Choosing running shoes with bunions

Related guides

• Stiff big toe · When the joint itself is stiff and sore.
• Forefoot pain · Pain under the ball of the foot as well.

Before you change shoes

A shoe is one of several things that load this area, and usually not the biggest. Before or alongside a shoe change, look at how much you run, how fast, how hilly, and whether anything changed recently. If your current shoes are comfortable and not worn out, you may not need new ones.

What helps more than the shoe: Room, not correction: no shoe or exercise has been shown to straighten a bunion. In a trial in painful bunions, foot orthoses eased pain at six months compared with no treatment, but at a year surgery was clearly more effective; surgery is an option when pain limits daily life despite roomy shoes. (Torkki 2001)

What loads it

What to look for in a shoe

Room inside, where the bump is

The bump sits at the widest part of the forefoot: check the forefoot width (inside) first; the toe box width, measured near the big toe, shows room for the drifting toe. The width of the sole underneath says little about room for the bump. Many models also come in a wide fit.

A foot-shaped toe box

The toe box shape compares the width near the toes with the widest part of the forefoot, from photos of the sole outline. A higher value means less taper, so the big toe is pushed inwards less.

A soft upper over the joint

Knit or mesh without seams, overlays or stiff bands where the bump sits. Press it with your thumb in the shop: it should give.

A stiff, rockered forefoot if the joint is stiff

If the big-toe joint itself aches or barely bends, a stiff forefoot with an early rocker lets the shoe roll instead of the joint bending; the stiff big toe guide has more on this.

Where the load goes

A roomy toe box takes pressure off the bump without moving load elsewhere. A stiff, rockered forefoot takes the bend out of the big-toe joint but moves work to the ankle and calf; a wide but flat, flexible shoe lets the toe bend as much as before.

What to be careful with

• Narrow, pointed toe boxes, and racing shoes with tight, stiff uppers for everyday running.
• Seams, overlays or logos across the bump.
• Going up a size only to get width: the widest part of the shoe then sits in front of the joint and the heel slips; choose a wider model or a wide fit instead.

Terrain

Best

Road and treadmill, where push-offs are even.

Be careful with

Steep uphills and sprinting, which bend the big toe furthest, and long downhills, where the foot slides forward into the toe box.

Trail

Trail shoes are often narrower and stiffer at the toe; look for a foot-shaped trail shoe and lace firmly over the midfoot so the foot does not slide forward on descents.

Combine the shoe with

Lacing

Skip the lowest eyelet, or lace loosely at the front, so the shoe can open around the bump.

Pads and sleeves

A gel sleeve or pad over the bump reduces rubbing for some runners; it takes up room, so try it with the shoe.

Orthoses

Eased pain in the short term in a trial; a shoe with a removable insole and enough depth makes room for one.

Check in the shop

• Bend the shoe: it should bend at the ball of the foot (or barely at all, for a stiff big toe or forefoot pain), never in the middle.
• Twist it: it should resist.
• Press the heel counter with your thumb: it should not collapse.
• Length and width: about a thumb's width beyond the longest toe, and the widest part of your foot over the widest part of the sole.
• Try shoes later in the day, in your running socks and with any insert you use.
• Judge comfort over a few real runs, including some at your usual pace, not only in the shop.

What the research shows

Each point says whose evidence it is: runners, walking, a clinical group not studied while running, or mechanical reasoning that has not been tested.

• How common bunions areClinical evidence, not in runners

  Pooled surveys put bunions at about 23 % of adults aged 18–65 and 36 % of people over 65, and more common in women (30 %) than in men (13 %). (Nix 2010)

• Narrow shoesClinical evidence, not in runners

  In 176 people aged 62–96, most wore shoes narrower than their feet, and shoes substantially narrower than the foot went with bunions, corns and foot pain. A single survey shows an association, not that shoes cause bunions. (Menz 2005)

• Orthoses and surgeryClinical evidence, not in runners

  In 209 people with painful bunions, foot orthoses reduced pain at six months compared with a waiting list, but surgery was clearly more effective at a year. Running was not studied. (Torkki 2001)

• Room in the toe boxMechanical reasoning, not tested

  A wider, less tapered toe box presses less on the bump. We found no trial of running-shoe toe boxes for bunions.

Not known

• Whether any running-shoe feature changes bunion pain or progression in runners.
• Whether toe spacers or foot exercises change a bunion.

Switching to these shoes: weeks 1–6

A common way to introduce a new shoe, as a rule of thumb rather than a tested plan:

Weeks 1–2

One or two short, easy runs a week in the new shoe; the rest in your current pair.

Weeks 3–4

If the mornings after are no worse, about half of your easy runs.

Weeks 5–6

Long runs, then faster sessions.

Bigger changes take longer: a drop 4 mm or more lower, 10 mm or more of stack difference, a first plated shoe, much more toe spring (a strongly rockered shoe), or zero drop, which can take months. In one study, more than half the runners who moved to minimalist (barefoot-style) shoes, gradually over 10 weeks, showed early bone stress in the foot on scans. (Ridge 2013)

• Do not change shoes in the same weeks as you increase mileage or speed.
• Do not race in a shoe you have not run in several times, including at race pace.

For this area: A roomier toe box needs no adaptation, but many of the roomiest shoes have a low or zero drop, which is a big change if you come from 8 mm or more. If you also move to a stiffer, more rockered shoe for a stiff joint, expect push-off and calf work to feel different for a few weeks.

How big is your change? Compare your current shoe with a new one

Keeping more than one pair in use was linked to fewer injuries in an observational study of recreational runners. (Malisoux 2015) Use the list as a shortlist of a few shoes to try on, then let comfort decide: researchers have proposed that runners choosing the shoe that feels most comfortable tend to pick one that suits how they move. That is a proposal, not a proven rule. (Nigg 2015)