Rothbarts Foot. The white arrow points to the supinatus (elevated and inverted) of the hallux and first metatarsal when the foot is placed into its anatomical neutral position (subtalar joint congruity).

A commonly used hip joint prosthesis (implant)
A bunion is a swelling of tissue and/or an enlargement of bone around the joint at the base of the big toe (1st metatarsophalangeal articulation). The big toe may turn towards the second toe (displacement), and the tissues surrounding the joint may be swollen and tender (See Animation below). Today, the term bunion is usually used to refer to the abnormal (pathological) bump on the inside of the big toe joint. The bump is the swollen bursal sac and/or an osseous (bony) deformity that has grown on the inside of the big toe joint.

The term ‘hallux valgus’ or hallux abducto valgus’ are the most commonly used medical terms to describe the bunion deformity, where ‘hallux’ refers to the big toe, ‘valgus’ refers to the abnormal rotation of the big toe, and ‘abducto’ refers to the abnormal drifting or leaning of the big toe towards the second toe.
The symptoms associated with a bunion deformity include swelling of the bunion joint, irritation and redness of the skin surrounding the bunion joint, joint pain, and a possible shift of the big toe toward the other toes.
In most cases, two factors must be present before a bunion deformity can develop: (1) foot twist, and (2) out toeing (abducted) foot position. The interplay between these two factors and the development of a bunion deformity are discussed below.
Foot twist (technically referred to as pronation), when excessive, disrupts the structural stability of the entire foot (Zitzlesperger, Elftman). In essence, foot twist allows the big toe to float towards the second toe. Typically this only happens if the foot is excessively abducted (pointing outwards).
This outward pointing of the foot, in the presence of foot twist, can dramatically distort the structure of the 1st metatarsophalangeal articulation. That is, the metatarsal bone shifts inward and the hallux (big toe) shifts outward (e.g., the classic bunion deformity). Wearing tight shoes with pointed toes can rapidly accelerate these shifts in the metatarsal and hallux.
Bunions are frequently treated in a variety of ways including changes in shoe gear, padding and shielding the bunion joint, rest, ice, anti-inflammatory medications, steroid injections and surgery . However, all of these therapies only treat the symptoms of the bunion (pain or joint misalignment) and not the cause. In order to effectively treat the bunion and eliminate the pain, the cause of the excessive foot twist must be addressed.
The two most common causes of foot twist are the Rothbarts Foot and the PreClinical Clubfoot Deformity. The only effective therapy to eliminate foot twist resulting from either of these foot structures is termed Rothbart Proprioceptive Therapy .
Professor/Dr. Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot Structure and the PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Inventor and Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain
References:
Zitzlesperger S 1960. The mechanics of the foot based on the concept of the skeleton as a statically indetermined space framework. Clinical Orthopedics (American) 16:47-63
Elftman H 1960. The transverse tarsal joint and its control. Clinical Orthopedics (American) 16:41.
Surgical intervention on the feet is frequently done for bunions, heel spurs, hammertoes and post tibial nerve entrapments. In some cases the surgery is very successful in correcting the subjective complaint and eliminating the foot pain. However, if you have one of two inherited, abnormal foot structures (the Rothbarts Foot or the PreClinical Clubfoot Deformity); the surgical intervention can actually end in failure and exacerbate the pain.
Let’s look at two surgical interventions - for nerve entrapments and bunions - and see why surgery for these problems is not a solution.
Let’s start with some information about the Rothbarts Foot and the PreClinical Clubfoot Deformity:
If you were born with the Rothbarts Foot or the PreClinical Clubfoot Deformity, your bunion or nerve entrapment is frequently a symptom of these foot structures. That is, having one of these abnormal foot structures can result in the formation of a bunion or a nerve entrapment. This is why:
Post Tibial Nerve Entrapment: Both the Rothbarts Foot and PreClinical Clubfoot Deformity force the foot to excessively pronate (twist) during stance phase of gait (walking). This foot twist can compress the post tibial nerve between the surrounding connective tissue and the medial malleolus (inner ankle bone). This nerve entrapment can produce a sharp, lancinating and debilitating pain.
Surgery for Nerve Entrapments: Frequently this nerve entrapment is surgically treated by releasing (cutting) the soft connective tissue around the entrapped post tibial nerve in an attempt to reduce the compression on the nerve. However, cutting this soft connective tissue can result in scarring and hardening of this tissue. If this occurs, the post tibial nerve is now being pushed up against the inner ankle bone by hard connective tissue instead of soft connective tissue. This results in more pain.
The solution: In order to eliminate the pain produced by an entrapment of the post tibial nerve you must eliminate the cause, and not merely treat the symptom of the entrapment (your pain). And that cause is the foot twist being generated by either the Rothbarts Foot or the PreClinical Clubfoot Deformity.
Eliminating this foot twist is accomplished by Rothbart Proprioceptive Therapy, a non invasive treatment that naturally decompresses the nerve. As a result, the nerve is eliminated.
Bunions: Both the Rothbarts Foot and PreClinical Clubfoot Deformity force the foot to excessively pronate (twist) during stance phase of gait (walking). This foot twist destabilizes the 1st metatarsal phalangeal joint, which can distort this joint’s alignment. The distortion of this joint's alignment is referred to as a bunion.
Surgery for Bunions: Frequently the alignment of the 1st metatarsal phalangeal joint is surgically corrected by remodeling the joint. However, the foot twist resulting from either the Rothbarts Foot or the PreClinical Clubfoot Deformity continues. The surgically corrected bunion is weaker than the joint was before surgery. The result is that the continuing foot twist can reproduce the bunion within several years. You now have a weaker foot, more prone to be destabilized by the foot twist.
The solution: In order to eliminate the pain produced by bunions you must treat the cause, and not merely treat the symptom of the bunions (your pain).
If you have a Rothbarts Foot or PreClinical Clubfoot Deformity, you must eliminate the foot twist caused by these foot structures, as it is this foot twist that is responsible for the formation of the bunion.
Eliminating the foot twist coming from the Rothbarts Foot or PreClinical Clubfoot Deformity is done by Rothbart Proprioceptive Therapy. If done early enough, this therapy can stop the bunions from getting larger and more disfiguring, and in some cases can actually diminish the size of the bunion.
As you learn more about my innovative therapy, you may find that addressing and effectively treating your foot structure may be the missing link to ending your long time battle with unrelenting muscle and joint pain.
If you would like to read more information about the Rothbarts Foot and the PreClinical Clubfoot Deformity, go to: How Chronic Pain Resulting From The Rothbarts Foot And The PreClinical Clubfoot Deformity Can Be Eliminated.
If you would like to make an appointment with me to see if I can help you to permanently eliminate your foot pain, go to: Schedule a Consultation
Professor/Dr. Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot Structure and the PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Inventor and Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain
Professor/Dr. Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot Structure and the PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Inventor and Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain
Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain
Professor/Dr. Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot Structure and the PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Inventor and Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain
Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain
Professor/Dr. Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot Structure and the PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Inventor and Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain
Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain