Bunions (Hallux Valgus): Causes, Stages & Treatment Options That Actually Help

If you’ve noticed a bony bump forming at the base of your big toe, you’re not alone — and you don’t have to just live with it. Bunions (medically known as hallux valgus) affect an estimated 23% of adults aged 18–65 and become even more common as we get older [1]. The good news is there’s plenty you can do long before surgery enters the picture. Here’s everything you need to know about what causes bunions, how they progress, and how bunion treatment in Bassendean at The Wellness Place can help you stay active and pain-free.

What Exactly Is a Bunion?

A bunion isn’t a growth or a tumour — it’s a progressive deformity of the foot. The medical term is hallux valgus, which describes what’s happening beneath the surface: the big toe (hallux) starts angling inward toward the second toe (valgus), while the long bone behind it (the first metatarsal) shifts in the opposite direction. That bony bump you see is the head of the metatarsal protruding at the joint.

Over time, this misalignment puts pressure on the joint, leading to inflammation, pain, and — if left unmanaged — arthritis and further deformity. The earlier you catch it, the more you can do to slow or even halt its progression.

What Causes Bunions?

There’s no single cause, but a few key factors tend to play a role:

Genetics

Bunions have a strong hereditary link. If your parents or grandparents had them, you’re more likely to develop them too. Research points to inherited foot mechanics — things like flat feet, hypermobile joints, or an unusually long first metatarsal — that predispose the foot to instability at the big toe joint [2].

Footwear

This is the factor you can control. Narrow, pointed shoes and high heels squeeze the toes into an unnatural position and load the forefoot with excessive pressure. While shoes don’t cause the underlying structural tendency, they absolutely accelerate the deformity in someone who’s already predisposed [3].

Foot Mechanics

How you walk matters. People with overpronation (flat feet that roll inward) put extra stress through the big toe joint with every step. This repetitive loading can slowly push the joint out of alignment over years and decades.

The Stages of a Bunion

Bunions don’t appear overnight. They progress through three broad stages:

Mild

The big toe has started deviating slightly — less than 20 degrees on X-ray. You might notice a small bump when you look at your feet, but there’s minimal pain, if any. At this stage, the joint is still well-aligned and highly responsive to conservative care.

Moderate

The bump is more visible, and the big toe is pushing closer toward the second toe (hallux valgus angle of 20–40 degrees). You may experience intermittent pain — especially in tighter shoes — along with redness or swelling after long periods on your feet. This is the stage where most people start seeking help.

Severe

The big toe is now overlapping or being pushed under the second toe (angle greater than 40 degrees). Pain becomes more persistent. The second toe may develop corns or hammer toe from the constant rubbing, and the joint itself can become arthritic. Mobility and balance may also be affected, increasing the risk of falls.

Non-Surgical Treatment: What Actually Works?

Surgery gets a lot of attention, but the vast majority of people with bunions never need it. Conservative management — done properly — can relieve pain, slow progression, and keep you moving well. Here’s what evidence-backed care looks like:

Footwear Modifications

Switching to shoes with a wide toe box, low heel, and good arch support is the single most effective change you can make. Your toes need room to spread naturally — your shoes should match the shape of your foot, not the other way around.

Toe Spacers & Orthotics

Custom orthotics prescribed by a podiatrist can correct the underlying biomechanics — think of them as re-aligning the foundation your foot works from. Toe spacers help keep the big toe in a straighter position, reducing pressure on the joint during weight-bearing activities.

Padding & Taping

Simple gel pads or moleskin applied over the bunion can reduce friction in shoes and relieve discomfort. Taping techniques can temporarily support the joint and offload stress during activity.

Foot Exercises

Strengthening the intrinsic muscles of the foot — the small muscles that control toe movement — can improve joint stability. Exercises like toe spreads, towel curls, and resisted abduction of the big toe help maintain function and slow progression.

When Is Surgery Needed?

