Most people don’t think of Bunions when they think of children’s feet! However, I see a fair amount of bunions in children (kids, you can thank your parents for some of that!). Bunions affect the alignment of the big toe as well as lead to bone growth on the inside of the foot near the big toe joint. In my experience children with bunions usually have flat feet, very flexible joint articulations in the feet, and are involved in sports that either require tight fitting footwear or cause repetitive stress to the first toe joint (cleats, skates, dance). When we work out, we stress our muscles and they respond to the stress by growing bigger. Same thing happens in bone. When you stress the big toe joint by rolling onto it when your arches collapse or by wearing a tight cleat or skate that rubs along the side of the toe, you are creating stress to that bone and if you have hereditary factors you are going to stimulate the growth of the bone in the big toe area. Probably one of the worst cases I saw of adolescent bunions were in a 14 year old girl who skates 5x per week and whenever she takes off her skates there is marked redness in the bunion area. When she is not in skates, she is in a Puma style flat shoe. Most of the kids I see nowadays are unfortunately not wearing well structured shoes and this leads to a big discussion about style when I try and educate them about the virtues of a good shoe. Parents, you are not held harmless on this one! There have been many a conversation in my assessment room on footwear when the parent says to me “she’s never going wear a running shoe, she only wears flats.” If you have a family history of bunions and your child’s foot is flexible, they are at risk of bunions. Help them, work with them to find a compromise. I certainly am not suggesting that your child wear an ugly orthopedic shoe! The difference a good Asics, Brooks or New Balance running shoe can make to your child’s feet is quite significant, and with the cool colours and styles nowadays surely we can find a compromise. My goal for bunion treatment is accommodation to limit any future growth. This begins with footwear education as well as supporting the arches of the foot to take the pressure off the big toe.
Steve Lawcock, Certifed Pedorthist, www.burlingtonorthotics.com
