This is the Move Your DNA podcast where movement science meets your everyday life. I'm Katie Bowman, biomechanist, author, and I can lift just my big toes while keeping all the other toes down. Can you? Everybody is welcome here. Let's get started.

Hello, everybody. Welcome to this episode. I'm very excited to make a quick announcement before we get started, and that is move your DNA is getting a co host. And that cohost, you have been hearing from her in the last few episodes, Jeanette, Lauren, biologist. Would you be my co host?

I would love to. It's an honor and a new adventure at least for me

I love having a co host. I really miss the Danny days of the of the podcast, and it's just more fun, I think, to, chat with people.

Well, I'm really excited. We chat a lot off camera. Yeah. And, yeah, it's gonna be fun.

Yeah. I think the tricky thing is gonna be to keep the episode lengths short. Right? Because we can definitely what do they say? I was gonna say wax on.

Is there a more British way of

saying? My husband would probably say drone on. Oh, right. But I'm trying to think of a more positive

How about crone on? Since we're crone. Yeah. Maybe. We're gonna crone on.

Yeah. We're gonna yeah. That's it. Perfect. I think it's better.

Yeah. Crone just feels more like you know? Yeah, it's where we're headed. It's it's it's in the direction we're going. We might as well talk about it on our way there.

Okay, so today we're going to talk about bunions. I know. I I feel like in any other podcast, this would be the not exciting episode. It's like it's the bottom of the barrel. For me, it's a peak.

It's a it's a peak to get here. And I just got back from North Carolina where I was leading a 3 day foot mechanics retreat, foot exercise, foot health, healing your soul is what we called it. And it was quite fun.

Lots of lots of bunion chat, I imagine.

Well, I mean, yes. There was lots of bunion chat. And bunion chat is tricky to to do when you don't have the foot right in front of you, where you can be moving and pointing to things. It's what makes it tricky to write about. Mhmm.

And we're gonna try to talk about it recognizing that people listening are going to have to work kinda hard to imagine the shapes we're explaining because even when I had people unsaid and could be right next to them to show them sort of the movements I was talking about that created height, let's say to the foot. Three-dimensional modeling I find is very challenging to for folks to grasp. It's it's not easy when there's 3 planes of motion you have to consider all at the same time.

Yeah agreed

And bunions is and bunions requires that.

Mhmm.

I kept saying I'm like, I would love someone who creates origami. I mean, I know origami is a an ancient paper art, but surely there's someone out there who's, like, trying to figure out if they can create a new animal shape by folding the paper a different way. I would like a foot I would like an origami foot. Yes because so much of if you've ever done origami you start with something flat and you're folding it and then through special folds, I don't really even know what it is through special folds, you're able to then all of a sudden, create a three-dimensional object from a two dimensional piece of paper.

Mhmm.

And the foot is very much like that. So there's this way of creating height in the foot by starting with this, you know, sort of what we think of as flat object. I don't know if I'm gonna be able to

to create

that in in a pot well, I'm not gonna be able to do the origami. I'm just hopeful if I can create the image in people's minds as they're listening right now that will help them understand.

I definitely felt one reading about bunions that actually me standing in front of a mirror Mhmm. And make you know, actually trying to push the feet into the directions we're talking about is helpful. So maybe listeners could actually try or film themselves to look at their foot when we're talking about things.

Right. And then we'll just remember as we're talking to go go to the mirror. Yes. This would be a good time to go to the mirror. Even if you're out on a walk, stay on your walk.

But when you go back home,

try

this in front of a mirror. Yeah. So the reason I wanted to do this episode is there was an article in the National Geographic. By the time you're listening to this, it's been about a month, but I got a lot of people forwarding me this article because the article title was do you have it in front of you?

I do. Why do we have bunions? Blame an evolutionary toe failure.

Oh, yes. Always with the always with the blame. Always with the headline.

Always with the blame. And I feel like this risk I I bristle Yeah. Straight away. Yep. What when I well, it's, you know, we're badly designed.

That's that's always the blame. And we should say that this this article is behind a paywall. Right. So if you don't have access I mean, we can try and explain what the article says. But when you get into the article, that's not really the meat of the article, which I found fascinating.

And I do wonder whether there's somebody who writes the article, and then there's another person who picks out a Inflammatory. Inflammatory. Clickbait.

