Active Court Community Facebook ad: “Pickleball players: just a bunion is how they end up on my…”

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If you play pickleball and you've got a bump on the side of your big toe, and somebody told you it's just a bunion, I need you to hear this. I don't give a f*ck if this upsets you. "Just a bunion" is how my patients end up on my table. 24 years. More than 2,000 of them. These days, most of them carry a paddle bag into my office. And last spring I walked into my own kitchen and watched my wife hide her foot from me. My name is Neil Hartman. I'm a foot and ankle surgeon in Tampa. I need you to understand what I mean when I say I've seen 2,000 bunions. I don't mean on an X-ray. I mean I've opened the skin and looked at it. On the outside it's a red, shiny bump. Hot to the touch. Some people have it the size of a grape. Some the size of a walnut. Under the skin there's a sac of fluid sitting right on top of it, swollen and angry from rubbing. You cut through that first. Under that is the bone. The end of the long bone behind your big toe, pushed out sideways where it was never supposed to be. The cartilage on one side is worn down and rough, like an old tire. And the big toe itself isn't pointing straight anymore. It's leaning into the second toe. Sometimes it's pushed so far over, the second toe has been shoved up on top of it. I take a small saw and shave the bump off. It comes off like chalk. Five years ago, my bunion patients were mostly women who'd spent 30 years in dress shoes. Then pickleball took over Tampa. There are courts at every park and every church now. And my waiting room changed. People started walking in with paddle bags. Women in their 50s. Men too. People who'd never had a foot problem in their lives. Same bump. Same red, shiny joint. Just showing up faster. Two years of open play, three mornings a week, and they were sitting on my table. I started a notebook that year. Every pickleball player with a bunion who's sat on my table is in it. There's one I'll never forget. Linda. 52. Dental hygienist. Pickleball four mornings a week. She came to me at 48 with a bump the size of a walnut. She'd done everything she was told. Wide shoes. Toe spacers. Gel pads. Orthotics. So I did the surgery. I shaved the bone and straightened the toe. It looked great on the X-ray. Afterwards she did everything right again. Wide shoes. Spacers at night. Gel pads on the court. Four years later she was back in my office. The bump was bigger than before I operated. Her second toe had been pushed up over the big toe, bent like a claw, with a hard corn on top of it. She sat on my table and tried to take her shoe off. She couldn't, because her sock was stuck to a blister on the side of the bump. She cried while I peeled it off. "I did everything you said." She had. I took the bone off. Then I sent her back into the same kind of shoe. And the shoe put it right back. I sat in my car in the parking garage for a long time that night. The bump is not the problem. The bump is what the problem leaves behind. Look at almost any court shoe. The front comes to a point, like an arrow. Your foot is widest right at the toes, and that's exactly where the shoe gets narrow. So every step, the shoe pushes your big toe in toward the other toes. Every day. For years. The joint at the bottom of that toe has nowhere to go. So it goes out sideways. That's the bump. And pickleball is the worst thing you can do to that toe in the wrong shoe. Every time you shuffle sideways, your foot slides and the big toe slams into the side of the shoe. Every hard stop at the kitchen line drives it into the point. Every dink you lunge for puts your whole weight on that joint. Two hours of open play is hundreds of those. Three mornings a week. Now the bump rubs the inside of the shoe all game. It gets red. It swells. The sac fills up with fluid. You feel it as a burn on the side of your foot by the second game. A throb when you take the shoe off in the car. A dull ache in bed at night that you can't get comfortable around. Then the big toe leans harder into the second toe. The second toe gets pushed up. A corn grows on top where it rubs the shoe, and a callus grows underneath. You start hanging back from the kitchen line because getting up there hurts. You sit out the third game and say you're tired. You pick your court shoes by which pair hurts the least. Surgery takes the bone off. The shoe is what put it there. That's why nothing you tried worked. The wide size gives the bump a little more room. The front still comes to a point, so the toe still gets pushed in. The bigger size makes the shoe longer, not wider. Your foot slides forward into the point even harder. Toe spacers push your toes apart for a few hours. Then you put the shoe on and it pushes them right back. Gel pads and tape before open play soften the rub. They don't stop the push. And surgery fixes the bone. Then you put the foot back in the same shoe, and the clock starts again. I knew all of that. I'd watched it fill up my notebook for five years. Then I came home one night in April and found my wife in the kitchen with her foot in a bowl of ice water. Donna is 58. She started playing pickleball two years ago with a group from church. Three mornings a week. She loves it. There was a gel pad on the table, cut in half with scissors. When I walked in, she pulled her foot out of the bowl and put it under the chair. I asked her to show me. "It's nothing. It's just a bunion." I knelt down on the kitchen floor and looked. A red, shiny bump on the side of her right foot. Her big toe leaning into the next one. A blister starting on the side of the joint. Then I looked at her court shoe by the door. The side was stretched out and