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q-and-a

Q:I just wondered whether you would be able to give me some advice. Later this year I will be having a bunion operation and, being a leisure runner, I am concerned how this will affect my fitness as I won’t be able to run for a minimum of two months.

Any tips to keep my fitness up without using my feet would be greatly appreciated,
and how to get back into running after recuperation.

Gill B, Cardiff.

A) I’m not sure of the history of your bunion and treatment/advice you’ve already had, but before you take the plunge with surgery, I’d advise you to get a second opinion/assessment with a biomechanics coach, podiatrist or a really good physio. Someone who understands the biomechanics of running and the loading which has potentially led to the bunion developing in the first place.

There are lots of exercises you can do which may help to reduce the load through the joint and reduce your symptoms. In my experience I’ve found that people who have a biomechanical weakness, which leads to excessive pronation, are prone to developing a ‘bunion’ as the joint becomes ‘overloaded’ during running and walking, often developing over many years.

Of course genetics and footwear also play a part and I don’t know your history, so it’s hard to advise. Getting better movement/function through the hallux joint itself with exercises and improving your pelvic function – with release exercises for your pelvis/glutes and glute stability exercises – may help as well. You may find you need to work on glute max and glute med in particular – so ask a physio or biomechanics coach for advice.

It’s also important to ensure you wear running shoes with a roomy toebox and make sure your toe isn’t being restricted when you run. You may find an orthotic helps or kinesiology tape for the joint. I’m not sure how bad your bunion is, but unless it’s extremely painful or preventing you from running, I’d look at alternatives to surgery first. If surgery remains your only option and you decide to go ahead, then you’ll need to avoid running for the first 6-8 weeks post op, then gradually introduce some short jog/walk sessions and see how it feels.

In those first 6-8 weeks there’ll still be lots you can do. Take the opportunity to do some Pilates and strength work –
adapt the moves to reduce pressure on your foot – and get really strong and robust before you start running again. Using an indoor stationary bike is probably your best bet to maintain CV fitness – try mixing it up with interval sessions to keep things interesting. As the wound heals, you’ll be able to swim – although front crawl may be more comfortable than breast stroke.

I always advise using a foam roller and massage ball to release tight muscles both pre and post surgery. Increased bed rest and sofa time will cause rapid muscle loss and tightness, so work on this as soon as you feel able. Have a look at TP Therapy for more information and check out their videos on YouTube ‘Trigger Point Therapy Tuesday’.

Longer term – regardless of whether or not you have the surgery – make sure your biomechanics and movement patterns are good and your knee joints are in good alignment without any excessive stress on the medial line. Work on strength training, especially glutes and quads and include lots of cross training in your programme as well as running.

However, before you commit I’d fully recommend you get more advice and don’t rush into surgery. You should be able to find a biomechanics coach biomechanicseducation.com or mama.solutions

Check out our dedicated Training Section for more help.

Coach Sarah Russel has over 20 years experience in the fitness industry as a running coach, trainer, freelance writer and athlete.

She also has a Masters degree in Sport Science and is a qualified England Athletics running coach sarah-russell.co.uk