Of course. Absolutely. Absolutely. Yeah. As someone who writes sometimes articles for larger publications.

This is sort of behind the scenes and and it's not necessarily relative to the foot, but I think it's helpful to recognize when you see articles like this, I will write a full article and they'll say suggest a headline, but now AI is really good at picking keywords, and and you're usually wanting content to be framed in a way that would sort of incite indignant, you know, and then to get people to do what they did with this particular article. And I'm not sure if they've recognized that there are certain communities that are likely to spread a particular article, but for sure, the person writing the article did not write the headline because it's always tinkered with even my articles that I submit are tinkered with to try to get these language. These keywords you know in in in them and so anyway, another reason I wanted to do this podcast was because I figured a lot of people that I could see discussing the article probably didn't read it because again it was behind the paywall and so I thought we could. Sort of go through the article and then just have a general discussion about bunions but through the lens of the article because I think I think that the article is you know the conversation starter and we'll just set the headline away because once again, that's not really what the article was saying at all and and the article was really circulated in the minimal footwear community.

You know the the minimal footwear online community the foot natural foot movement a foot health spaces. You know people who are all about the feet and are trying to spread messaging about the state of your feet is well II think in the footwear community. It's very much being created by the shoes that you are wearing. I try to talk about a gate and and you're again your full movement diet as what's going on in your feet. It is not as simple as the shoes that you're wearing it has a lot to do with what you do with your whole body all the time.

It's not just toast breading, but yeah, so I have the article in front of me. We're not gonna read it verbatim, but I'll just read the top line. People for millennia have suffered from the painful foot deformity, and I mean the bunion, that may be the result of a uniquely human toe. Here's why and what you can do to ease the pain. So it seems like I always try to read This is also helpful.

Like, how do I read articles? How do you read articles? I always start with, like, what's the intention of the article? So it seems like the intention of the article is what to do about foot pain that's caused by a bunion. I mean, at least that's stated at the beginning.

Mhmm. You you pick a different

Yeah. I well, I was a bit confused. I'll be I'll be honest. Because they sort of say, well, people from millennia have suffered from this deformity, here's why, but then they really state the thing still perplexes scientists. So I think they don't resolve that at all.

They just kind of throw some ideas, but they don't really resolve it. And then yeah. And I think you're right. The end of the article is much more about what you you can do. And I think you're probably right that that's what they were trying to get to in the end.

Well, I guess the overall point of the article is to get to the website. I mean, like, let's just call a spade a spade. So when articles often don't make sense, it's like, did you get to the website? Then then that need was met. But I assume also like oh I would you know be gracious enough to think that when someone wrote it that they were interested in this idea So just now, we're gonna step out of the article, but also use the article as a temp not a template, but as a trail guide, I guess, for this conversation.

Bunion? Yeah, so they have a line also known as hallux valgus bunions are. And I just had to stop right there because I taught sort of this biomechanical training for movement teachers for a long time. And one of the questions on the test was what is hallux valgus specifically to differentiate hallux valgus from a bunion because hallux valgus hallux is the great toe the big toe and valgus is AA direction. So it's just a joint position.

How's valgus is a joint position and that's when the big toes are let's just say angled in the direction of the pinky toe. That's sort of what you see. And then I'll just this is where you have to work with me in in visualizing shape. All of your toes have their own bones, but inside the foot, there's like a bone for every toe, a long bone for every toe, your first metatarsal. And when you have hallux valgus, when the big toe points towards the pinky toe on the left side, that longer bone inside the foot that would normally be in line with the big toe, it sort of buckles in the opposite or it deviates in the other direction.

So you get sort of a a a small corner on the outside of your foot. So it's not just that you've got this one toe sort of angled off to the side. The the bone in front of that toe also kinda goes off in the opposite direction. So you've got this sideways protrusion, and not just the great toe is technically hallux valgus, but what creates a bunion is both of those things happening and then when you combine those two things the pressure of of that new protrusion interacting with the ground or the friction that's caused in that area from this joint configuration starts to grow new bone. There's inflammation and an and it's like a very similar to a bone spur.