Surgery is generally considered when pain persists despite good conservative care, the deformity is severe enough to interfere with daily life, or arthritis has developed in the joint. There are over 100 different surgical techniques for bunions — your surgeon chooses based on the angle of your deformity, joint health, age, and activity level.

Recovery varies. Traditional open bunionectomy typically involves 6–8 weeks in a special shoe or boot, followed by a gradual return to normal footwear and activity. Minimally invasive techniques are gaining popularity and often offer faster recovery, but not every bunion is suitable for them.

The key point: surgery should be a well-considered decision made after you’ve exhausted non-surgical options — not a first resort.

How Podiatry Can Help: Meet Dr Aaron Gregory

At The Wellness Place in Bassendean, our podiatrist Dr Aaron Gregory takes a thorough, hands-on approach to bunion management. Aaron brings more than just clinical expertise to the table — he’s a former competitive athlete who represented Australia at the World Cross Country Championships, so he genuinely understands how important it is to keep you doing what you love.

As a sports podiatrist, Aaron doesn’t just look at your foot — he looks at how you walk, how you stand, and what demands you’re placing on your body. He’ll assess your foot mechanics, check for contributing factors like overpronation or muscle weakness, and put together a personalised bunion treatment plan that fits your lifestyle.

This might include custom orthotics to correct your gait, specific strengthening exercises to stabilise the joint, footwear advice tailored to your daily activities, and manual therapy techniques to improve joint mobility. The goal is always to manage your bunion conservatively for as long as possible — saving surgery for when it’s genuinely needed.

Because The Wellness Place is a multidisciplinary clinic, Aaron can also collaborate with our physiotherapists and exercise physiologists if your bunion is affecting the way you move through your hips, knees, or lower back. It’s all under one roof — and it means your care is genuinely coordinated.

Don’t Wait Until It Hurts to Walk

Bunions are progressive — they don’t get better on their own. But with the right advice and early intervention, you can keep them from taking over your life. Whether you’re in the early stages and want to prevent things from getting worse, or you’re already dealing with pain and looking for real solutions, we’re here to help.

Call us today on (08) 9379 3838 to book an appointment with Dr Aaron Gregory and take the first step towards pain-free feet. You don’t have to put up with bunion pain — let’s get you moving comfortably again.

Why Rest Alone Won’t Fix Your Plantar Heel Pain (And What Actually Works)

If you’ve been dealing with a sharp, stabbing pain in the bottom of your heel every time you take those first steps out of bed in the morning, you’re not alone. Plantar heel pain is one of the most common foot complaints we see at The Wellness Place in Bassendean — and, frustratingly, one of the most misunderstood. The old advice of “just rest it” or “stay off your feet” might feel sensible, but the evidence tells a very different story. In fact, modern research shows that the right kind of loading — not rest — is often the key to recovery. Here’s what you need to know.

First, Let’s Get the Name Right: It’s Not Just “Plantar Fasciitis” Anymore

You’ve probably heard the term plantar fasciitis. The “itis” ending suggests inflammation — like tonsillitis or tendonitis. But here’s the thing: when researchers have actually looked at tissue samples from people with chronic plantar heel pain, they’ve found something surprising. Instead of inflammatory cells, they see degenerative changes — collagen disorganisation, micro-tears, and a notable lack of the usual inflammatory markers. (1)

That’s why many clinicians and researchers now prefer the term plantar fasciopathy or plantar fasciosis. It’s not that there’s zero inflammation in the very early stages, but for most people, the condition is driven by repetitive strain and failed healing — a degenerative process rather than a purely inflammatory one. This distinction matters, because it changes how we treat it.

Not All Heel Pain Is Plantar Fasciopathy

One of the most important steps in getting the right treatment is getting the right diagnosis. Plantar heel pain can come from several different sources, and treating the wrong one is a recipe for frustration. At The Wellness Place, our podiatrists and physiotherapists work together to distinguish between:

Fat Pad Atrophy

As we age, the natural cushioning pad under our heel bone can thin out, losing its shock-absorbing ability. This tends to cause a deep, bruising ache right in the centre of the heel — different from the medial arch pain of plantar fasciopathy. It’s more common in people over 40 and those who spend a lot of time on hard surfaces.

