The symptoms of a bunion are enlarged bones at the base of the big toe. A hallux valgus presents as angulation of the big toe away from its normal linear alignment. These symptoms can occur individually or simultaneously.

What causes bunions and hallux valgus?

Both bunions and hallux valgus result from poor foot function caused by wearing shoes that are too tight or too stiff in the toe area.

Bunions and hallux valgus occur when the foot excessively pronates and when the arches collapse while walking or running.

When this happens, toes are pointed outward so that the foot rolls off the inside of the ball of the foot when walking with all the torsional forces concentrating there. With each step, the ball of the foot (or 1st metatarsal head) rubs against the shoe and a bunion forms over time. The bone enlarges and soft tissue thickens at the points of intermittent pressure.

Bunion Hallux Valgus

Change in the size and shape of bones is accompanied by damaging soft tissue stress that leads to inflammation and pain.

Hallux valgus occurs when narrow shoes or shoes with pointy toe boxes force the toes to realign.

Excessive Foot movement

Over time, the foot’s bony structure and soft tissue maladapt to the shape of the shoe’s toe box.

Footwear with narrow, pointy and stiff toe boxes further contributes to the functional maladaptation of overpronation.

This is why bunions and hallux valgus are commonly observed together.

For proper function, our feet require the Right Stimulus and the Right Movement.

Right Stimulus consists of the subtle varied stimulus that the soles of our feet receive when we walk, especially when we walk barefoot on natural terrain. With each step, there are subtly different sensations.

These subtle differences in stimulus keep our brain on high alert so that our body’s protective reflexes function properly with optimal muscle function.

When our brain is uncertain about what will happen, it triggers protective reflex muscle activations that support our arches before our feet contact the ground to ensure that our feet and legs can safely manage the forces generated by the activity intensity of our bodies.

As activity-related stimulus intensifies, a progressively higher arch is created. That is why, when they are functioning properly, our arches and toes rise and fall dynamically in response to the varying activity stimulus intensities. This uninhibited dynamic movement is Right Movement.

Right Stimulus and Right Movement prevent excessive pronation, as well as maladaptive bone and soft tissue modeling.


Conventional footwear impairs optimal foot function in two ways:

First, most conventional footwear dampens Right Stimulus.

This is particularly true for shoes or insoles that support or cushion our feet. They spread the forces evenly across the soles of our feet, creating sensory input that is muted and repetitive, step after step. Within a short period of time, our brain tunes out the stimulus and stops responding to it.

As a result, our brain doesn’t sufficiently activate the muscles that stabilize our arches and properly align our feet, legs, hips, and lower back, before our feet contact the ground. This “tuned-out” brain response is natural and happens all the time. For example, the same thing happens when we walk into a room and first smell coffee that we no longer notice after only a few minutes.

Soft Cushy Insole

Second, most conventional footwear, especially footwear that’s tightly laced, has snug toe boxes or stiff midsoles or outsoles, restricts the Right Movement dynamic raising of the arches and toes that is critical in the creation of a strong stable arch system and healthy linear propulsion with the toe off forces spread across the forefoot.

Footwear with narrow, pointy, and stiff toe boxes doesn’t just impede Right Movement, it contributes to the maladaptation of bone and soft tissue.

Wearing footwear that dampens Right Stimulus and impedes Right Movement can create the damaging stresses that cause bunions and hallux valgus.


Conventional treatment methods for bunions and hallux valgus include:

  • Braces
  • Supportive products such as orthotics
  • Modified or more roomy footwear
  • Therapeutic exercise and
  • Surgery

While these methods may temporarily alleviate symptoms, they don’t address the poor neuromuscular function that is the cause of the problem. In fact, the more we artificially support or cushion our feet, the weaker and the more dependent we become on these types of products.

These “old school” support and cushioning treatment methods are not recommended in any other area of musculoskeletal medicine as a viable long-term treatment option.

In fact, modern treatment methods for poor neuromuscular function focus on increasing mobility, muscle strength, and proper alignment via Proper Technique exercise, which requires both Right Stimulus and Right Movement. Science has shown that simply challenging the body to “do its job” is the best way to restore and enhance function.

This principle is the foundation for virtually all of today’s sports training/rehabilitation programs.

Recommendations to address the poor neuromuscular function that causes bunions and hallux valgus and prevent them from reoccurring:

  • Walking barefoot on natural terrain as much as possible. This provides the optimal Right Stimulus and allows for the Right Movement required for healthy neuromuscular function.
  • To obtain Right Stimulus in your conventional footwear, use BioPods® Stimsoles® and, for best results, use them in loosely laced, soft, flexible footwear that allows your arches and toes to rise easily.
  • Consult with your healthcare practitioner to ask about employing soft tissue mobilization therapies to address the fibrotic scar tissue that may have formed, prior to using BioPods products.