worn thin, right where the bump sat. You could see the shape of it pressed into the shoe. I spend all day asking people to take their shoes off. I'd never once asked my own wife. She told me she'd been taking Advil before every game for six months. She'd been planning to quit after Christmas and hadn't figured out how to tell her friends. I wanted to fix it the way I fix everything. I almost booked her surgery that week. Then Carol came in. Carol is 61. I'd seen her a year before with a bunion as bad as Linda's, and she'd said she wanted to wait on surgery. I pulled her chart expecting to book her. The bump was still there. But the redness was gone. The swelling was gone. She told me she'd played pickleball the day before and it didn't hurt. I asked her what she'd done. "I went to Sal." Sal is 83. He made shoes by hand in Ybor City for 60 years. Carol's mother had bought her orthopedic shoes from him in the '70s. I drove over that Saturday and took Donna with me. The shop smelled like leather and glue. There were wooden foot forms hanging on the wall and drawers full of paper. Sal said every pair of feet he'd ever made a shoe for was in those drawers. He sat Donna down, took her shoe and sock off, and put her bare foot on a sheet of paper. He traced around it with a pencil. Then he pulled the insole out of her court shoe and laid it on top of the tracing. Her big toe stuck out past the insole on one side. Her little toe stuck out on the other. Sal tapped the paper. "There's your bunion, Doctor." I didn't say anything. "Every shoe I ever made started with the paper," he said. "Your foot first, then the shoe. These big companies make the shoe first. Then they sell it to you and let your foot figure it out." "And your foot figures it out. It grows a bump." I asked him what he'd tell Donna to look for, since he doesn't make shoes anymore. He held up three fingers. "First, trace your foot on paper and lay the insole on top. Every toe has to fit inside it, with room." "The front. Round like a foot, not pointed like an arrow. The big toe has to be able to point straight ahead." "The heel. Flat with the toes. If the heel sits up high, it slides you down into the front all day, and you're right back in the point." That night I sat at our kitchen table and did what Sal did. I'd bought Donna three pairs of court shoes from the big sports store that week, including two wide versions. I traced her foot and laid every insole on the paper. All three failed. Her toes stuck out past every one of them. The wide ones were the same pointed shape. Just bigger all over. I kept looking. The only pair that passed was CUURT. I laid the insole on Donna's tracing and every toe fit inside it, with room to spare. The front was round. Her big toe could sit straight ahead for the first time in I don't know how long. From the side, the heel and the toes were level. And the bottom was firm and grippy, made for a hard court. I took them to Sal. He turned one over in his hands for a while. "That's a shoe," he said. Week 1, Donna took them off after a game and didn't wince. Week 3, the redness on the side of her foot was down. Week 6, she played three mornings in a row and the ice bowl stayed in the cupboard. Month 3, she went back to four days a week. She stopped taking the Advil. She didn't tell me. I noticed the bottle hadn't moved. I have to be honest with you about one thing, because I'm a surgeon and I owe you the truth. The bump is still there. Bone doesn't go back. But nothing is pushing on it anymore. It stopped hurting. And it stopped getting worse. A month later Linda came back for her follow-up. Before I said a word about a second surgery, I traced her foot and put her insole on the paper. Her toes hung off both sides. Now I do that with every bunion patient who walks through my door. Before we talk about a saw, we talk about the shoe. If you play pickleball and you have a bump on the side of your big toe, listen to me. If it burns by the second game. If you've started hanging back from the kitchen line. If you tape it or pad it before every session. If you take your court shoes off in the car because you can't wait until you get home. If somebody told you to just buy the wide size. Maybe your mother had them too. Maybe you're older than you used to be. But it's the shoe that keeps pushing that toe in, every single shuffle, every single game. And it gets worse every game you keep playing in it. Tonight, take a pencil and trace your bare foot on a piece of paper. Pull the insole out of your court shoe and lay it on top. If your toes stick out past the insole, you've got your answer. The shoe I send my patients to now is CUURT. Round in the front where your toes are. Flat from heel to toe. Firm and grippy on the court. Right now it's buy one, get one free. One pair for the court and one for every day. And if the size isn't right, you get 100 days to swap it for free. Order your real size, not the bigger one somebody talked you into. 👉 cuurt.com/products/cuurt-muuv-wide-toe-box-court-shoes ~ Dr. Neil Hartman, foot and ankle surgeon, 24 years, Tampa P.S. Don't let anyone shave that bump off until you've changed the shoe. I've done the surgery more than 2,000 times. If you go back into the same pointed shoe, the shoe will put it right back. P.P.S. To the daughters reading this. If your mom plays pickleball and she's started sitting out the third game, look at her court shoes. If the side is stretched out where her big toe sits, she's not fine. Do the paper test with her this weekend. 👉 cuurt.com/products/cuurt-muuv-wide-toe-box-court-shoes

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Pickleball players: "just a bunion" is how they end up on my table

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