Baxter’s Nerve Entrapment

The first branch of the lateral plantar nerve (known clinically as Baxter’s nerve) can become compressed as it passes near the heel bone. This can mimic plantar fasciopathy quite closely, but the pain is often more burning or electric in nature, and may radiate slightly differently. This is a diagnosis that an experienced podiatrist or physio can pick up on with a careful hands-on assessment.

Calcaneal Stress Fracture

A hairline fracture of the heel bone can produce heel pain that gets worse with weight-bearing activity and doesn’t improve with warming up. If you’ve recently increased your running volume or training load significantly, this is one to consider. Imaging like an X-ray or MRI may be needed to confirm it.

Getting an accurate diagnosis is the first and most important step — which is why our multidisciplinary team approach at TWP is so valuable. Your podiatrist, physiotherapist, and massage therapist can each contribute a piece of the puzzle.

What Evidence-Based Treatment Actually Looks Like

So, if rest isn’t the answer, what is? The good news is that we have a strong evidence base for several treatments that genuinely work. Let’s walk through them.

1. Calf Stretching (But There’s a Catch)

Stretching the calf muscles — particularly the gastrocnemius and soleus — has been a cornerstone of treatment for decades, and for good reason. Tight calves place excess strain on the plantar fascia. However, research over the last decade has shown that stretching alone is often not enough, especially for chronic cases. Think of it as a helpful foundation, not the whole treatment.

2. The Rathleff Protocol: High-Load Strength Training

This is one of the most exciting developments in plantar heel pain management. In a landmark 2015 randomised controlled trial, Dr Michael Rathleff and his team showed that a progressive high-load strength training programme — specifically, unilateral heel raises performed with a towel under the toes to engage the windlass mechanism — produced superior outcomes compared to plantar-specific stretching alone, with benefits sustained at 12-month follow-up. (2)

The protocol is simple in concept but requires proper guidance: starting with 3 sets of 12 repetitions and progressing up to 5 sets of 8 repetitions over 8 weeks, performed every second day. It’s a perfect example of why the right kind of loading beats rest — you’re essentially building strength and resilience into the tissue, not just hoping it settles down on its own.

3. Night Splints

Night splints keep the ankle in a neutral or slightly dorsiflexed position while you sleep, providing a gentle, prolonged stretch to the calf and plantar fascia. The evidence suggests they can be particularly helpful for that dreaded “first step in the morning” pain. (3)

4. Orthotics

Custom or prefabricated orthotics can offload the painful area and support the arch, reducing strain on the plantar fascia. At TWP, our podiatrist Dr Aaron Gregory takes a thorough biomechanical assessment to determine whether orthotics are appropriate for your specific foot type and activity level.

5. Shockwave Therapy

Extracorporeal shockwave therapy (ESWT) delivers acoustic waves to the affected area, stimulating the body’s natural healing response. A 2024 systematic review and meta-analysis confirmed ESWT as an effective and well-tolerated treatment for plantar fasciopathy, particularly for people who haven’t responded to other conservative treatments. (4) We offer this at TWP as part of our podiatry and physiotherapy services.

6. Dry Needling

Dry needling targets trigger points in the calf and intrinsic foot muscles that can refer pain into the heel. A 2024 systematic review found that dry needling is effective in reducing pain and restoring function in patients with plantar fasciitis, with moderate-quality evidence supporting its use. (5) Our physiotherapists and massage therapists can incorporate this into your treatment plan.

Why the Multidisciplinary Approach at TWP Works So Well

Here’s the thing about plantar heel pain: it’s rarely just a “foot problem.” Tight calves, weak glutes, poor hip stability, and even the way you walk can all contribute. That’s why a single-practitioner approach sometimes falls short.

