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[@PeterAttiaMD] Bunions & Hammer Toes: Causes, Symptoms, & Solutions | Courtney Conley, D.C.

· 4 min read
[@PeterAttiaMD] Summarizer
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@PeterAttiaMD - "Bunions & Hammer Toes: Causes, Symptoms, & Solutions | Courtney Conley, D.C."

Link: https://youtu.be/_ddXXvJwi_g

Short Summary​

Number One Action Item/Takeaway:

Prioritize foot health by wearing shoes with a wide toe box that allow toes to splay naturally and actively strengthen foot muscles to prevent and manage bunions and hammer toes.

Executive Summary:

Bunions and hammer toes often result from muscle imbalances in the foot, exacerbated by restrictive footwear and lack of foot exercise. Instead of relying solely on surgery, which may not address the underlying muscle weakness, focus on wearing appropriate footwear and strengthening foot muscles for long-term foot health.

Key Quotes​

Here are four quotes from the transcript that I found particularly insightful:

  1. "You don't come out of the womb with a bunion. You might inherit connective tissue laxity for example or there might be um hypermobility issues. But if we know that just like we talked about with the kids earlier, the earlier interventions, right, you get them in the right foot footwear. You make sure they're in shoes, right, that have a toe box where the toes can actually spllay, especially if you know that your mother has a bunion." (Highlights the environmental factors contributing to bunions even with genetic predispositions and emphasizes preventative measures.)

  2. "Once you start pinning things together, you might take care of alignment, right? But you've done nothing to to strengthen the muscle that allowed this to get there." (Critiques the common surgical approach to bunions by pointing out the lack of addressing the underlying muscle weakness.)

  3. "I think it's the same thing. I think that we have not been paying attention to our feet for a very long period of time. And if you think about if you were to walk around with your hands in mittens for 20 years, you shouldn't be surprised when your hands don't function." (A powerful analogy for the effects of restrictive footwear on foot function and development of conditions like hammer toes.)

  4. "All a bunion is, by the way, is this bone basically shifting to the outside." (A simple, easily understood explanation of a complex issue.)

Detailed Summary​

Here's a detailed summary of the video transcript, focusing on the key topics and arguments, excluding any sponsor announcements or advertisements:

  • What is a Bunion?

    • A bunion is a transverse instability at the junction between the midfoot and forefoot.
    • The bone shifts to the outside, creating a visible "out pouching."

  • Surgical Repair of Bunions

    • Surgery often involves shaving part of the bone and realigning the toe.
    • The metatarsal is often pinned to the cuneaform to stabilize the area of instability.
    • Pinning addresses alignment, but doesn't strengthen the muscles that contribute to the bunion's formation.
    • Caution advised, surgical intervention may not be successful.

  • Bunion Development

    • Bunions are not congenital (you're not born with them).
    • Genetic predisposition (e.g., connective tissue laxity, hypermobility) may be a factor.
    • Early intervention with appropriate footwear (toe box that allows toes to splay) is important, especially if there's a family history of bunions.

  • Footwear and Bunions

    • Flat nail beds with adducting toes often indicate bunions caused by footwear.
    • Rotated nail beds suggest a lack of rotational control in the foot.

  • Personal Experience

    • Speaker has bilateral bunions from wearing pointe shoes.
    • Bracing feet led to weakness, strengthening and proper shoes were more effective.

  • Hammer Toes

    • Hammer toes are when toes (typically two through five) start to hammer the ground.
    • Caused by muscle imbalance, specifically weakness in the foot.
    • Short toe extensors are overworked, while long toe extensors are not.
    • Short flexors aren't doing anything while long flexors are.

  • Hammer Toes and Metatarsal Pressure

    • Pain on the bottom of the foot, especially under the 2nd or 3rd metatarsal, indicates excessive pressure in that area.

  • Environmental Trigger for Hammer Toes

    • Similar to bunions, hammer toes are attributed to lack of attention to foot health and function.
    • Wearing restrictive footwear (like mittens for your feet) for extended periods leads to dysfunction.