Bunion night splints

Discussion in 'Ask the Docs' started by NickW, Jul 25, 2012.

  1. AnneTanne

    AnneTanne Barefooters
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    About the heriditability aspect...
    I'm not a podiatrician, but I know that recent research seems to suggest that at heriditary aspects may contribute at least to bunions (hallux valgus) in people under 60.
    A collegue of mine (an orthopedic surgeon) told me hallux valgus in children definitely runs in SOME families en is than heridited through the mother with an uneven penetration of about 70 %.

    But like also in my domain of medicine... I'm sure that both genetics and environmental factors come into play here...
    What is inherited is probably a weaker/predisposing bone structure , that through the use of high heels and/or shoes with a narrow toe-case leads to the deformation. (predisposing bone structure: bigger angle between first and second metatarsal, sometimes accompanied by an additional articulation between the bases of the two metatarsals, as my collegue explaned me.)
     
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  2. Neil_D

    Neil_D Chapter Presidents
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    Most health insurance is a con anyway. Coming from the UK where it's paid from your taxes is much fairer as it is in Australia. I've never had insurance as I believe by its nature it is discriminative. I've always learned to take care of myself.
     
  3. Longboard

    Longboard Chapter Presidents
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    Nick, you need to find a doc that participates in your plan. But remember, it sounds like you are looking for PF relief not involving orthotics, shoes, or surgery.
    The information you need is available from sources other than a doctor's consultation, for example right here in the BRS.
     

  4. Longboard

    Longboard Chapter Presidents
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    Thank you for the well thought out and written overview of the bunion etiology. Instead of editing down the quote I left the whole thing because it bears repeating. Too often forums like this one include speculation as if it's fact, confusing readers who have not done their own research.
    As you know there is a very well established genetic link, as well as an environmental cause.
    Some 60 year old women have worn pointy heels for life and aside from a shortened achilles tendon show no other pathology, while some teenage girls who wore "sensible" shoes require surgery at a very young age.
     

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  5. NickW

    NickW Guest

    LB, I just haven't found a bf friendly pod around here other than Dr Ray, and unfortunately Dr Ray doesn't ACCEPT insurance. He gives you forms so you can be reimbursed, but you still have to pay out of pocket in the first place... I have followed sock docs advice for pf, I've followed my old pod's advice, I've followed many different advices on pf and so far nothing is really working all that well. I spend a good half hour a day or more doing the exercises, rolling, mashing a couple of the trigger points that I know are actually trigger points, and stretches in addition to now wearing shoes to try to combat this pf. In any case, that's neither here nor there, I just wish our system wasn't flawed so that drs wouldn't feel the need to not accept insurance. I would prefer to be able to have a choice in being able to go to Dr Ray. Unfortunately that's not the way it is.
     
  6. Neil_D

    Neil_D Chapter Presidents
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    Hi Longboard,
    It might be helpful if you can point us to some of the information of the genetic links so we can read this and have an informed opinion.

    Cheers

    Neil
     
  7. AnneTanne

    AnneTanne Barefooters
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  8. SillyC

    SillyC Barefooters
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    Oh, thanks AnneTanne - I ran out of time and was going to post links to these exact studies.
     
  9. Dr. Nirenberg

    Dr. Nirenberg Barefooters
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    Bunions can occur from many reasons. The general school of thought in the podiatry world is that bunions can be hereditary. I have seen photos of natives who never wore shoes and have bunions. However, I have not seen a study proving it. However, most of the time bunions are the result of tight-fitting shoes and/or poor mechanics of the foot. Depending on the severity, you can lessen them in some cases to the point of barely being visible with stretching, getting out of shoes or wearing shoes with a wide toe box or wearing correct toes. I wore correct toes for an extended period of time and wrote about them on my site and you can read about them there. I do recommend them. Once a bunion is at a certain point with arthritic changes, stretching may lessen them but is unlikely to make them disappear.
     
