It has been over 2 months now since my bunionectomy/osteotomy and my big toe is elevated from the floor. Is this normal? Could it have something to do with the remaining swelling?

Elisa, I had the same problem with my big toe! I thought that it was because I was so nervous about putting my foot flat on the floor. My foot doctor ended up sending me for physical therapy. That really helped with the swelling also. The hard work of therapy payed off and now all of my toes are flat on the floor. Did your doctor give you any exercises to do on your own? That might help. Good luck! I know what you are going through!

Linda

Originally posted by linda lou:
Elisa, I had the same problem with my big toe! I thought that it was because I was so nervous about putting my foot flat on the floor. My foot doctor ended up sending me for physical therapy. That really helped with the swelling also. The hard work of therapy payed off and now all of my toes are flat on the floor. Did your doctor give you any exercises to do on your own? That might help. Good luck! I know what you are going through!

Linda

Hi Linda. I've been doing exercises since the surgery almost 3 month ago where i bend the toe back and foward(even though it doesn't budge foward, it's really stiff). I had extensive surgery though(3 pins, 2 sets of stiches, 8 weeks in a cast and on crutches)
What type of exercises did the physical therapist have u do?

Hi Elisa, Happy New Year! I looked at the phamplet that the doctors office gave me and it looks that my surgery was the one beneath yours. I have three pins but, I did not have to be casted. I was also given the back and forth exercises to be done and they did not help me at all! My doctor was not happy with the swelling and also the range of motion so he wanted me to be assessed by the physical therapists. I was given mostly stretching exercises to do there and at home. They were increased as we went along. When I went in...which was three times a week for three weeks....I was also given something like a heat treatment. I can not remember what it was called exactly. I also had a really hard time with being overly sensitive. So, I had some things to do for that also. They basically work up a program specifically designed for you and what ever problems you are having. At my final visit I was amazed at the difference! And so was my physical therapist!! Has your Doctor said anything about going for therapy? I was really nervous about it but, I think that it made all the difference in the world for me. Now I just hope that when I go for the other foot I will be more prepared for all of this!!

Linda

Originally posted by linda lou:
Hi Elisa, Happy New Year! I looked at the phamplet that the doctors office gave me and it looks that my surgery was the one beneath yours. I have three pins but, I did not have to be casted. I was also given the back and forth exercises to be done and they did not help me at all! My doctor was not happy with the swelling and also the range of motion so he wanted me to be assessed by the physical therapists. I was given mostly stretching exercises to do there and at home. They were increased as we went along. When I went in...which was three times a week for three weeks....I was also given something like a heat treatment. I can not remember what it was called exactly. I also had a really hard time with being overly sensitive. So, I had some things to do for that also. They basically work up a program specifically designed for you and what ever problems you are having. At my final visit I was amazed at the difference! And so was my physical therapist!! Has your Doctor said anything about going for therapy? I was really nervous about it but, I think that it made all the difference in the world for me. Now I just hope that when I go for the other foot I will be more prepared for all of this!!

Linda

Hi linda. My dr. said that my range of motion is good and he said that he doesn't think i need physical therapy. I don't have a lot of swelling just a little and I'm know wearing a surgical to the knee stocking which he recommended to keep swelling down.
I've noticed howere that the bunion is still there a little. I thought my foot was going to be straight. Well how were you're results?

After bunion surgery, you do not want an extremely straight big toe. You would have difficulty getting your foot into a shoe. If you look at a "normal foot", you will notice that the big toe has somewhat of a curvature towards the 2nd toe. This is normal. Some doctors will overcorrect the bunion and will cause the big toe to go in the opposite direction. This is an even bigger problem. These are a lot harder to correct.

Originally posted by Foot Pro:
After bunion surgery, you do not want an extremely straight big toe. You would have difficulty getting your foot into a shoe. If you look at a "normal foot", you will notice that the big toe has somewhat of a curvature towards the 2nd toe. This is normal. Some doctors will overcorrect the bunion and will cause the big toe to go in the opposite direction. This is an even bigger problem. These are a lot harder to correct.
hi foot pro. my question was about my toe being elevated from the floor. it's been 3 months and it is not touching the floor. my dr. said that physical therapy might or might not help.what do u think?

