Causes and treatment of bunions in dancers and ballerinas

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Common feet and ankle problems in ballerinas and dancers.

How many times have you heard that ballet or dancing causes bunions? ‘Bunions’, medically known as hallux abducto valgus, usually affects the big toe and is commonly highlighted as a risk particularly for dancers. This article discusses the impact of dancing on bunions and other causes of bunions.

What causes bunions in dancers and ballerinas?

If dancing alone caused bunions, we would expect to see all dancers with bunions. Or, we would expect to see only dancers being affected by bunions. Dancing may indirectly be one of many contributing factors leading to bunion formation, but there are a large list of other, non dance-related contributors that have a greater direct impact on a dancer’s risk of developing bunions.


The number one risk factor for developing bunions is a person’s genes. A family history of flat feet (pes planus), hypermobility, a short or dorsiflexed 1st metatarsal or a combination of these factors all increase one’s risk of developing bunions. They do this by impacting the mechanics of the 1st toe and these factors can be objectively measured by your podiatrist.

Foot function

Another contributing factor for the formation of bunions is mechanical and functional change in the foot. These changes may include:

  • Higher demand on the ball of the big toe while walking or whilst completing daily activities

  • Poor foot muscle control which can be due to injury, weakness or slow degeneration over time

  • Strength imbalance between the muscles of the foot vs the leg

  • Collapse of the arch of the foot through the ‘toe off’ portion of walking

Foot function can be tested in many ways, such as a podiatry gait analysis (an analysis of you walking style), reproduction of specific movements and muscle tests.

Environmental factors

Environmental factors also can contribute to the development of bunions, but they more commonly exacerbate bunion symptoms rather than cause them. These factors include wearing narrow footwear, or shoes with pointed toes, shoes with a shallow toe box and wearing shoes that don’t support the rearfoot and midfoot regions. Other environmental factors include activities such as standing for long periods or change of direction sports.

Environmental factors may increase your risk of developing bunions, particularly if you already have genetic and functional foot factors at play. The podiatrists at Performance Podiatry are experienced in helping you to understand which of these are impacting the formation of your bunions.

Which risk factors particularly affect dancers?

Dancers are at as much risk as any other person who displays similar genetic changes or foot function to them, whether they’re a dancer or not. Realistically, it is the environmental risk factors for bunions commonly associated with dance that draw all of the negative attention, but the impact of environmental factors vary too much between each individual dancer to be able to say that dance causes bunions. The environmental risk factors, specific to dancers, that increase the risk of bunion formation include:

  • Tight, stiff, unique footwear that may be inadequate to support some dancers’ foot types

  • More risk of mechanical changes from overloading and fatigue in intrinsic foot muscles than some other sports and activities

  • More risk of injury and imbalance in muscles, ligaments and joint in the forefoot and surrounding the 1st toe than some other sports and activities

  • An environment where joint hypermobility needs to be very well managed by each dancer

  • Pressure for dancers with ‘flat feet’ to ‘work harder’ or wear pre-arched or aesthetically customised footwear that may further exacerbate impaired foot function and posture

  • Flat ground surfaces, often with inadequate shock absorption to match the activities

Most, if not all, of these factors that could predispose dancers to a higher risk of bunions can be improved with the correct management and care. Thus, the misconception that bunions are caused by participation in dance is an oversimplification so large, it borders on a wives tale!

Come and visit our knowledgeable dance podiatrists to have your feet assessed and treated today.

Why dancers should see a podiatrist.

A podiatrist can help to emphasise the specific risks affecting each dancer based on extensive foot function testing, level of experience in ballet and dance, as well as medical and family history.

Make an appointment with our specialist dance podiatrist. 

Tayla Forland is a specialist dance podiatrist and is qualified to treat all podiatry problems. Tayla has completed further specialist training and certifications to assist all dancers with pre-pointe preparation and assessments, pointe shoe fitting and Progressing Ballet Technique (PBT). Tayla has a specialised interest in foot and leg injuries, pain and conditions associated with ballet, dance and artistic sports for clients of all ages and experience levels.

With over 17 years of experience as a dancer, Tayla developed a passion for dance podiatry. This means that she has a specialised interest in foot and leg injuries, pain and conditions associated with ballet, dance and artistic sports for clients of all ages and experience levels.

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