It doesn't have a spur shape, but it's the same mechanism. It's the same type of bony growth bony growth that grows. Because of excessive rubbing pressure pushing, pulling, however you wanna think about it. And that is more what the bunion is. It's the development from that joint position.

So I think keeping them separate is helpful. Because you can straighten a big toe, but you still have this bony growth to continue. And then the bony growth starts to create further. Buckling of that area right it. It's a mass unto itself now and we all have a bunions in different states so you can have a bunion that that growth is quite large or you just the deviation right now and no growth at all.

And that I wouldn't consider that necessarily a bunion.

Okay. That's interesting because some articles say the metatarsal head is because of its position of being pushed medially is the bunion, and then on top, you can get a bigger bunion with the growth of the bone. Yeah.

I like some I think it's it's just one of those things of where do where do you wanna call it? So my big thing is I like to keep the the position separate from. The problem the right right you know or or the or the painful bit because what is like, what's the problem with the bunion? You know, that it's something that I think changes for a person over time because a bunion doesn't show up overnight.

You know

what I mean. It's it's something that's happening and deepening is that the right word progressing. It's probably a better word. Yeah. It's progressing slowly.

Yeah And, you know, I I have seen severe hallux valgus without a real significant protrusion. I mean, I can I could see what what someone would call onion, right, because it is the metatarsal head? Mhmm. It's round. It's there, but it's different than when you have the growth.

And that's possibly where the gait patterns come in. Right? You could have

Well, I think the gait pattern I mean Well, that's part

of what creates the the valgus.

Yes. Right. That the gait pattern itself is part of what's pushing the, big toe out of the way. Right. But then what happens is once you get a formation in that area, now you have that formation informing your gait, so it becomes a cycle.

And I think that's where we are oftentimes in younger and middle age. The things we're doing that are shaping us in the future are just sort of benign. Like it's just not a big deal and it's why it's so tricky to work on something that's not causing you a problem right now. But over time, the big toe is so important for gait, this extension of the big toe, when it deviates laterally as it does with hallux valgus, as it does when you have a bunion, you're not able to really push off. We would look for points of a foot moving through when you're taking a walk, and you will not see those because the foot's gonna sort of be pushed out of the side.

And then you can also develop hallux rigidus, which is a stiffness where you don't get extension at all, and then walking becomes painful.

So we've got the shape, and we've got the bunion. How do those things happen in the 1st place would be the next question. But this is the way I work through it in my mind.

Mhmm.

If you have a toe bone, a mestarsal bone that's deviating Mhmm. It either has to have been pulled into that position or pushed. Like, it's it's something's pulling or pushing it into that position. So this is where the the title, I think, comes in. Because they talk about this is when they do talk to the the evolutionary, creation of the human foot.

And I think this idea has been around for a while. It's almost this return to a primitive 8 foot thing.

Who's saying return to a primitive 8 foot?

Oh, it was written in a paper ages ago. But if you look at the paper, which was a 2000 I'm just looking at my notes here. It was a 2017 paper that they extracted this little nugget of information from.

Oh, just the the one sheet sort of like a it looks like a physician a physician paper sort of,

you know, wink And they compared feet of chim chimpanzees Right. Gorillas, and humans. And obviously, apes had a grasping for and like everything in the human body, we come from a, you know, a an ape structure.

Mhmm.

And what the authors were essentially saying is through time, the foot of an ape, our ape ancestor, has been rejigged to make the human foot, which is different because we we vault over that big toe. It's stiff and we vault over that toe.

And we don't grasp. Like, to me, I feel like it was saying we're not climbing in trees. We're we're not wrapping it around, basically, these rounds.

So rather than having a

A thumb.

A big toe like a thumb. Right. Right. We have one that's flat, but they're saying we still have these slightly oblique pulls from some of the muscles. So really what they're just saying is because those those slightly oblique pulls, if things get out of balance, which they have no there's no information of what what that imbalance might be.

High stress. They just say, like, if you High high a high stress. A push or pull. A big push or pull.

So and the pull could start pulling because those those muscles are aligned slightly obliquely. They could start to pull. So that's kind of what what the Nat Geo article has taken and said, right, you've got this kind of poor engineering in your toe because it was from an old ape structure. Yeah. But there's no in the entire Nat Geo article, there's no reference to the a push.

