Everything Runners Need To Know About Bunions with Doctor Brad Schaeffer

Finn Melanson [00:00:13]: Hello, fellow runners. I'm your host, Finn Melanson, and this is the Run to the Top podcast, The podcast dedicated to making you a better runner with each and every episode. We're created and produced by the expert team of coaches at runnersconnect dotnet, where you can find the best running information on the Internet as well as training plans to fit every runner, every budget. Roughly 20 5% of US adults suffer from bunions. And whether you knew it or not, there's actually such a thing as National Bunion Day. That's only a few days away. Given the time of year and the applicability to our community, I figured it'd be a good topic of conversation. For runners like us, bunions often result from the repeated stress of hitting the pavement, wearing shoes that are too tight, as well as having flat feet or over pronation to aggravate the problem.

Finn Melanson [00:01:08]: With that context in mind, I invited doctor Brad Shaffer, who you may know from the hit TLC show, my feet are killing me, onto the pod to talk about the issue. Doctor Schaeffer trained at the comprehensive foot and ankle reconstructive surgical residency program at the Hoboken University Medical Center and is a board certified foot surgeon with the ABFAS. In this episode, we talk about the causes of bunions, the symptoms of bunions, what to keep in mind if you have them and you're running with them, how to treat them nonsurgically, and some of the latest cutting edge procedures out there to take care of them fast with quick recovery. CBD is perhaps one of the most innovative and misunderstood supplements in the endurance world right now. The biggest advantage of CBD for a runner like you is the anti inflammatory properties. CBD can help your muscles heal and recover faster. Additionally, CBD can help you sleep better which also helps to better rest and improved recovery times. What CBD will not do is make you high.

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Finn Melanson [00:04:05]: Doctor Brad Schafer, it is great to have you on the show. How are you doing today?

Guest [00:04:09]: Thank you. I'm doing great. Thanks for having me.

Finn Melanson [00:04:13]: Pleasure to have you here. And yeah. As I was preparing for this episode, there was a a stat that I came across that that kinda blew me away, and it's that roughly 1 in 4 US adults suffer from bunions. And we're actually about a week away from National Bunion Day, which is which is relevant. I'm sort of curious about the history of this. Like, are we at a point where that percentage of adults that suffer from this condition, is it increasing? Has it has it been that way forever? Is it decreasing? Talk about sort of the state of that statistic.

Guest [00:04:45]: I mean, that's a that's a good question, for the stat people of the world. I I don't fully know. I know that, you know, butt ins are some of the main things that we treat as podiatrists, foot and ankle surgeons. Have I seen a rise in it? Not necessarily. You could probably ask somebody that's been in practice 30 years if they've seen a rise in it, but I haven't really studied those stats.

Finn Melanson [00:05:08]: What is a bunny by the way? Just for people that that aren't familiar, how how would you define it? What's the cause?

Guest [00:05:15]: Sure. It's yeah. It's a great question. So you need to be born with a bunion. You can get it from your family, parents, things like that. You can get it from trauma or the shoes that you wear and just kind of your activity. So a bunion is a bump on the inside of the foot, and it's kind of that, protuberance, so to speak, and it's really when your bone goes off to the side and then your big toe goes in, and it can create a lot of pain when you're walking on that area. It can create bruising, fractures, and just overall discomfort, let alone being unsightly.

Guest [00:05:49]: You know, they're not the cutest thing to have in the world. So when you're in pain every step that you have, that bump starts to become red. It starts to become bruised, and then you alter your gait cycle, which is the way that you walk, and you develop a myriad of different issues from your knees to your hips to your lower back. So it's so important, that you get it checked out even if you have a small one, and to get it taken care of sooner rather than later.

Finn Melanson [00:06:16]: You mentioned you can be born with them, but I'm sure there are people that develop them too. Are are there any things that people do in their in their day to day lives that exacerbate this issue that that sort of that create bunions? Because, yeah, you're you're talking to a running audience here, and I know that I'm sure there are probably 25% of the people sitting here that that are dealing with this or could be dealing with this soon.