At The Wellness Place, we’re a multidisciplinary allied health clinic in Bassendean, which means your care can involve:

• Podiatry with Dr Aaron Gregory — biomechanical assessment, orthotics, shockwave therapy, and expert diagnosis
• Physiotherapy — strength and loading programmes like the Rathleff protocol, movement retraining, and dry needling
• Remedial Massage Therapy — releasing tight calves, plantar fascia, and foot intrinsic muscles to complement your active treatment

Our clinicians talk to each other. Your podiatrist’s findings inform your physio’s exercise prescription, and your massage therapist works on the areas your physio identifies as tight. It’s coordinated, it’s efficient, and it gets results.

So, What Should You Do Next?

If you’ve been dealing with heel pain for more than a few weeks — or if you’ve tried resting, changing shoes, or Googling exercises without success — it’s time to get a proper assessment. Plantar heel pain is stubborn, but it’s also very treatable when you use the right approach.

The team at The Wellness Place Bassendean can help you get to the bottom of your heel pain (pun intended) and build a personalised treatment plan that actually addresses the root cause.

Give us a call on (08) 9379 3838 to book an appointment.

You don’t have to put up with heel pain. Your first step toward recovery starts with the right advice — and we’re here to help.

Why Does the Ball of My Foot Hurt? A Guide to Forefoot Pain Causes and Treatment

Forefoot pain — that sharp, burning, or aching sensation in the ball of your foot — is more common than most people realise. It can turn a simple walk to the shops into a miserable experience and stop you from doing the activities you love. Fortunately, most causes of forefoot pain are highly treatable once you get the right diagnosis.

If you’re limping through your day in Bassendean or the surrounding Perth suburbs with pain under the front of your foot, you’re not alone. Forefoot pain affects roughly 10% of the general population at any given time, with prevalence rising significantly in older adults and those who spend long hours on their feet (Bowen et al., 2024; Dunn et al., 2004). The good news? Our podiatry team at The Wellness Place — led by experienced sports podiatrist Dr Aaron Gregory — can help you identify exactly what is going on and get you back to moving pain-free.

What Exactly Is Forefoot Pain?

“Forefoot pain” is a broad term that describes discomfort in the ball of your foot — the padded area between your arches and your toes. This region bears a huge amount of weight every time you take a step, and when something goes wrong, even standing still can hurt.

The tricky thing about forefoot pain is that many different conditions can cause very similar symptoms. That’s why a proper diagnosis is the critical first step. At The Wellness Place in Bassendean, we take the time to listen to your story, examine your foot mechanics, and use diagnostic imaging when needed to pinpoint the underlying cause.

Common Causes of Forefoot Pain

Morton’s Neuroma

One of the most well-known causes of forefoot pain, Morton’s neuroma is a benign thickening of the nerve tissue between the metatarsal bones — most often between the third and fourth toes. People describe it as feeling like they’re “walking on a marble” or a bunched-up sock. Symptoms typically include burning pain, tingling, or numbness in the forefoot that radiates into the toes. Tight shoes and high heels often make it worse, while removing your shoes and massaging the area can bring temporary relief (Cleveland Clinic, 2023).

Metatarsalgia

Metatarsalgia is a general term for pain and inflammation in the metatarsal heads — the knuckle-like ends of the long bones in your forefoot. It’s essentially a overload injury of the ball of the foot, often caused by high-impact activities like running and jumping, wearing unsupportive footwear, or carrying excess body weight. The pain is usually felt as a dull ache that worsens with standing or walking (Mayo Clinic, 2024).

Stress Fractures

A stress fracture in the metatarsal bones is a small crack caused by repetitive force, rather than a single traumatic event. These are especially common in runners who rapidly increase their training volume and in individuals with osteoporosis. The hallmark symptom is pain that gets worse with activity and improves with rest, along with pinpoint tenderness when pressing on the affected bone.

Freiberg’s Disease

Freiberg’s disease — also known as Freiberg’s infraction — is a less common condition involving avascular necrosis (loss of blood supply) to the metatarsal head, usually the second metatarsal. It most frequently affects adolescent girls and typically presents as stiffness, swelling, and localised pain around the affected joint. Early diagnosis is important, as conservative treatment with activity modification, orthotics, and sometimes immobilisation can often prevent the need for surgery (Merck Manual, 2024).