There's no reference to how you walk and how you might the toe might deviate, apart from saying that we walk on very hard ground.

And and then shoes. I mean, I Shoes. So the thing the thing that was in the article, which if everyone in the footwear community who are kind of upset about the article would have seen is like II feel like they did pretty well represent that. A push from the outside of the shoe. Yes, you know would be something that could create it.

So if you were read that article and you were concerned that footwear was not represented as we'll say, a cause of bunions. I felt I feel it was.

Like, I It was. Yeah. And they they talk about the really interesting study in Cambridge, the archaeological study, which, just very briefly, they looked at different populations in cemeteries in Cambridge from, I think it was the, I wanna say, the 10th to 14th century, and they saw this big increase in bunions when there was a transition to these very pointed medieval shoes.

Yes. Right. That that fashion trend.

That fashion. And they could really link it to that fashion, and it more occurred in wealthier as well. So people that would have worn those kind of fashionable Right. Shoes. So yeah.

So that was nice.

Yeah. Well and, also, in the the beginning of the article, I thought they they used ancient footprints as a way as a way to sort of like to support the like bunions have been around forever because here are these here are these footprints of you know someone walking across a plane that got fused in mud and you could see that they had a bunion, but if you go back and you check the sources of where people are pulling bits of information if you read they didn't link it, but we were able to find it. He was talking about a tailor's bunion, which is which is not what the article was about at all. So that's a tailor's bunion is on the pinky toe side of the foot developing a little bump on the on the outside edge just around the usually like the 5th metatarsal head. So it's again those it's just below the pinky toe and on the outside of the foot.

And it's named Taylor's bunions because if you were a tailor sitting and sewing cross legged on the ground, that the outsides of your feet would be pressing against the ground and that pressure would cause this thing to develop. So anyway, I just thought that it's a bunionette. I just thought it was very funny that they're using a piece of information that that's gonna support their overall argument, but this is the problem with skimming for keywords and saying you know ancient foot has bunion and then not reading it.

And they they were make trying to make the point it was this eternal ailment. Right. But they had one data point. But Yeah. But, yeah.

So that was that was interesting. And actually, like, if you look in a lot of the more robust sort of review articles, you actually find that there's not a lot of ancient footprints with bunions. And it's much more common in shod populations than barefoot populations, you know, and there's quite a lot of information out there to to show that.

It kinda reminded me of folded fin.

Syndrome very much so

and move your DNA. You know where it's like well, if you look at almost all of the whales in the orcas in the wild like their dorsal fin will look this certain way unless there's been some sort of trauma But every single one in captivity has it this particular way and rather than looking for You know, the the one folded fin from a trauma in the wild and say, see you know this is just a natural thing that could happen.

Yeah. That's exactly what I thought. That's what I was

when I was reading it. I was like, okay. It's a stretch but II see that you have your data point, but it is

a stretch. That's right. You're a single data point.

Okay. The rest of the article seems to be what you can do about a bunion, which, obviously, I feel like many is a is a good conversation to pair together. Yeah. And I'll just say that the article states fairly strongly that there is no cure or fix for a bunion beyond surgery. You know, and they talk about they're interviewing a podiatrist, and the podiatrist is talking about you know, I'm all of the things on the market that there are to fix bunions and I was like they don't work and I mean one of them was Apple Cider Vinegar.

Yeah and Epsom salts. I think

yeah right and so II I guess mechanically what I didn't see in this article was it talking about really the mechanics, the push and pull. And and in a much bigger perspective, there's not a lot of talk on on humans learning or correcting their push and pulls in general. Like, we're not at that place, I think, with musculoskeletal situations.

No. And it was it was interesting because he talks about splints. Mhmm. Which is

push and pull.

Which is push and pull. And it's basically, like, as soon as you take them off, you revert back, which I thought was interesting because we may well, maybe we don't think about the feet in the same way as they have muscles that can respond and change. Mhmm. So I thought it was interesting that he just dismissed. And I understand, like, if it's just passive, there might be limited change you can make, but there was no appreciation that you could change your pushes and pulls through corrective implements or corrective movements.

It was straight, like, that's useless, which I thought was interesting.