Guest [00:06:38]: Absolutely. You know, at the end of the day, it's improper shoe gear, you know, trying to fit into tighter shoes, maybe high heels or flats or, you know, tight boots, work boots, things like that. It can really squeeze the front of your foot and kind of put your toes in. Whenever you're walking, you can either be flat footed or high arched or sometimes neutral, which is, you know, the way that we'd like to be. If you overpronate and you're flat footed, everything kind of collapses in. And when everything collapses in, the toes, as you see, start to go out and then you develop a bump here, and that bump is, you know, the bunion. Now other foot deformities and issues like that can cause bunions too. But if you're not supported up, you know, and every step that you take isn't in a neutral position, you can do that with inserts, you do that with proper shoes, and different things like that.

Guest [00:07:37]: That's what's going to support your foot for the long term. So really improper shoe gear activity, you know, people that really pound their feet every day, whether you're working outside, whether you're running miles every day and not supported properly in the right shoes, All of those things contribute, to bunions progressing a lot faster than they should.

Finn Melanson [00:07:59]: And is this something that could just be cosmetic or at some point in time, in addition to the pain, you're gonna have to deal with it one way or another?

Guest [00:08:10]: I mean, at at the end of the day, I think pain's relative. Pain can be, you know, every step that you take. Pain can be, you know, just sometimes just say when you're running or pain can be you just look down and you hate to see that bump. You know, you're going to the beach every day and you hate the look of, you know, the way that that is, and it makes you feel a certain way. So I would say just to get an exam, get it checked out, whether you have a baby bunion with a little bump, you know, we can treat that pretty 1, 2, 3, maybe with orthotics, insert, proper shoes. Or if it's a bigger bunion, we have different surgeries out there that we can do. They're very streamlined nowadays. Back in the day, it used to be a lengthy recovery process.

Guest [00:08:56]: Now one of the things that I specialize in is this, like, 3 d bunion procedure. It's called a lapoplasty. 10 out of 10, get you back on your feet within 2 weeks and you're back to your activity within a couple months. It's just, you know, the way to go right now for the long term fix. So you just need to get it checked out and see what procedure you need.

Finn Melanson [00:09:20]: What enables that, pretty expedited recovery?

Guest [00:09:25]: You know, it's really just technology. You know, back in the day, we used to fixate bunions with 2 screws on the top of the foot and really just shift the head of the bunion bump over and then put 2 screws in there and hold it together. That's fine. Still works and it still has a place in surgery. But if you really fix a bunion at the base and you shift that whole bone over in a three d plane, everything realigns straight, and that's with a plating system or a staple system. And that's the technology that's out now. A lot of different people are trying to do exactly what I'm talking about right now, but the 3 d bunion procedure, it's called a laparoplasty. That is like the game changer that I absolutely love doing.

Finn Melanson [00:10:11]: And what would would there be any reasons to go the route of the the the prior surgery option to this? Talk about those.

Guest [00:10:18]: The the head procedure? Yeah. Yeah. There there's there's definitely a place for that. And really, it's just like if you have a little bump, sometimes you can go in there and just shave the bump a little tiny bit, just so whenever you're running, it's not creating that friction on the bump. So that's someone that might have a little arthritis or maybe a baby bunion. If it's a little off to the side, yeah, you can shift the head over a little bit or you can do a procedure just at the top of the, at top of that joint, which is just really the toe. It's called your hallux. It's your big toe.

Guest [00:10:53]: So you can do a procedure there too. So there there's a lot of different procedures that can be done for bunions. But if you have a little mild, moderate to severe, I always go with, fixing it at the base, fixing it where it started, and I do that with a 3 d button procedure.

Finn Melanson [00:11:12]: One thing I'm curious about in in that case, so obviously a great outcome in in the sense that you you sort of fundamentally fixed something and people can get back to exercise or quality of life relatively fast. Do you advise them on the underlying issues that may have created the bunny? And though, like, for the people that weren't born with it, do you say, like, look, if you don't want a recurrence or regrowth, whatever you wanna call it, like, you need to wear these types of shoes. Here's your exercise protocol. Like, how do you how do you advise patients for sort of movement patterns that will make sure that this doesn't happen again?

