Skip to main content
Book cover

Sports Injuries of the Foot pp 35–48Cite as

Bunions in Athletes

  • 2108 Accesses

Abstract

Hallux valgus generally occurs as a degenerative process, but it also may occur in the athletic population. Bunions may be a hereditary condition or be a consequence of a flatfoot deformity. A majority of bunions in athletes may be a result of overload and trauma. The first metatarsal phalangeal (first MTP) joint is subject to a large portion of weightbearing, especially in the high-level athlete. These forces make the joint susceptible to trauma. Injury to the first MTP joint includes turf toe, sand toe, collateral ligament sprains, and sesamoid complex injuries. Poor management of these injuries may lead to chronic pain, stiffness, and instability of the first metatarsal phalangeal joint, which may result in a hallux valgus deformity in the athlete. Prolonged deformity and pain will decrease an athlete’s performance and may prematurely end their career. Therefore, any athlete presenting with an injury about the first metatarsal phalangeal joint should be examined diligently and promptly treated in hopes to prolong competition. Conservative treatment measures are successful in treating injuries about the first MTP joint, and surgical treatments are to be entertained in certain traumatic conditions, but mostly after the athlete’s career or season comes to an end. Surgical treatment options are focused on restoring the stability of the first MTP joint. In cases of deformity, the surgical options are similar to those of the degenerative bunion, and surgical preferences are used at the surgeon’s discretion.

Keywords

  • Hallux Valgus
  • Proximal Phalanx
  • Metatarsal Head
  • Sesamoid Bone
  • Plantar Plate

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

This is a preview of subscription content, access via your institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-1-4899-7427-3_4
  • Chapter length: 14 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   109.00
Price excludes VAT (USA)
  • ISBN: 978-1-4899-7427-3
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   139.99
Price excludes VAT (USA)
Hardcover Book
USD   199.99
Price excludes VAT (USA)
Learn about institutional subscriptions
Fig. 4.1
Fig. 4.2
Fig. 4.3
Fig. 4.4
Fig. 4.5
Fig. 4.6

References

  1. Hockenbury RT. Forefoot problems in athletes. Med Sci Sports Exerc. 1999;31:S448–58.

    CrossRef  PubMed  CAS  Google Scholar 

  2. Mann R, Coughlin M, editors. Surgery of the foot and ankle: 2-volume set, 8e. St. Louis: Mosby; 1999.

    Google Scholar 

  3. Coker TP, Arnold JA, Weber DL. Traumatic lesions of the metatarsal phalangeal joint of the great toe in athletes. Am J Sports Med. 1978;6(6):326–34.

    CrossRef  PubMed  CAS  Google Scholar 

  4. Bowers Jr KD, Martin RB. Turf-toe: a shoe-surface related football injury. Med Sci Sports. 1976;8:81.

    PubMed  Google Scholar 

  5. Clanton TO, Butler JE, Eggert A. Injuries to the metatarsophalangeal joints in athletes. Foot Ankle. 1986;7:162.

    CrossRef  PubMed  CAS  Google Scholar 

  6. Drakos MC, Taylor SA, Fabricant PD, Haleem AM. Synthetic playing surfaces and athlete health. J Am Acad Orthop Surg. 2013;21:293–302.

    CrossRef  PubMed  Google Scholar 

  7. Stokes IA, Hutton WC, Stott JR, et al. Forces under the hallux valgus foot before and after surgery. Clin Orthop Relat Res. 1979;142:64–72.

    PubMed  Google Scholar 

  8. Nigg BM. Biomechanical aspects of running. In: Nigg BM, editor. Biomechanics of running shoes. Champaign: Human Kinetics; 1986. p. 1–25.

    Google Scholar 

  9. Dedmond BT, Cory JW, McBryde Jr A. The hallucal sesamoid complex. J Am Acad Orthop Surg. 2006;14:745–53.

    PubMed  Google Scholar 

  10. McBryde Jr AM, Anderson RB. Sesamoid problems in the athlete. Clin Sports Med. 1988;7:51–60.

    PubMed  Google Scholar 

  11. Mann R. Biomechanics of the foot and ankle. In: Mann R, editor. Surgery of the foot. 5th ed. St Louis: CV Mosby Co; 1986.