Well and I I think I run into this a lot. I I do think it has a lot to do with training. We'll call it training volume of working on something. Like, I there's plenty of things in the market for foot issues that you wear at nighttime. And because our musculature is so habituated to our patterns, I think that a lot of the times just doing something like passive positioning in isolation, so splinting.

I mean, it could even be something like you know, I talk about wearing my happy feet socks at nighttime. That's that's passive too. Like, to just do that in isolation and not do anything that affects the other pushes and pulls, I think you'd have a hard time correcting a bunion. So I'm using air quotes for correcting a bunion right because I think that you can make a lot of progress to mobilizing the area and improving your gait upon that foot. So it goes back to, like, what's the actual problem with the bunion?

In one hand, it could be the actual pain or soreness of the area. But I think for many people it has more to do with the way the toe the great the big toe the hell is moving and feeling when you're walking and I think that there's a lot you can do to mobilize that area and strengthen that area and change the loads throughout your foot. So it poses less of a problem Right. For you. And you're you're effectively not continuing to create it.

Because I think with a a bunion, you just keep making it. Once you're in that space, if you don't change your pushes and pulls, the way you're walking is pushing and pulling that. Shape.

Kind of a positive feedback. It just because of the shape is going in that direction, it makes it multiplies. Like so there's a few things. Can we address what to do with the toes and the and the alignment of the foot and how that could help people?

There was one section of this article that did talk about push and pull whether it it called it that or not, and that was talking about the people most prone to bunions 1, he said. Flat feet and I would say it's pronators but II know that journalists will wanna simplify it. Flat feet are not the same thing as pronation, so people who have a lot of pronation in their feet and also people with joint laxity. So we'll just say like collagen disorder where they're where many parts of their body aren't stable due to qualities in their connective tissue that are genetic. So let's talk about pronation first.

How do we how do we how do we clarify pronation for the people listening?

Could we describe pronation as the foot lowering and flattening to the floor and maybe rotating into that valgus shape. Is that is that true? Yes.

Yes. Your foot is like a bag of bones. So when we think of anatomy, I do think we tend to think of hearts staying in their general orientation right and deviating you know getting longer or spreading that is those are 2 movements but the key thing that I think we're missing with bunions is that it's the rotation part if you've read whole body barefoot. What I'm trying to talk about is smear effectively pronation is just a description of motion. Smear is the effect of that motion.

So when your sole of your foot touches the ground and then your foot sort of spreads out and the bag of bones kinda rolls over onto itself a little bit why this is important for bunions is you are pressing on the side of the bunion, which is a big part of why it can't resist that motion. It doesn't have the the ligament orientation to resist pressure in this particular direction.

And is that why sorry. A question. Because often you see with the bunion, the the toenail starts to look toward the midline. Like, there's actually a a twist. The toe is rotated also.

Yeah.

It is not just these two dimensional deviations.

Right.

The the bones themselves have rotated it. It's you know. It's just like all the subtleties that we're that I try to teach with rotating your upper arm because it's not actually where you think it is and rotating your thigh because it's not actually where you think it is the same with bunion. It is not purely a lateral deviation. That's what you can see.

It is laterally deviated, but it's not only laterally deviated and I think it's that rotation this complex sort of arch structure that rocks over it. It's sort of it's collapsing as it's spreading. And then every step that you're taking even when your foot is seemingly flat. It's not flat. It's being pushed from the side and and it's a buckles so easily in that particular.

Orientation and that's the push that's the push and pull right, but you've got multiple pushes and pulls there. It's just hard to see them all. Tri triplanar movement is 3 pushes and pulls.

I'm not sure. I think people use different terms. I think they're slightly different. Mhmm. Like a medial heel whip, which I think might be when the foot is actually off the ground, but that kind of what's the term I would use, an abductory twist Uh-huh.

Where you see the the heel spin in towards in towards the body. So there's actually that another rotation that could potentially be in somebody's gait, causing again these rotational effects.

Well and and once your once your that helix valgus has started, you can't really extend your big toe.

Right.

In the way that we would say fits into a gait cycle. So you start abducting, you start turning out your feet even more so that you do not have to deal with toe the toe extension part of walking. And that's when it really starts to reinforce itself because it's sore you know, your joints bend in the directions that they bend. They're they're set up to articulate in certain ways. And the great toe is set up to you know really extend you know, move straight up curl down.