Capsulitis

Capsulitis refers to inflammation of the ligament (capsule) that surrounds the joint at the base of your toes. It is most common at the second toe and can be a precursor to more serious problems like a plantar plate tear or a dislocated toe. Symptoms include swelling at the base of the toe, a feeling of instability, and pain when pushing off during walking or running. Early treatment with taping, footwear changes, and orthotics can prevent the condition from progressing (NHS Kent Community Health, 2025).

Sesamoiditis

The sesamoids are two tiny, pea-shaped bones embedded in the tendons beneath the big toe joint. Sesamoiditis is an overuse condition where these bones become inflamed, typically affecting dancers, runners, and those who spend a lot of time on tip-toes. The pain is felt directly under the big toe joint and can make bending the big toe extremely uncomfortable. Conservative treatment — rest, ice, cushioned footwear, and orthotics — is effective for the vast majority of cases (AAOS, 2024).

How Is Forefoot Pain Diagnosed?

Getting the right diagnosis starts with a thorough consultation. Your podiatrist will ask about your symptoms, activity levels, and footwear habits, and then perform a physical exam to assess foot posture, range of motion, and tender areas. Depending on what they find, they may recommend:

• X-rays — to check for stress fractures, Freiberg’s disease, or arthritis
• Ultrasound — to visualise Morton’s neuroma, capsulitis, or plantar plate tears
• MRI — for detailed assessment of bone and soft tissue structures

Treatment Options for Forefoot Pain

Footwear Modification

One of the simplest and most effective treatment strategies is changing what you put on your feet. We recommend shoes with a wide toe box, good arch support, and a stiff sole to reduce pressure on the forefoot. High heels and pointed-toe shoes are best avoided while your foot is healing.

Custom Orthotics

At The Wellness Place, our podiatrists design custom foot orthotics that are tailored to your unique foot shape and biomechanics. These devices redistribute pressure away from painful areas, support optimal foot function, and can make an enormous difference for conditions like metatarsalgia, Morton’s neuroma, and sesamoiditis.

Activity Modification and Rehabilitation

Sometimes you simply need to give your foot a break. Reducing high-impact activities, cross-training with swimming or cycling, and following a structured rehabilitation program can allow inflamed tissues to settle and prevent the problem from returning.

Injection Therapy

For stubborn cases, ultrasound-guided corticosteroid injections can provide powerful anti-inflammatory relief directly to the affected area. This is particularly effective for Morton’s neuroma and capsulitis, where inflammation is a major driver of symptoms. Our team can discuss whether this option is appropriate for you (StatPearls, 2024).

Other Conservative Options

Ice therapy, non-steroidal anti-inflammatory medications (NSAIDs), stretching programs (particularly for the calf muscles and plantar fascia), and manual therapy all play a role in managing forefoot pain and preventing recurrence.

Why Choose The Wellness Place for Forefoot Pain Treatment in Bassendean?

When you visit our Bassendean clinic, you’re not just seeing a podiatrist — you’re stepping into a multidisciplinary allied health team where your podiatrist, physiotherapist, chiropractor, exercise physiologist, and massage therapist can all collaborate on your care. This means your treatment is coordinated, comprehensive, and tailored to you.

Dr Aaron Gregory leads our podiatry team. A former state-level basketballer and Australian representative at the World Cross Country Championships, Dr Aaron understands the demands active people place on their feet. He brings a genuine, caring approach to every consultation — because, as he puts it, “like most things in life, it’s the simple things done consistently and well that produce the best results.”

Ready to Put Your Best Foot Forward?

You don’t need to live with forefoot pain. Whether you’ve been struggling for weeks or years, the right diagnosis and treatment plan can make all the difference.

Call us today on (08) 9379 3838 to book an appointment with Dr Aaron Gregory or another member of our podiatry team at The Wellness Place, 103 Old Perth Road, Bassendean. Let’s get you back on your feet — pain-free.