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There's a twist happening in your knee on every stride you run You can't feel it But it's there, and a 2025 study measured exactly how much With a bunion, the knee turns inward an extra 2.59 degrees on every single step It sounds small But the knee is a hinge — built to bend straight, not twist So even a couple degrees is force landing where the joint was never meant to take it And that's just walking On a run, you're driving that twist into the joint thousands of times an hour Mile after mile The whole time, you feel nothing Until the day you start to You know the mile where the knee shows up Early on it's quiet, you feel good, you're moving Then somewhere out there the ache arrives — the one that turns the back half of the run into a negotiation You've started planning around it Shorter loops on the bad days The long run you used to look forward to, now the one you're not sure the knee will let you finish You've had it looked at New shoes, a strength routine, maybe a session with someone who watched you run and handed you drills It helps for a few weeks Then it comes back It comes back because none of it touched the twist Here's where the twist comes from The study authors had a name for it — the ripple effect A problem at the base of the chain doesn't stay at the base It travels up And the base, in this case, has been sitting in your shoe the whole time On the inside of your foot there's a small muscle — the abductor hallucis — whose only job is to hold your big toe in line Every step is supposed to load it, fire it, reset it When it fires, the foot loads the way it's built to and the force that travels up to the knee is clean When it goes quiet — slowly, over years, without a moment you'd point to — the big toe drifts The joint at its base pushes out the other way That's the bunion The weight rolls to the outside of the foot And the knee starts taking that inward twist on every step to absorb a push-off that's no longer straight Every appointment you've aimed at the knee has been treating the joint that's receiving the twist Not the foot that's sending it You can check whether that muscle's gone quiet in about ten seconds Sit down, shoe and sock off, foot flat on the floor Try to pull your big toe out to the side — away from the other toes — without lifting it and without curling it under Slides out easily? The muscle's still working Barely moves? It's gone quiet Whole foot rolling to fake it? That's your answer If it's been quiet a while, every step you've run has sent that twist up into the knee And here's the part most runners don't let themselves think about The bunion sending that twist doesn't sit still It drifts further every year you run on it The knee damage is one price of that drift But the drift has a second destination Left alone long enough, the bunion reaches the point where the only thing left to straighten it is surgery The exact surgery you've been hoping you'd never need And foot surgery is the one that takes a runner off the road Not weeks Months Months off your feet while the bone heals Watching the base you spent years building drain away — the long runs, the pace, the easy miles that used to be automatic — while you sit and wait And at this age, it doesn't come back at the rate it left The first run back starts from a number you haven't seen since you were a beginner That's the road the knee is quietly pointing you down The same drift wearing your knee is the drift carrying you toward the table There's a way to change what the foot sends up before it gets there Not a brace, not a night splint, not something you wear instead of a shoe A soft sleeve that fits over the front of the foot and sits inside whatever shoe you're already in — including your running shoe You lace up the same way you always do Nothing changes about the fit or the feel Adjustable tension draws the big toe back toward its line and keeps the abductor hallucis loaded while you move During the day During the miles During the exact hours the knee has been taking the twist This doesn't treat the knee It changes what the foot sends up to it — because the muscle that sets the foot's load pattern is being worked instead of going quiet Week one, nothing feels different — the sleeve stays put, the toe stays where it puts it, the twist going up is already smaller, you just can't feel it yet Week three, the morning stiffness is gone before you reach the kitchen Week four, you hit the stretch of a run where the knee always shows up — and it doesn't Week six, someone asks if you changed something in your training The bunion hasn't reversed The toe doesn't go back in six weeks But the twist it's been sending up to the knee on every stride is different now And the run you'd been cutting short is one you finish There's an article below that breaks down the full chain — the study, the muscle, and what the sleeve does that treating the knee never reached The link is below The knee you protect now is the one you're still running on in ten years