It can also go side to side. It has that ability, but it's all about the volume of the

right.

You know you're the the muscular system is set up to resist and support you know mostly an extension strength and extension. You know like really you're in that extended and that's position as you pass over your foot when you're walking and it does not have that same robust system to deal with the big toe being off to the side. So you turn your foot. So then you sort of roll on that foot even more and then you're creating even more pressure, which continues to push the bunion out to the side. So what I like to help people do is 1.

It's a lot of same muscular things that we would want to do to come out of over pronation right and that's a lot of hip work. That's a lot of standing up straight legged work. It's not only with the toes. I I do think we tend to think I have this toe problem. I need just toe exercises you do need toe exercises like you wanna be in you wanna be in shoes that allow you to spread your toes widely.

You know as widely as you

can and with a bunion it can your feet can get even wider right because you have that extra mass and that can be a challenge to find

to find issues. Yeah right because you don't wanna keep adding pressure and that's that's another thing with like kind of a callus that sits over that bunion because it's rubbing on things more often and I know a lot of people with bunions will tend to go to sandals or you know things where they can get that pressure off of that area So wide enough shoe to accommodate or reduce the pressure from the shoe on the bunion, but also to give space so you can start to abduct. You can start to move those big toes in the opposite direction and then trying to to decrease that pronation so there's strength for that restoring some of the arch strength in your foot kind of on smearing on smearing your foot and and lifting it up and off of that area and and then gate you know then looking at how you're using your foot when you are walking. You're not gonna be able to do that all the time because we we're not usually as you know, we're not able to be mindful with every step, but at least to start to become aware of options and set aside time to mobilize the foot and try to create a gait pattern that doesn't just, you know, blindly reinforce that issue.

So possibly the best book is Whole Body Barefoot of yours for Move Your DNA. And you'd be looking for toe spreading movements, you'd be looking for hip rotation, you'd be looking for standing leg strength.

Mhmm. All of those pieces. Backing your hips up, you know, like Yeah.

Getting up the weight off the toes.

Getting the weight off the toes. You know, like, we talk about pushes and pulls in the feet, just having the hips sort of casually forward, which pushes a lot of weight on the toes. If you already have a bunion, that's another big push from the top that's pressing that shape into your body, not just into the ground, but into your body. So it really is a whole body thing. But yeah whole body barefoot is where you're starting to develop this idea of like Oh II can actually use my hips and my legs to change the shape of my feet.

Right.

And I can use the muscles in my feet to change the shape of my feet. And actually, that could

be a movement break. Everyone could stand up and push their hips forward and see what happens to their feet. They'll probably get longer.

Watch what happens with your toes. Well, and also if you if you let your hips go way forward, really forward on your toes, you'll see the toes contract. They have to contract to keep you from pitching forward. So when you're dealing with anything in your toes, bunions, hammertoes, Morton's neuroma, anything where those bone the bone shape is creating pressure in other places, note how your pelvic position absolutely creates a foot a toe response. Right.

And then you'll back your hips up, and then you can look down and see like Oh II have more options with my toes when my hips are not directly over the toes and that's why we don't wear heeled shoes. That's That's why minimal shoes don't have heeled shoes because there's this automatic relationship between what the toes Absolutely have to do when your hips go forward. Mhmm. If if they don't do it, you would fall flat on your face. And so if you're trying to make any changes in there, back your hips up.

Free those toes.

You can just go find an article, stance makeover, on my website, and that's, like, the first thing.

Fantastic. So that's that's movement correctives, which, in general, the article did not talk about. Do we want to contrast that with what they did talk about, which was surgery? Yeah. Just to just to talk to that part, which was really that this is what you'll need to do.

Yeah. I mean, they are basically saying the surge that surgery is the only way to get into alignment.

Right. So there there's, like, loads of different varieties in surgery. There's 3 groups, right? There was one that just kind of took this shaving, the the blow Shaving? A shaving, which just takes the lump off and doesn't change doesn't change the deviation of the Yeah.

It doesn't adjust alignment.

Just just doesn't adjust the alignment. And then there was the lapidus, which is a fusion of the toe. So you essentially fuse the joint, you lose the mobility in that joint, and it's realigned.

Realigned and fused. Realigned and fused.

