Why fix something that isn’t broken? This seems to be the theme as our generation hits the pavement in an effort to keep moving forward with career and life. You wake up, throw on your work clothes and ‘work shoes’ and hit the road. Walking for blocks upon blocks, standing on uneven surfaces with thin-soled shoes and then sitting for hours at your desk at work. For the highly motivated, a post-work HIIT class ensues.

Why am I reiterating your daily schedule to you? Well, you may not be experiencing any significant pain (yet), but the level of movement, or lack thereof, can create dull and achy pain down the road. Perhaps your body is already showing signs of this change?

Take a look at your feet. Is your big toe starting to snuggle up next to your second toe? Cue gasp!

What is a bunion?

Technically speaking, a bunion is a bone deformity that forms at the base of the big toe, right at the joint. But you know it as that thing on Aunt Jan’s foot that she’s been complaining about for years and have been hoping will never happen to you.

The thing is, bunion formation happens slowly and not because you’ve had a specific injury to a specific joint in your body and it is most definitely not genetic (so don’t worry about Aunt Jan’s bunion being contagious). Our bodies respond to the stress and load we put on them and do so by finding ways to keep us out of pain.

When a bunion is starting to form, that means that there is something happening from your foot that can be tracked all the way up your body and vice versa. This is how muscle and joint compensations take place in the body. What’s more? A bunion can simply be the result of sitting all day long with your glutes turned off and wearing tight shoes.

I have had both male and female patients walk through the door stating that their only complaint was bunion pain. Whether coming from a dancer or someone with a more sedentary lifestyle, once I dove into their health history we were able to uncover where their bunion journey began.

When looking at bunion pain, tracking up the kinetic chain (the major joints in our body and how they are aligned) is important. Common factors looked into:

• Feet: do your arches collapse to make you appear to have flat feet?
• Ankle Sprains: Were older sprains addressed with proper treatment and care?
• Knees: Do they dive inward as you walk?
• Hips: Is there tightness or instability into the hips? Are you sitting all day long?
• Footwear: Tight shoes with a pointed toe? Orthotics?

These questions and so many other factors that go into what we look at here at Urban Wellness Clinic during your initial assessment. We look into how you are walking, utilize Active Release Technique and strength training, but all of these components to your treatment plan are only addressed after NKT Testing.

What is Neurokinetic Therapy?

Neurokinetic Therapy (NKT) is a manual muscle testing technique that allows you and your practitioner to feel what muscles are being overshadowed by others. When wanting to understand what new patterns have been created in the body, NKT can help you determine what muscles need what type of focus. Weak vs. strong and strength vs. stretching.

We guide you through the process by testing individual muscles that can be overshadowed by common compensators in the body. NKT testing is done by applying resistance against your practitioner’s hand. We start by testing your core strength and then focus on the muscles around the area of your complaint. If these areas do not reveal any weak muscle tests, then we look for other compensations in the body such as higher up into your upper back and neck if dealing with a lower-body complaint and vice versa. Essentially, we are looking for muscles that should be working, but are hiding under the ones that have taken over their role.

Urban Wellness Clinic Patient Case

I recently had a patient come in with bilateral bunions, but the pain was only on the right foot. The pain was sharp and constant and made walking very difficult as every time he pushed off his toes while walking, it recreated a sharp and shooting pain at the joint.

An avid soccer player for years now spending most of his day sitting at his desk. Numerous ankle sprains into both feet, but more on the right foot, a history of low back spasms, tight hips and bunion formation into both feet.

Within the first few visits, we found his right peroneal muscles and right iliacus muscle overworking for his gluteus maximus muscle on the same side. The peroneal muscle group help you point your toes or plantar-flex your foot while your iliacus muscle helps you flex your hip.

The treatment plan was then driven by NKT testing. Since we found two muscles overworking for the glutes on the right side, we released the peroneals and iliacus utilizing Active Release Technique and incorporated strength training to turn on the glutes so that they were the driving muscles for gait and exercise – as they should be!

Remember, the patient came in with pain that became worse while pushing off his back foot while walking. This action is heavily driven by the glutes because the glutes should activate to help propel you forward, not your hip flexors or smaller muscles down into your leg. Activation of the glutes while walking also takes a lot of pressure off of your feet!

After 4 follow up visits, the patient was not only pain-free, but walking without any pain and had a strength training routine that was combining total body movements, but with an emphasis on glute and core strength.

If you are experiencing bunion pain either on a daily basis or it is keeping you from your favorite activities, then NKT testing can help. Your body finds compensation patterns differently than others. In this case, we found peroneals and iliacus, but you may need to work on your plantar fascia, hamstrings, or quadratus lumborum muscles. And sometimes, we find these compensations as layers within the treatment.

How else can you treat a bunion?

There are ways to keep bunion pain at bay while also preventing them from coming back on or becoming an issue into both of your feet.

Spend time barefoot at home!

Allow the intrinsic muscles of your feet to feel different surfaces and activate so that they are able to support you and the load from the rest of your body.

Wear shoes that allow your feet to splay out

That’s right, take a break from the point-toe shoes that make you want to scream after 1 hour. Opt for brands like Vivobarefoot.

Movement!

Are you training the right muscles so that they don’t get overshadowed by others? Strengthen your core, glutes, work on movement patterns like single-leg stance. Bonus: try working out without shoes on so that you really get those foot muscles working!

Gait Analysis

Have a provider watch the way you walk. A lot can be said about how you load your weight to one side or the other and can even tell you why. Sometimes, what we do while remaining in a static position, i.e. sitting at a desk all day, can trickle into how we move.

If you are unsure where to begin to treat bunions or want to avoid them altogether, reach out to us! The Urban Wellness Clinic team utilizes a wide variety of treatment approaches and rehab along with NKT testing to make sure that your treatment plan is for you and you alone. Don’t let someone tell you that bunions are genetic! Come in to get the answers no one else has been able to give you.

Yours In Health,

Dr. Monisha Mallik, D.C.