Bunions have become a normal appearance in many chiropractic and manual therapy offices. This has occurred due to shoe and footwear choices and improper ankle mobility. Surgery is the only option to decrease the size of the bunion, but to stop growth and decrease pain soft tissue work and rehabilitation is your best bet. Strengthening the peroneal muscles can help stabilize the big toe joint and ankle mobility exercises can help decrease the rate growth. Here is an easy way to start stabilizing the toe.
- Stand facing a wall using your hands to balance yourself.
- Spread your feet apart wider than shoulder width.
- Flatten your inner foot and raise your heels off the ground.
- Only raise the heels, do not come up on the toes.
- Repeat 3 sets of 25.
- This is not a calf exercise, do not perform calf raises.
Do you have knee pain and do not like to squat? Your problem may not be the knee themselves but who you squat and how you move through the hips. Proper hip posterior/backwards translation can take pressure off the knees and allow you to squat and train your hip and gluts without pain. Try these ball squats and see if your pain while squatting goes away.
- Begin by standing feet shoulder width apart just far enough from the wall that the ball is sandwiched between your low back and the wall.
- Start your squat by sitting BACK and down.
- Go down until your knees reach a 90°, angle being sure that your knees do not extend past your toes.
- DO NOT LET YOUR BUTT AND LOW BACK COME OFF THE BALL!!
- Return to the standing.
- Perform 3 sets of 10 repetitions 2-3 times every day.
- Begin with a band around your knees, standing feet shoulder width apart just far enough from the wall that the ball is sandwiched between your low back and the wall.
- Repeat setup above.
- You should be able to do 3 sets of 10 of the regular ball squats with little to no fatigue before beginning the advanced ball squats.
- Make sure you are squatting back and down.
I have only found one VMO exercise that consistently activates the VMO. Oh, and it does a number of the gluteus as well.
Diagonal Sit Backs
- Start with the patient on one knee and heel directly under opposite buttocks. (right knee on the ground with right heel in line with left buttocks)
- Now the leg should be at a 45 degree angle, slight hip external rotation.
- Instruct the patient to perform a brace & breathe and slow start to sit back onto their heel. Do not have them go into lumbar flexion.
- They may not be able to touch their heel.
- Return to the starting position and repeat.
- No flexion or posterior pelvic tilting should be noted.
- The arms can be raised for balance.
- This should be felt in the VMO and gluts.
Hallux Limitis literally means limited big to motion. Hallux Limitis is a degenerative or arthritic condition in which the big toe becomes progressively stiffer ad more painful. While motion still exist in the big toe with Halux Limitis, Hallux Rigidus is an extreme version of Limitis where little to no motion is present.
Many people have Hallux Limitis and do not realize it. Pain generally does not occur until toe range of motion is less an 35-40 degrees. Hallux Limitis occurs more commonly in runners, especially those whose big toe is longer than their second toe. With this condition a bone spur begins to grow directly on top of the big toe “knuckle.”
Hallux Limitis can cause many biomechanical problems and needs to treated correctly. Techniques like Active Release and Graston can restore motion by 30 degrees and home exercises can help prevent the recurrence of ROM loss. General ankle mobility should be addressed and over-the-counter orthotics can help lessen pain. Click here for ankle mobility exercises.
Yours in health,
Dr. Justin Hildebrand