And then there's also realignment without fusion, which is you break the bones, put screws in, but don't actually fuse the joint. Yeah. And as far as I understand, the difference seem some people, if you have arthritis, they recommend a lapidus because the joint is not healthy enough to to not be fused. Yeah. So those are the options.

And and you had you had found some work about the recurrence, because it might be realigning, but it's not removing the pushes and pulls that you are repeatedly creating. Am I is that correct?

Yeah. Reoccurrence is a big issue with the nonfusion options right because you haven't usually addressed the gate issue. And that is the biggest frustration I hear. Of course, the people that I hear from are the people seeking yes more help you know so if it work for you and you went on your merry way fantastic but it often can regrow back or rechange because again, it's not. The problem is mechanical It's it's in a wet a web of forces that you're creating all the time that you can't see but it's not like it just flopped out in that direction and that was what made the problem.

The problem is it's like throwing a pot, a clay pot. You're throwing a bunion, you know on the wheel you're on the wheel and you're creating these forces here and so if you cut off your clay and you get your clay all and you start again. But then you go back and you do the same spinning and you put your hands in the same place. It's the same set of pressure you're gonna create that that same shape again.

Yeah. And I think the article really missed that. There was something I'm gonna find the quote because I thought it was it was interesting if anyone has actually got it. It was oh, here we go. With increasing stress, the human big toe can override the muscles and ligaments that surround it drifting out of place.

And I was like, And total just drift.

There's no drift about it, honey. There is no drift. There's no drift.

That it has to be pushed or pulled there. Yeah. And I think that's what this article did not do well.

But I was happy to see that the article at least mentioned footwear.

It definitely did. Yeah. It definitely did. Although it did mention that's a good point, because it mentioned footwear particularly it quoted the podiatrist again. And his his comment about footwear was that it's unsupportive.

Mhmm. The footwear we choose is unsupportive and the grounds that we walk on are very hard and this is part of the problem. And it may have been something about because we have unsupportive footwear, we're throwing our feet under the bus to kinda save our spines and our hips.

Where can you walk that's not hard? Like, where are we supposed to be walking?

So so the podiatrist, again, was all for supportive supported footwear. Of course. And I see that, especially I think from his perspective of the flat feet.

Mhmm. Right. Right. If it if you have these pronation Yes. For hypermobility Yes.

Conditions, get shoes in there that really hold the bones in place so we don't have this drift. Which was interesting because I would like to know, would we consider these medieval shoes supportive?

Not at all. Yeah. They were kind of soft leather just with with points.

With just like a like a ballet slipper with Yeah. A needle on the front that you cram your toes into? That's that's right.

Yeah. They certainly wouldn't have had arch support. Mhmm. Yeah. So that's that's that's perhaps something to consider, isn't it?

If you how if you've been told you need supportive footwear because you're an over pronator, and your bunion is going to get worse, it might be a slower process, you know, of you've written about this, you know, this transition to more minimal footwear with the correctives, you know, rather than if you've been if you've been told you need these this supportive footwear, how can you do the correctives you need and then get the foot movement you need?

People are gonna hate me for saying this, but I actually think that the footwear could be the last thing

Right.

That you

That you change.

That you would yeah. I think that, you know, the idea of minimal footwear I mean, the heel of a shoe would be something to get out of right away. Yes. You know, minimal footwear is a set of characteristics. It's not any particular shoe.

Because getting out of the heel right away will get you off of, it will allow you to get off of your toes right away and then from there, I really think that the correctives are your main thread. Towards. Foot realignment foot strength, restoration coming out of hyperpronation. And then you could go to something with a flexible soul and wider so that you're promoting more movement. I mean, and all of this depends on the person, the body, and and you know if you're younger and more malleable, then you can drop right into something if you don't haven't been told that you need arch supports you can move into this space more rapidly if you have more years with particular habits with your feet and you're reluctant, you know to get rid of your.

Foots or arch support supportive shoes just work on the correctives focus on the correctives definitely come down out of your heel too and you know again upper was talking about a toes in your upper. The upper is the part of the shoe that connects your foot to the shoe. So like if you have a tennis shoe, the upper is the part with the laces. If you have a flip flop, the upper is that, you know, teeny tiny strap. That's not a a full attached upper.