    Google Scholar 

  12. Anderson R. Turf toe injuries of the hallux metatarsophalangeal joint. Tech Foot Ankle Surg. 2002;1:102–11.

    CrossRef  Google Scholar 

  13. Aper RL, Saltzman CL, Brown TD. The effect of hallux sesamoid excision on the flexor hallucis longus moment arm. Clin Orthop Relat Res. 1996;325:209–17.

    CrossRef  PubMed  Google Scholar 

  14. Alvarez R, Haddad RJ, Gould N, Trevino S. The simple bunion: anatomy at the metatarsophalangeal joint of the great toe. Foot Ankle. 1984;4(5):229–40.

    CrossRef  PubMed  CAS  Google Scholar 

  15. Mann RA, Coughlin MJ. Hallux valgus: etiology, anatomy, treatment and surgical considerations. Clin Orthop Relat Res. 1981;157:31–41.

    PubMed  Google Scholar 

  16. Sammarco GJ, Miller EH. Forefoot conditions in dancers—part I. Foot Ankle. 1982;3(2):85–92.

    CrossRef  PubMed  CAS  Google Scholar 

  17. Coughlin MJ, Shurnas PS. Hallux valgus in men: part II: first ray mobility after bunionectomy and factors associated with hallux valgus deformity. Foot Ankle Int. 2003;24:73–8.

    PubMed  Google Scholar 

  18. Coughlin MJ. Juvenile hallux valgus: etiology and treatment. Foot Ankle Int. 1995;16:682–97.

    CrossRef  PubMed  CAS  Google Scholar 

  19. Jones DC, Reiner MR. Turf toe. Foot Ankle Clin. 1999;4:911.

    Google Scholar 

  20. Cortés ZE, Baumhauer JF. Traumatic lateral dislocation of the great toe fibular sesamoid: case report. Foot Ankle Int. 2004;25(3):164–7.

    PubMed  Google Scholar 

  21. Smith TF, Cain TD, Stapp MD, et al. Dislocation injuries of the foot. In: Scurran BL, editor. Foot and ankle trauma. 2nd ed. New York: Churchill Livingstone; 1996. p. 333.

    Google Scholar 

  22. Jahss MH. Traumatic dislocation of the first metatarso-phalangeal joint. Foot Ankle. 1980;1:15.

    CrossRef  PubMed  CAS  Google Scholar 

  23. Sikka RS, Hunkele T, Sugarman E, Myerson MS, et al. Dorsal dislocation of the great toe in a professional football player: case report. Foot Ankle Int. 2012;33(9):798–802.

    CrossRef  PubMed  Google Scholar 

  24. Mata SG, Ovejero AH, Grande MM. Dorsal dislocation of the first metatarsophalangeal joint. Int Orthop. 1988;12(3):237–8.

    CrossRef  Google Scholar 

  25. Good JJ, Weinfeld GD, Yu GV. Fracture-dislocation of the first metatarsophalangeal joint: open reduction through a medial incisional approach. J Foot Ankle Surg. 2001;40(5):311–7.

    CrossRef  PubMed  CAS  Google Scholar 

  26. Hussain A. Dislocation of the first metatarsophalangeal joint with fracture of the fibular sesamoid: a case report. Clin Orthop Relat Res. 1999;359:209–12.

    CrossRef  PubMed  Google Scholar 

  27. Tosun B, Akansel G, Sarlak AY. Traumatic dislocation of the first metatarsophalangeal joint with entrapment of the flexor hallucis longus tendon. J Foot Ankle Surg. 2008;47(4):357–61.

    CrossRef  PubMed  Google Scholar 

  28. Ryan AJ, Behling F, Garrick JG, et al. Artificial turf: pros and cons (round table). Physician Sports Med. 1975;3:41–50.

    CrossRef  Google Scholar 

  29. Meyers MC, Barnhill BS. Incidence, causes, and severity of high school football injuries on FieldTurf versus natural grass: a 5-year prospective study. Am J Sports Med. 2004;32(7):1626–38.

