry.

And here are two of the biggest myths related to feet:

  • Shoes cause bunions.
  • Shoes treat bunions.

Kind of weird, huh? We both blame shoes for causing this problem … and celebrate them for being the cure.

Both can’t be true, right? But are either of them accurate? Let’s take a closer look.

Late 80’s/Early 90’s Air Jordan Commercials Got It Wrong—It’s Definitely NOT the Shoes!

Here’s something that happens often:

An 80ish-year-old patient will reminisce about this one specific pair of hand-me-down shoes that are the specific cause of their problem. The can recall the details all the way down to color, style, etc.

“Doc, if I did not have to wear my older/younger brother/sister’s shoes, I wouldn’t have to deal with this bunion pain!” Now these shoes were used over 7 decades ago but their problem just started just 1 year ago. THE CAUSE IS NOT THE SHOES.

Another situation we encounter frequently:

A patient (of any age) is confused as to why he/she has a bunion and they’ll say, “But I wear good shoes!”

So we’ll ask “What is a ‘good’ shoe?”

Invariably, there’s an extended pause before the reply—“Well, ones that cost a lot” or “ They are brand XXX and everybody wears them.”

To a certain extent, cost and quality usually go hand-in-hand, but simply paying more or a trendy brand doesn’t always guarantee that you’ll end up with shoes that work better for your feet.

In many cases, the elevated price tag can be attributed simply to the brand or fashion status. (Hey, Michael Jordan’s and Manolo Blahnik’s kids have to eat!)

But the fact of the matter is that it’s not about how much a shoe costs, or even what kind of footwear is being worn. Which leads us to something that might surprise you:

We aren’t going to tell you that you can’t wear high heels.

Seriously, as long as you are committed to keeping your Achilles tendons from tightening up, you may be able to avoid most of the problems commonly associated with pumps, stilettos, and any other type of high-heeled footwear.

But keep in mind that if you don’t maintain calf muscle flexibility, any underlying foot problem will be exacerbated and you’ll find your “3” on the pain scale becomes an “8” pretty darn quickly!

(That is especially true if you go from wearing dressy high heels for 30-40 years to suddenly making flat-soled shoes your primary choice in footwear.)

Okay, this all begs the question:

If not shoes, then what in the world causes bunions?

Probably your parents.

Nope, we’re not kidding. Most bunions can be attributed to inherited structure and biomechanical issues—and especially flat feet and excessive pronation.

Feet that are flatter than normal tend to exaggerate a normal biomechanical process called pronation, which is basically a slight rolling inward motion the feet go through during the ground contact portion of a step.

Pronation is completely normal and helps feet absorb a tremendous amount of physical force. When the rotation is excessive, however, too much pressure and stress is placed on the inner edge of the foot, particularly up by the big toe.

When that happen, it creates instability in the metatarsophalangeal (MTP) joint—the joint where a toe connects to the foot.

Since joint stability is impaired, the excess pressure from every step will eventually cause the big toe to angle inward as the MTP joint is forced out of position (which explains the characteristic bunion bump).

Leibovitz Custom Orthotics

Real Problem, Real Solutions

At the end of the day, here’s the fact of the matter:

If you already have this problem, the root cause really doesn’t matter all that much—you just need the condition to be addressed!

And if you are fashion-conscious, you might want to think about the fact that it doesn’t make a whole lot of sense to have “pretty” shoes if you don’t have “pretty” feet (due to a bunion).

The good news is that a bunion doesn’t have to be a permanent condition.

Yes, this particular condition isn’t going to go away on its own without professional intervention—and the odds are good it will continue to worsen—but we use effective treatment options that have helped many people just like you overcome bunion pain and difficulty.

When caught at an early stage, we may be able to relieve symptoms and slow (or possibly even halt) a bunion’s progression without surgery.

Now, changing your footwear will not correct a wayward toe, some kinds of shoes are better at accommodating deformity than others for this condition. In particular, one brand we may recommend is are the Altra as our “Hail Mary” shoe.

Altra shoes are particularly popular with the ultra-distance running crowd (the runners who sometimes log 50-100 miles at a time and chuckle at marathons…). (They also make casual shoes.) One particular feature that makes them an excellent choice for those who have bunions is the ample amount of room in the toe box. Keep an eye open for my upcoming review of the Altra Torin.

(As an added bonus to wearing Altras, you can just give a sly smile and nod when they ask you, “Hey, did you just run the Dances with Dirt race?

While these shoes will be more comfortable, they don’t exactly constitute treatment for the condition.

What we may recommend is combining a change in footwear with orthotic therapy.

A pair of custom orthotics—not the “snake oil” they try to peddle at places like The No Good Foot Store—is customized to work with your unique foot structure, biomechanics, and gait pattern. Because of this, we can adjust them specifically to correct motion issues and keep excess pressure off specific areas.

This is generally a popular treatment option, but something worth keeping in mind is that men’s shoes are more accommodating to orthotic devices.

Many—but not all!—women’s shoes are more “form” than “function,” which can make this a trickier—but not impossible!—endeavor.

Now, conservative treatment for a bunion may be able (depending on the case) to achieve two things:

  • Address symptoms
  • Slow, or possibly prevent, further progression

That being said, there is only one way to actually correct a bunion—surgical intervention. Fortunately, bunion surgery is very successful. (Of course, we will still take every measure possible to avoid surgery whenever possible.)

Don’t Blame Your Shoes OR Rely on Them to Make Things Better!

At the end of the day, here’s the deal:

Your footwear choices did not cause you to develop a bunion in the first place. There was likely another explanation—and the odds are pretty good that genetics had a role.

No matter why you have a bunion, the simple truth of the matter is that you need to have it treated, sooner rather than later. This condition is progressive and will continue to worsen when left unaddressed. (Sure, some medical issues do go away in time, but this is not one of them!)

If you are in need of bunion treatment—and having a bunion means, yes, you do need this—make the choice to do something about it today.

We have experience in helping patients just like you find solutions to the problems caused by this common toe deformity. See us early enough, and the odds are better that we won’t need to recommend surgery to do so.

For more information, or to request your appointment, simply give us a call at (317) 545-0505. If you’d prefer, please feel free to use our online form