When you wear shoes that slide on they also slip off very easily and so you have to push and you have to scrunch your toes to hold them on well, there is another push and pull that's in your foot all of the time so you're trying to get rid of these pushes and pulls that are part of your clay pot throwing set of forces that keep throwing the bunion shape so you can get a get a fully attached shoe so you don't have to add. Toe scrunching to hold your shoe on you can back your hips up so you can allow toe relaxation and then you can be working on these other things as well. There's so much to do before you get rid of. Supportive shoes in the sense of an arch that that you could just even set that aside for right now, if you're feeling uncomfortable with the notion and just do everything else great and and see how things go. You know there's toe exercises to start you know getting out of that tension that's pulling you towards your pinky toe start stretching and strengthening in the other direction the exercise that I gave at the beginning the challenge and introduction.

It's like, can you lift just your big toe and leave all your other toes down if you have a bunion when you do that and actually even if you don't have a bunion if you do that you you might see that your great toe when you don't think about it not only lifts, it lifts and goes towards the pinky toes. And so try to lift without also pulling and you're gonna get a different motion than if you lift alone and you'll start getting cramps in the feet because you are using muscles that you don't usually use.

I love that one. I have it's interesting for me because it mine. My left is different from my right Uh-huh. So my right veers off a little bit more than my left, and my right foot is the foot that I more likes to turn out more. The discrepancy between our

right and left toes is very good evidence for the push and pull because it's the same supportive shoes that you are or aren't wearing. It's the same genetics.

You know, it's all the same. It's the same across me.

Exactly. You're you are your best sort of data point of comparing apples to apples and when you see something create this particular shape, you want to be thinking okay pushes and pulls and pronation is not we do pronate to different degrees. You know we've got all of these things going on in the body that are happening without us really knowing how to see them. That's why like in move your DNA weekends, we do knee pits

right

Because knee pit is a big bunion thing. Yes. Knee pit alignment is a huge bunion contributor.

And If people don't know what knee pits are, could we

We're not gonna tell them.

We're not gonna tell them. Mystery. We could put this we could put a link in the show notes to knee pits.

So so maybe we can make a video for listeners to we can put it in our stories, or we can maybe embed it into the, show notes.

Perfect. Yeah. We can do that.

We can use your knees. Can we use your knee?

I am a good I am a good knee pit model because, Carrie, I have very clear tendons on the back of my knees, and I am more extremely internally rotated on my right. So it's quite easy to see the difference which lines up with the fact that my right foot likes to turn out and my big toe likes to deviate off.

Alright. So we'll get them a video so you get a sense of what these knee pits are. As far as the article goes, I think we've given it due diligence. My take on it was, I think the unfortunate part is it reinforces idea that this thing going on in your body is kinda beyond your control. It has to do with your your ape toes and your unsupportive shoes and once you have it, there's nothing that can be done and I don't think that's the case I've seen enough people make a shift make a shift and actually the the extent of their lateral deviation the extent of their bunion shape and then also just a reduction in the impact the shape has on their life.

Right. Right. To the

best that's the key. That's the key for people.

Exactly. Feeling empowered. So thank you for coming on and talking to me about bunions. I mean I think an hour about bunions is probably where we should stop.

Yeah.

I thought so and if you wanna read more whole body barefoot, we can link to that in the show notes. Yeah. You can buy it or get it from your library. Rethink your position. Yeah.

You have some

nice nice article, a lovely article, and rethink your position on bunions, which gives a nice summary.

Yeah. And it's really video based. Come come to a foot retreat so you can spend 3 days no. And then, of course, as always, you have to do the exercises. That is always the sticking point.

Knowing about how a bunion is made is not enough to undo it. Alright. Bilal, thanks for coming.

Oh, thanks for having me. Yep. Bye.

Hi. My name is Jennifer Derryberry Mann from Nurture Nashville Yoga. This has been move your DNA with Katie Bowman, a podcast about movement. We hope you find the general information in this podcast informative and helpful, but it is not intended to replace medical advice and should not be used as such. Our theme music was performed by Dan McCormack.

This podcast is produced by Brock Armstrong and is transcribed by Annette Yin. Make sure to subscribe to this podcast wherever you listen to audio and find out more about Katie, her books, and her movement programs at nutritiousmovement.com.