Guest [00:11:47]: Yeah. You're exactly right. It's biomechanics. So you, you know, you do a biomechanical exam on the patient. You do a gait analysis on the patient, before to make sure we understand why they're developing that. Look, if you're an overpronator and you develop a bunion from that and hammertoes or whatever, that's because you're an overpronator. We can fix the bunion all day. You know, we can get that straight, but you're still going to collapse in.

Guest [00:12:15]: So we then have to, raise the arch, get you in a neutral position so you're not putting so much pressure on that area, which is what caused the bunion in the 1st place. So, yeah, you're a 100% right. You yes. You treat the issue, but you have to treat the overall problem too. And that's treating over pronation, over supination, things like that.

Finn Melanson [00:12:39]: When people are running with bunions, are there any symptoms they may be experiencing that might not be localized to that area of the foot, like like knee issues or hip issues? Any other indicators that there's a problem here and and I should get this checked out?

Guest [00:12:55]: Yeah. Great question. You know, whenever someone has an issue with their foot, I always say, like, our feet are our body's natural stabilizers and shock absorbers. So that's kinda like where your initial shock is coming from, and that has a ripple effect up through the knees, hips, lower back, and things like that. I used to have an issue with my left foot. I used to do like a lot of plyo. So I would explode up, come down, and I had this thing in the front of my foot called an aroma. So that was an inflamed nerve, and a lot of runners get it too.

Guest [00:13:27]: And they're painful. So I would always alter the way I jump and land, and then it started creating hip problems with me and then led to back problems. So, yeah, it it has a ripple effect, whether it be a bunion or another foot problem, pain, you know, you definitely have to get that taken care of because it it just creates havoc on the rest of your body.

Finn Melanson [00:13:51]: Talk to about, I guess, your overarching mission here, which is to raise awareness about the issue and and eliminate the stigma. I I wasn't even aware there was a stigma associated to talk about that.

Guest [00:14:02]: Sure. You know, feet are an interesting part of our body. You know, some people are, you know, ashamed of their feet. Some people find them gross, disgusting. Some people find feet sexy. I mean, there is a, like, a weird thing out there with feet straight up. So whatever level you fall on, you know, you can really cover up that shame and embarrassment with socks and shoes. Whenever you have an opportunity to cover it up with socks and shoes, it's just one part of our body that we can kinda like forget.

Guest [00:14:30]: You know, the outside world's not seeing. We can kind of, you know, cover up that shame. We have to educate people that, a, it's not embarrassing, it's not shameful, everyone has foot issues, and you can cut it off at the past. If you just get routine foot exams with your local podiatrist, kind of like you go to the dentist, you know, you go to the dentist every 6 months or so, you just get your teeth cleaned real quick, Dentists will give you an x-ray every year or whatever. That's really what your feet need. Your feet need just a general checkup. You can get fungus check, bacteria, skin checks for cancer, and different things like that, but you're also gonna get x rays. You're gonna get a gait exam and make sure that you're doing everything possible to literally keep you on the right track.

Finn Melanson [00:15:17]: That whole concept of relating this to the dentist and having a general checkup is great. I'm a trail runner in my personal life. I'm looking down I probably got 4 black toenails that I could rip off at any given moment. So

Guest [00:15:29]: I've had I've had that so much. On your second toe is the most common. Yeah. But That's what a lot of runners get.

Finn Melanson [00:15:38]: How come 4? That big toe. I have 4. It's it's I'm I'm an embarrassment.

Guest [00:15:43]: Yeah. No. That's okay. Listen. You're doing what you love. When whenever you jam in the front of the foot, really, a lot of times that second toe is what hits first. Sometimes people have a longer second toe, and it's actually pretty common. So that's just what hits first.

Guest [00:15:59]: It's kinda like you heel strike, you know, you're proning proning proning and it's kinda just slides forward first.

Finn Melanson [00:16:07]: Yeah.

Guest [00:16:08]: So it's you have that are all jacked up.