The first question I would ask is how much motion do you have in your big toe joint? Does it bend up or down? Also, if it does bend up and stop what does it feel like? Is it a hard, abrupt stop or is a softer stop? If it is a hard and feel like it is jamming, then you probably have a bone problem. Physical therapy would not be beneficial here. However, if it is secondary to scar tissue, or swelling, then physical therapy may be very beneficial. Did your surgeon take any postoperative xrays? If so what did he say about them? Are you performing any physical therapy exercises at home? What I have my patients do is to start moving their big toe joint (not the toe) at week number two. I will also let my patients begin to walk fairly early to prevent a stiff, cocked up great toe. Without seeing your foot and the postop xrays, it is very hard to make any treatment recommendations. Were you in a cast at all? If so, for how long? Being in a cast for a prolonged period will also cause your great toe joint to become elevated due to disuse and muscle imbalances. I hope this helps.

I just saw where you were in a cast for 8 weeks. I would keep working with the range of motion exercises. In addition, I would try what they call a contrast bath to help with the swelling. A contrast bath is as follows: You begin by soaking your foot in warm water for 5-10 minutes and then alternate into cool water for 5-10 minutes. Do 3-4 cycles of this and this should help with the swelling as well as pain. The theory behind contrasts baths is that the warm water helps increase blood flow to the area by dilating your blood vessels. This in effect will help to flush out the inflammatory cells. The cool water also acts as an anti-inflammatory and causes your blood vessels to constrict to prevent the influx of new inflammatory cells. This is one modality I find that helps with postop pain and swelling in my patients once the incision is completely healed. Good Luck.

Hi Elisa, after carefully examining my toe, I would have to agree with Foot Pro and say that mine does curve a little towards my second toe. I kept thinking that it should be perfectly straight but, I think that having had bunions for soooo long I may have forgotten what my foot used to look like! Or should look like. Do you have to have your other foot done or is it okay? I still think that there should be something that can be done for you.

Originally posted by linda lou:
Hi Elisa, after carefully examining my toe, I would have to agree with Foot Pro and say that mine does curve a little towards my second toe. I kept thinking that it should be perfectly straight but, I think that having had bunions for soooo long I may have forgotten what my foot used to look like! Or should look like. Do you have to have your other foot done or is it okay? I still think that there should be something that can be done for you.

hi linda,
yes my other foot is bad too. i just expected my toe to be straight and it looks like i still have a little bunion , but my dr. says since my bunion was so bad that's really teh best it can be. he said the x-rays looks good and that there is still some scar tissue.

Originally posted by Foot Pro:
The first question I would ask is how much motion do you have in your big toe joint? Does it bend up or down? Also, if it does bend up and stop what does it feel like? Is it a hard, abrupt stop or is a softer stop? If it is a hard and feel like it is jamming, then you probably have a bone problem. Physical therapy would not be beneficial here. However, if it is secondary to scar tissue, or swelling, then physical therapy may be very beneficial. Did your surgeon take any postoperative xrays? If so what did he say about them? Are you performing any physical therapy exercises at home? What I have my patients do is to start moving their big toe joint (not the toe) at week number two. I will also let my patients begin to walk fairly early to prevent a stiff, cocked up great toe. Without seeing your foot and the postop xrays, it is very hard to make any treatment recommendations. Were you in a cast at all? If so, for how long? Being in a cast for a prolonged period will also cause your great toe joint to become elevated due to disuse and muscle imbalances. I hope this helps.

hi foot pro, i can move my toe back a good range just not down. the joint doesn't move down. i am doing the exercises where i move my toe up and down. i have been doing these exercises after around 10 days or so after the surgery and still am 3 months later now.
my dr. took several x-rays throughout the healing process and he took one after all the pins were out. he said thatthey looked good.he said since most of my surgery was at the big toe joint it probably won't bend down much at the joint. i had an osteotomy also.thanks for your help and info.

Sometimes when we perform osteotomies of the 1st metatarsal there can be some lengthening believe it or not of the 1st metatarsal. An osteotomy can be made in such a way to legthen your metatarsal, shorten the metatarsal, drop it down or plantarflex it, or elevate or dorsiflex it. If the osteotomy was dropped down (plantarflexed) and lengthened, then your downward range of motion maybe restricted for good. Sometimes this will work out. That is, the limitation of motion. One question, does it hurt? Does it cause problems in your shoes? If it is not painful, I wouldn't really be too concerned. I will reiterate this point, after bunion surgery, you should not have a completely straight big toe. If so, you would not be able to get into a shoe. You want the deformity gone (ie the bump, the rotated great toe) but to get it really straight would cause more problems in the long run. Don't give up. Keep doing the range of motion exercises.