    CrossRef  PubMed  Google Scholar 

  30. Rodeo SA, O’brien S, Warren RF, et al. Turf-toe: an analysis of metatarsophalangeal joint sprains in professional football players. Am J Sports Med. 1990;18:280.

    CrossRef  PubMed  CAS  Google Scholar 

  31. Clanton TO, Ford JJ. Turf toe injury. Clin Sports Med. 1994;13:731.

    PubMed  CAS  Google Scholar 

  32. Frey C, Anderson GD, Feder KS. Plantarflexion injury to the metatarsophalangeal joint (“sand toe”). Foot Ankle. 1996;17:576.

    CrossRef  PubMed  CAS  Google Scholar 

  33. Kadakia RA, Molloy A. Current concepts review: traumatic disorders of the first metatarsophalangeal joint and sesamoid complex. Foot Ankle Int. 2011;32(8):834–9.

    CrossRef  PubMed  Google Scholar 

  34. Debnath UK, Hemmady MV, Hariharan K. Indications and techniques of first metatarsophalangeal joint arthroscopy. Foot Ankle Int. 2006;27(12):1049–54.

    PubMed  CAS  Google Scholar 

  35. Coughlin MJ, Kemp TJ, Hirose CB. Turf toe: soft tissue and osteocartilaginous injury to the first metatarsophalangeal joint. Phys Sportsmed. 2010;38(1):91–100.

    CrossRef  PubMed  Google Scholar 

  36. Altman A, Nery C, Sanhudo A. Osteochondral injury of the hallux in beach soccer players. Foot Ankle Int. 2008;29(9):919–21.

    CrossRef  PubMed  Google Scholar 

  37. Douglas DP, Davidson DM, Robinson JE, et al. Rupture of the medial collateral ligament of the first metatarsophalangeal joint in a professional soccer player. J Foot Ankle Surg. 1997;36(5):388–90.

    CrossRef  PubMed  CAS  Google Scholar 

  38. Fabeck LG, Zekhnini C, Farrokh D, et al. Traumatic hallux valgus following rupture of the medial collateral ligament of the first metatarsophalangeal joint: a case report. J Foot Ankle Surg. 2002;41(2):125–8.

    CrossRef  PubMed  Google Scholar 

  39. Watson TS, Anderson RB, Davis WH. Periarticular injuries to the hallux metatarsophalangeal joint in athletes. Foot Ankle Clin. 2000;5:687.

    PubMed  CAS  Google Scholar 

  40. Mullis DL, Miller WE. A disabling sports injury of the great toe. Foot Ankle. 1980;1:22–5.

    CrossRef  PubMed  CAS  Google Scholar 

  41. Bohay DR, Johnson KD, Manoli A. The traumatic bunion. Foot Ankle Int. 1996;17(7):383–7.

    CrossRef  PubMed  CAS  Google Scholar 

  42. Munuera PV, Domínguez G, Reina M, Trujillo P. Bipartite hallucal sesamoid bones: relationship with hallux valgus and metatarsal index. Skeletal Radiol. 2007;36(11):1043–50 [Epub, Sep. 2, 2007].

    CrossRef  PubMed  Google Scholar 

  43. Kubitz ER. Athletic injuries of the first metatarsophalangeal joint. J Am Podiatr Med Assoc. 2003;93:325–32.

    CrossRef  PubMed  Google Scholar 

  44. Churchill RS, Donley BG. Managing injuries of the great toe. Phys Sportsmed. 1998;26:29.

    CrossRef  PubMed  CAS  Google Scholar 

  45. Bowman MW. Athletic injuries of the great toe metatar-sophalangeal joint. In: Adelaar RS, editor. Disorders of the great toe. Rosemont: American Academy of Orthopedic Surgeons; 1997. p. 1.

    Google Scholar 

  46. King DM, Toolan BC. Associated deformities and hypermobility in hallux valgus: an investigation with weightbearing radiographs. Foot Ankle Int. 2004;25(4):251–5.