  10. Dr. Gangemi_SockDoc

    Dr. Gangemi_SockDoc Barefooters

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    This makes me think of the research done by Weston Price and his studies on Aborigine tribes in the 1930s. Basically they were cavity free and had healthy, wide jaws with no dental problems (Price was a dentist) until the Western diet (refined foods) was brought in. Then significant structural changes were seen in future generations even before those affected were consuming the unhealthy foods. So these changes too could be considered "genetic" but really what happened was the population was altering their genetic expression because of the dietary/environmental changes. Is there a similar correlation to hallux valgus and bunions? I don't know but I think you can make a strong case for it, unless non-shoe wearing natives are truly eating a wholesome, unaltered diet - pretty hard to find today as most of those tribes have become wiped out. It's so hard to study "healthy" humans since in most studies healthy simply means cancer and disease free.
     
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  11. Sid

    Sid Barefooters

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    So were those 3 generations of shoe-wearing family members? Would they have had bunions, had they worn shoes with nice wide toe-boxes (if available back then)?
    I didn't pay the $31.50 for the article, so I can't say judge what evidence this statement is based on.
    So without shoes, would metatarsus primus varus cause hallux valgus, or would most people's feet end up like this native?
    [​IMG]

    Then, what is the incidence of pronation with and without shoes?

    Thought question: What is the incidence of hallux valgus in the fossil records/remains of predominantly barefoot cultures?
     
  12. Dr. Gangemi_SockDoc

    Dr. Gangemi_SockDoc Barefooters

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    That is the question Sid. I like the thought question. It's a good discussion. BTW - pronation is normal. Shoes often limit normal pronation (and sometimes even normal supination).
     
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  13. Sid

    Sid Barefooters

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    Definitely. Environment has changed a lot, and thus, so has phenotypic expression.
     
  14. Longboard

    Longboard Chapter Presidents
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    Price's photographs of Aborigines on their native diets illustrate dental structures so perfect as to make the reader wonder whether these natives were wearing false teeth. But like all the other primitive groups Price studied, the Aborigines soon succumbed to rampant tooth decay and disease of every type when they adopted the "displacing foods of modern commerce" - white flour and sugar, jams, canned foods and tea. Children born to the next generation developed irregularities of the dental arches with conspicuous facial deformities - patterns that mimicked those seen in white civilizations.

    This is the only reference I could find, and it isn't really clear whether or not the children of the next generation were exposed to the refined sugars during their primary dentition years or not. I would assume that they were, why would'nt they be?
    Does anyone have a link to a reference describing what was being implied by Dr. Gangemi?
     

  15. Longboard

    Longboard Chapter Presidents
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    Thanks Ann!
     

  16. Sid

    Sid Barefooters

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    Though I am fortunate enough to have insurance, sometimes I find it simpler to just pay the provider. That way, it's just between me and them, and no intermediary to skim profits or limit my care. The provider and I can negotiate a fair price, rather than one that is set by the insurance company. No deductibles to mess around with, either.

    I'm resigned to the fact that I'm pretty healthy and that my premiums go to pay for the care of others who may be less fortunate or less apt to take care of themselves. I also have it for family members.

    But yeah, if I need something big and expensive done, then hey, my insurance number is on my RoadID!
     
  17. Sid

    Sid Barefooters

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    No specific link. However, bone development is related to maternal diet, so it seems quite possible. In utero is an environment too and quite possibly the most important one. (I'll have to remember to thank Mom, the next time I talk with her.)
    Bone mass in childhood is related to maternal diet in pregnancy
     
  18. Sid

    Sid Barefooters

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    A question for SockDoc:
    Regarding the picture that I posted above with the native. Would that be within accepted normal variation of the foot, or would it be expected to cause problems at some point due to being flatfooted or otherwise?

    I watch a decent amount of documentaries, and I've seen fairly wide feet in barefoot populations, but not to that extent.
     
  19. Dr. Gangemi_SockDoc

    Dr. Gangemi_SockDoc Barefooters

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    I'm not sure Sid. I'd say yes it's normal because the toes are lined up nicely and the foot is naturally wide. I'm sure many have noticed that going barefoot for some time naturally widens your foot; I have.

    There is no problem with being flat footed - the arch of the foot has little if any relationship to function. More on that here (and research too in this post I wrote for those who need research to see validity in anything).
    http://www.drgangemi.com/2012/03/flat-feet/
     
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  20. Sid

    Sid Barefooters

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    I respect and admire your frankness.
    As well as your expertise and opinion.
    Thanks for the informative link and all of the great information!
     

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