Finn Melanson [00:16:11]: It's it's 234? Pretty much the it's 234 on both sides. And I I don't know if it's a fit issue. Should I be sizing up with my with my footwear? Yeah. I'm I'm not sure.

Guest [00:16:22]: You know what? It's a great question. I love to run. I love activity. I'm very involved in sports, but a runner's mentality is a lot different than I'll say, like, I had with athletics. So you guys would you're either different sizing, you know, ideas, different inserts, you know, ideas, more, you know, like, barefoot runners versus, like you know, you guys are all across the spectrum, so I don't necessarily know. I just start with what I know. I do a gait analysis, check you out, and then advise. But some people like a tighter fitting shooter running, and some people like a a little a little more room.

Guest [00:17:05]: I can't figure y'all out, to be honest. It's a different philosophy. Yeah. Yeah.

Finn Melanson [00:17:12]: Yeah. Last question I have for you. You kind of already addressed it with, sort of, the checkup. But do you have any other advice in general for for foot care, especially for runners? Like, you talked about sort of that periodic checkup with a podiatrist. But anything else we should be doing on a daily basis or a weekly basis to, you know, pay attention to that area as much as we pay attention to, like, our teeth and other areas of our body?

Guest [00:17:36]: Sure. Yeah. Listen, shoes, socks, and insoles are gonna be a lifesaver for a runner. If you get a gait analysis by a podiatrist or even at a running store, you know, they do really good things. You're gonna see, you know, where you land, how your heel strike is, and how to, you know, correct it or fix it for the long term. And that can be done with the shoe, that can be done with an insole, or a custom orthotic from your local podiatrist. Look, educating people about feet is my life. Like, I absolutely love it.

Guest [00:18:11]: I think it's super important. You know, don't cover up that shame and pain. You know, you can get it taken care of and not have that issue. Going to someone, getting an X-ray, and seeing how your bones are, it's pretty cool. And it's something that you just can keep with you that you know that you might have an issue here. You might develop an issue later, and this is how we can correct it. So you maybe don't have to do a surgical procedure like we were just discussing, but at least you're talking to someone that knows there are options out there and how to fix them so you're not in pain for years years years. Because for a while, foot issues, surgeries, things like that, that had like a horror story back in the day.

Guest [00:18:54]: And it's just because, you know, the foot is very intricate. There are a lot of tendons, vessels, and things in there that are, you know, very tough to treat. But nowadays with the training, we really have it figured out to where we can get you back doing what you love and, with a minimal invasive surgery is literally just the way to go nowadays if needed if needed.

Finn Melanson [00:19:17]: We will make sure to link to the procedure in your offerings in the show notes. I said that was the last question, but I have one more. You have a TV show, My Feet Are Killing Me. Talk about that.

Guest [00:19:27]: Yeah. Sure. TLC, you know, they they do a lot of great things out there, but one thing they do is they educate about different issues that we have. You can ever do go from doctor pimple popper to, you know, pimples on on the face and body, skin issues, to feet issues. So really just head to toe issues that, you know, we deal with. My feet are killing me on TLC. Great show. Five seasons running.

Guest [00:19:51]: It's been a blessing and, a lot of people out there are, you know, finally understanding that other people are dealing with this, and when you're seeing it on TV that it's able to be fixed, you know, pretty straightforward, then they're going to their local podiatrist and saying, hey. I saw doctor Brad on this TV show. You know? Can you help me out like that? And then most people can't. So, podiatrist can definitely help you out with anything foot or ankle related.

Finn Melanson [00:20:21]: Doctor Brad, thank you so much for your time. It's been a pleasure chatting.

Guest [00:20:24]: Sure. I appreciate

Finn Melanson [00:20:40]: Thanks for listening to the Run to the Top podcast. I'm your host, Finn Melanson. As always, our mission here is to help you become a better runner with every episode. Please consider connecting with me on Instagram at wasatchfin and the rest of our team at Runners Connect. Also consider supporting our show for free with a rating on the Spotify and Apple Podcast players. And lastly, going to runnersconnect.netback/podcast. Until next time. Happy trading.