I am developing a bunion on my right foot and it is increasingly painful to climb. I worry that my moderately aggressive climbing shoes have worsened the problem, as the toe-box pushes the big toe toward the middle of the foot. I basically can’t edge on my right foot at all, and it now hurts to run/walk more than a mile. If I have surgery, will I ever be able to edge, fully weight my foot, or smear? Is there a shoe you can recommend to use in the meantime? 

Kat / Rock and Ice forum

Ah, the old hallux abducto valgus deformity. The lump, which is mostly formed when the head of the first metatarsal tilts sideways, is usually painful and becomes increasingly difficult to accommodate even in generous footwear, let alone a climbing shoe.

There is a general consensus that bunions are caused by footwear. The more the shoes mess with your toes, the more likely you are to develop a bunion. There is also a bunch of research that suggests you can’t get a bunion unless you are genetically predisposed, even if you wear ridiculous high heels.

Don’t get me wrong about high heels. I love it when Hottie wears stilettos, but I would never expect her to walk in them—that would just be silly.

There is nothing in the conservative-management paradigm that will help you don a climbing shoe short of cutting a hole to allow your bony bulge some pressure relief. Opioidstrength painkillers could add some fun to your day but, like all drugs, long-term use will cause you more suffering.

Bunion operations have progressed greatly in the last 20 years. What used to be basic carpentry is now more about engineering, and can produce both an aesthetically pleasing and functional outcome.

Not only will you climb again but you will be able to use your inside edge! There are a few caveats, however. Climbing shoes, like your red stilettos, will not be recommended footwear, so do your best to be reasonable. Fit them a little bit less for performance and more for comfort. Think of it this way, loose shoes are better than no shoes. Horribly uncomfortable may get you up that polished granite slab, but it will also garner the wrath of your surgeon when you sit back down in her office 10 years from now.

Choose an asymmetrical shoe that minimizes sideways push on the big toe. A good rule of thumb is that if you can put them on with socks, not only will you look French, your toes will have some breathing space.

At all other times wear comfortable shoes (or no shoes). If your toes can rattle, the fit is perfect.

 

Does climbing in the cold (Like New England winter sport-climbing) cause you to increase capillary circulation to your hands? During my first few climbing sessions last winter my fingers felt as if they would freeze off. But later that winter, the same temps and cold rock didn’t feel that bad. If there is a peripheral vascular adaptation to the cold, would this pay off in spring as you are increasingly able to perfuse crimping muscles and remove metabolic waste? Just imagine the headlines: Freeze your fingers today, send tomorrow! 

Pat Bagley / Rock and Ice forum

Geez, Pat, you know how to throw a curly ball. When subject to cold temperatures, your body tries to conserve heat by superficial vasoconstriction. The result is in an increase in peripheral resistance that forces blood to evacuate from your forearms through fewer vessels. Outcome: Coke-bottle pump.

The palms have a capillary bed that is even more important for thermoregulation. When these constrict due to cold, and you squeeze the blood out of your finger tips, your fingers go numb by virtue of reduced blood perfusion, and the small muscles in the hand (largely used for fine motor control, though they do contribute to finger power) become cold and oxygen starved, i.e, you will feel like a stroke victim trying to knit.

Over a short period, winter, there are not likely to be marked increases in vascularization, but rather an increased tolerance to lactic acid in conjunction with reduced resistance from deeper capillary beds and venous capacity.

You probably adjust your behavior to accommodate cold without even realizing it. Thermal wear, long-sleeved thin tops, etc., all help to increase and maintain internal temperature. This in turn reduces peripheral resistance.

I dare say you approach routes differently as well, selecting ones that are less finger-intensive early on, or at least have a shake out jug not far into the route, on which you can allow your forearms some time to recalibrate and get some blood moving through.

Freezing for fitness purposes seems a little arduous. Try putting a constriction bandage around your forearm instead, as essentially that would achieve the same result and is not conditions dependent.