    PubMed  Google Scholar 

  47. McCormick JJ, Anderson RB. Rehabilitation following turf toe injury and plantar plate repair. Clin Sports Med. 2010;29:313–23.

    CrossRef  PubMed  Google Scholar 

  48. Tewes DP, Fischer DA, Fritts HM, Guanche CA. MRI findings of acute turf toe. A case report and review of anatomy. Clin Orthop Relat Res. 1994;304:200–3.

    PubMed  Google Scholar 

  49. Schon LC. Assessment of the foot and ankle in elite athletes. Sports Med Arthrosc. 2009;17(2):82–6.

    CrossRef  PubMed  Google Scholar 

  50. Sammarco GJ. Turf toe. Instr Course Lect. 1993;42:207–12.

    PubMed  CAS  Google Scholar 

  51. Grana WA. Cold modalities. In: Drez Jr D, Delee JC, editors. Orthopaedic sports medicine. Philadelphia: WB Saunders; 1992. p. 203–7.

    Google Scholar 

  52. Lillich JS, Baxter DE. Bunionectomies and related surgery in the elite female middle-distance and marathon runner. Am J Sports Med. 1986;14(6):491–3.

    CrossRef  PubMed  CAS  Google Scholar 

  53. McCormick JJ, Anderson RB. The great toe: turf toe, chronic turf toe, and complicated sesamoid injuries. Foot Ankle Clin. 2009;14:135–50.

    CrossRef  PubMed  Google Scholar 

  54. Blundell CM, Nicholson P, Blackney MW. Percutaneous screw fixation for fractures of the sesamoid bones of the hallux. J Bone Joint Surg Br. 2002;84:1138–41.

    CrossRef  PubMed  CAS  Google Scholar 

  55. Anderson RB, McBryde Jr AM. Autogenous bone grafting of hallux sesamoid nonunions. Foot Ankle Int. 1997;18:293–6.

    CrossRef  PubMed  CAS  Google Scholar 

  56. Pagenstert G, Hintermann B, Valderrabano V. Percutaneous fixation of hallux sesamoid fractures. Tech Foot Ankle Surg. 2008;7:107–14.

    CrossRef  Google Scholar 

  57. Biedert R, Hintermann B. Stress fracture s of the medial great toe sesamoids in athletes. Foot Ankle Int. 2003;24(2):137–41.

    PubMed  Google Scholar 

  58. Saxena A, Krisdakumtorn T. Return to activity after sesmoidectomy in athletically active individual. Foot ankle Int. 2003;24(5):415–9.

    PubMed  Google Scholar 

  59. Anderson RB, Hunt KJ, McCormick JJ. Management of common sports-related injuries about the foot and ankle. J Am Acad Orthop Surg. 2010;18:546–56.

    PubMed  Google Scholar 

  60. McCormick JJ, Anderson RB. Turf toe. Anatomy, diagnosis, and treatment. Sports Health. 2010;2(6):487–94.

    CrossRef  PubMed Central  PubMed  Google Scholar 

  61. Brophy RH, Gamradt SC, Ellis SJ, Barnes RP, Rodeo SA, Warren RF, Hillstrom H. Effect of turf toe on foot contact pressures in professional American football players. Foot Ankle Int. 2009;30(5):405–9.

    CrossRef  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopedic Foot and Ankle Center, 300 Polaris Parkway, Suite 2000, Westerville, OH, 43082, USA

    G. Alexander Simpson DO & Gregory C. Berlet MD

Authors
  1. G. Alexander Simpson DO
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gregory C. Berlet MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gregory C. Berlet MD .

Editor information

Editors and Affiliations

  1. Orthopedic Foot and Ankle Center, Westerville, Ohio, USA

    Terrence M. Philbin

Rights and permissions

Reprints and Permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Simpson, G.A., Berlet, G.C. (2014). Bunions in Athletes. In: Philbin, T. (eds) Sports Injuries of the Foot. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7427-3_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-7427-3_4

  • Published:

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-7426-6

  • Online ISBN: 978-1-4899-7427-3

  • eBook Packages: MedicineMedicine (R0)