Bunion & Big Toe Blisters

October 15, 2010 by
Filed under: blister care, Foot Care, Foot Care Products 

I have seen a lot of bunions over 13 years of patching feet. Some are minor while others are more pronounced. Any of them can cause problems. I’d say that until you have had bunions, you don’t realize the problems they can cause. This post is about bunions and the blisters caused on one runner’s feet.

Today I received an email asking for help. Not unusual. I get a lot of these.  This one came from Andrea. She lives in Tampa and wrote:

I am an ultrarunner and completed my first two 100 milers this year! I love the distance, and am starting to ‘get it,’ if that’s even possible! But my biggest problem is my crazy beautiful feet.

Bunions causing big toe blisters

Bunions causing big toe blisters

I have had bunions my entire life. They’ve been checked by docs who’d love to cut on them, but they really cause me no (or minimal) pain, so surgery is unnecessary, as far as I’m concerned.

The problem is that during every ultra I end up with huge blisters on my big toes. I have your book and have tried many different things, from lube to second skin to taping. But nothing works. I just ran Arkansas Traveller, and my toes are a mess!

I wear men’s shoes in a double-wide to accommodate my bunions.  I’m not sure if that’s the problem, or if there’s a remedy. But I figured if anyone knew…it would be you! Do you think you can help me?

Well Andrea, yes and no. As you and my readers can see, these are pretty pronounced bunions.

First, let’s understand bunions. Bunions are one of the most common deformities of the forefoot. A bunion is a bump caused by enlarged bone and tissue at the outer base of the big toe where the joint angles inward toward the other toes. A displacement of the first metatarsal bone toward the midline (center) of the body and a simultaneous displacement of the big toe away from the midline (and towards the smaller toes) cause this bump to appear. Over time, the big toe can come to rest under, or occasionally over, the second toe. The bony bump is a form of arthritis. The medical term for bunions is hallux valgus.

So, what can we do for Andrea?

The blisters on the outside of the big toes show friction caused blisters. My guess is that Andrea’s shoes are being stretched at the widest point of the bunions. As the big toes are angled inward, they are rubbing at the sides of the toebox. This pressure and friction creates blisters. The image shows blood in all the blisters. The skin appears to have blistered in the same places before.

Andrea says she has tried different lubes, 2nd Skin, and taping. Here are my suggestions.

1.     Depending on the shoes, I’d try to open the toebox up as much as possible and insert an Engo Blister Patch into the area touched by the side of the big toe. This may take several tries to get the patch in without creases. Cut the patch to the size and shape needed. Use either the large ovals or the rectangle size patches.

2.     Run a strip of tape from the inside of the big toe, around the tip and down the side past the bunion. For this, I would cut a piece of 2-inch Kinesio-Tex tape to a width that works for the size of the foot and covers the affected area. I like Kinesio-Tex for this because it conforms to the curves and shape of the toe and side of the foot.

3.     Experiment with different types of tape until you find one that works. A slick and smooth tape like duct tape would be nice for this but is hard to shape to the toe. I would not use Elastikon because it s too thick and rough.

4.     Check the inside of the shoe for any rough areas or seams – and eliminate them – or switch to other shoes.

Now, the reality is that Andrea has pretty severe bunions. While they are not bothering her in everyday life, they are interfering with her running – which she loves. This is the “No” part of the answer. There may come a point when she will have to make a decision to have surgery.

Common Bunion Treatments

Be sure your shoes are wide and deep enough in the forefoot and toebox. If you overpronate, try an arch support or orthotic to reduce the overpronation. Bunion discomfort may be relieved with wider shoes, pads between the big and first toes, arch supports, and warm soaks.

Bunion Surgery

When conservative measures don’t provide relief, surgery may be necessary in extreme cases. A bunionectomy removes the bony prominence. In severe cases, an osteotomy procedure realignes the toe joint. In these surgeries, screws, plates or wires hold the bones in position while they heal. A new procedure, developed by Dr. Goerge Holmes, MD, a Foot and Ankle Surgeon with Rush University Medical Center, offers new hope. The procedure, called the Mini Tightrope, a hole is drilled through the bone leading to the big toe and another through the bone leading to the second toe. A special type of wire, called FiberWire, is fed through the holes, with tiny buttons on each end keeping the wire from slipping out of the bones. The wire is tightened, pulling the outer bone toward the second bone – into a better alignment. Holmes then rebalances the associated ligaments, tendons, and nerves in the toe. Because no bones are cut, healing is faster and with less complications.

For my money, if I had severe bunions, I’d try this.

Resources for this Post

http://www.goengo.com – Engo Blister Patches

http://www.zombierunner.com/fixingyourfeet – carries Engo Blister Patches, Kinesio-Tex tape and other foot care supplies.

Disclosure: I receive samples of Engo patches from Engo and a small  amount of compensation for sales made by ZombieRunner through my link.

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Comments

8 Comments on Bunion & Big Toe Blisters

  1. Denise Jones on Sat, 16th Oct 2010 5:31 am
  2. Well stated John! This lady has a great resource in your help. This is the most complete advice she would get anywhere on the planet.

  3. Andrea on Sat, 16th Oct 2010 3:44 pm
  4. Thank you for your quick reply, John! And a whole blog post on my crazy feet…that’s pretty awesome!

    I have used duct tape, but with the humidity in Florida, it doesn’t stick well. I used kinesio tape at the AT100 and it stuck, but still had some bad blistering.

    So, I will try the patches next. Should I continue to tape as usual, or try the patches alone first?

    And on another note, I always have calluses on my big toes…what are your thoughts about calluses in my case…keep them soft or let them form?

    Thanks again :)

  5. John Vonhof on Sat, 16th Oct 2010 9:58 pm
  6. Any tape will stick better with Compound Tincture of Benzoin applied first. I would try both the Engo Patches and tape. I do not like calluses. If you are blistering under the calluses, then reduce them. The callus is a sign of pressure and friction.

    Peter Fish suggested: Have you ever checked out Karsten Solheim’s footwear? He cuts the entire toebox out of the uppers. I tried that with an old pair of Mizuno Wave Ascends, and found that it relieved some of my toe problems, and perhaps people with bunions (which I don’t have) could experiment with different kinds of surgery on their shoes, before resorting to it on their feet.

  7. Andrea on Mon, 18th Oct 2010 7:23 am
  8. I ordered the Engo patches from ZombieRunner and will give them a try.

    Peter: When you say “…cuts the entire toebox out of the uppers,” what exactly do you mean? Do you have a picture or example of how to do it?

  9. John Vonhof on Sun, 24th Oct 2010 5:45 pm
  10. If you need to cut the toebox out of your shoes, here’s how. It requires a good pair of scissors. Cut where the shoe’s upper joins the sole. Cut to the forefoot at the back of the toes. Cut around the shoelace stitching. You can do only one shoe if you want.

  11. Linda on Sun, 18th Sep 2011 4:00 pm
  12. You can also try Bunion Bootie. It fits like a glove and provides the protection of tape without the hassle or movement of tape.

  13. John Vonhof on Sun, 18th Sep 2011 4:19 pm
  14. The aforementioned Bunion Bootie can be found athttp://www.bunionbootie.com/. I looked at the site and it looks interesting. It would be good to hear some readers experiences, especially during a marathon or ultramarathon distance run. It is described as thin so I wonder if it would cause problems at its edges or at the fold on the large toe.

  15. John Vonhof on Sat, 24th Sep 2011 7:55 pm
  16. Andrew wrote with a suggestion, “My suggestion for the lady below is “correct toes”. Tell her to check them out at http://www.nwfootankle.com. They worked beautifully for me.

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