I had a cheilectomy of my right big toe just over 8 weeks ago and whilst things seemed to be getting rather better 6 weeks ago (after a pretty horrendous time post-op till then) it now feels as though things are almost worse. Its like a deep stretching pain under the toe joint every time I walk on it (pretty strong pain) and I still cannot use any shoes other than my old, wide, soft trainers.....Whilst I have managed to do some walks despite quite considerable pain, (increasing it seems) I now have to take quite strong painkillers well before this. So I feel really disappointed and very concerned that maybe the op hasn't worked for me.

At my 2nd post-op appt. 2 weeks ago, I was told that it may well be that this sort of pain is due the better toe movement now putting more stress on the joint - which, they discovered,

What sort of physical therapy did you do after the sutures were removed? And did they do an osteotomy (shave the bone off at an angle) too? What about drilling holes in the existing cartilege?

What sort of physical therapy did you do after the sutures were removed? And did they do an osteotomy (shave the bone off at an angle) too? What about drilling holes in the existing cartilege?
Hello. I did the suggested pulling back of the big toe (after 2 weeks) several times per day and over the next wks this eased it quite a bit. I had bone taken off both sides of the toe and some shaved at an angle at the front and apparently they found I had "no cartilege left" around the toe joint - and seemed surprised, as this had not shopwed up in the x-rays or ultrasound (I assume this is the "arthritis"). It is now wondered whether the better toe movement now is putting extra stress on the joint...hence my concern. Is this common at this stage or can I assume its still just early days and is to be expected..? (My original message was not all printed (re the no cartilege left, etc...I don't understand why as its my first time on the site). Thank you for your help.

I had a cheilectomy of my right big toe just over 8 weeks ago and whilst things seemed to be getting rather better 6 weeks ago (after a pretty horrendous time post-op till then) it now feels as though things are almost worse. Its like a deep stretching pain under the toe joint every time I walk on it (pretty strong pain) and I still cannot use any shoes other than my old, wide, soft trainers.....Whilst I have managed to do some walks despite quite considerable pain, (increasing it seems) I now have to take quite strong painkillers well before this. So I feel really disappointed and very concerned that maybe the op hasn't worked for me.

At my 2nd post-op appt. 2 weeks ago, I was told that it may well be that this sort of pain is due the better toe movement now putting more stress on the joint - which, they discovered,
Some of text of my posting was missing:...I need to know whether to expect this sort of pain at this early stage as am concerned re the finding of "no cartilege left" around toe joint (this didn't show in x-rays or ultrasound) and offers of a possible joint fusion - I;m unable to even think of another op so need info re what is actually 'normal' at 8 wks post-op. I also have some sharp pains occasionally on the site of the op and under, around ball of joint - even when not standing (i.e.in bed) but only sometimes....all comments will be really helpful to me as I try to keep positive and hope the op has worked. Thank you!

It's my understanding that if there is absolutely no cartilege left, you should have had either an implant or fusion. You need some cartilege left for a cheilectomy to be successful. The pain is coming from the bones rubbing together with no cushion.
In the US, I'd be back at the surgeon's asking what the next procedure will be and when. I have no idea how that works with your NHS.

Lisa, I had a cheilectomy on my right big toe the end of August. I'm very disappointed in the results thus far. I have many of the symptoms you describe and it's been difficult for me as I've always been very active. I have pain around the big toe as well as the 2nd & 3rd toes when I walk. In fact, my whole forefoot feels broken every time it flexes while walking. It's especially sore and stiff when I take my morning walk. The other muscles & tendons in my foot are starting to bother me as well. Often times my right knee will get sore or my hip because I'm thrown off from my normal gait even though I appear to walk normal. I keep thinking if I walk normally it will eventually work the joint and stretch out my foot but like I said I had the surgery back in August so I'm really disappointed and will need to go back to my Doc and figure this all out. I was hoping to be jogging by now but haven't done that since April. I do non-impact cardio now instead but now I'm hesitant to even ski because of the forefoot pain while in my ski boot.
A part of me wishes I never had the surgery because it's worse now than pre-op.

Colby: Did you go to the 49's doctor? If not, you might want to get a second opinion from them. The first most important thing with a cheilectomy is the right surgeon. The second it your PT afterwards. Like I asked Lisa, did they drill holes in the cartilege? Did oyu do your exercises?

Lisa, I had a cheilectomy on my right big toe the end of August. I'm very disappointed in the results thus far. I have many of the symptoms you describe and it's been difficult for me as I've always been very active. I have pain around the big toe as well as the 2nd & 3rd toes when I walk. In fact, my whole forefoot feels broken every time it flexes while walking. It's especially sore and stiff when I take my morning walk. The other muscles & tendons in my foot are starting to bother me as well. Often times my right knee will get sore or my hip because I'm thrown off from my normal gait even though I appear to walk normal. I keep thinking if I walk normally it will eventually work the joint and stretch out my foot but like I said I had the surgery back in August so I'm really disappointed and will need to go back to my Doc and figure this all out. I was hoping to be jogging by now but haven't done that since April. I do non-impact cardio now instead but now I'm hesitant to even ski because of the forefoot pain while in my ski boot.
A part of me wishes I never had the surgery because it's worse now than pre-op.

It's my understanding that if there is absolutely no cartilege left, you should have had either an implant or fusion. You need some cartilege left for a cheilectomy to be successful. The pain is coming from the bones rubbing together with no cushion.
In the US, I'd be back at the surgeon's asking what the next procedure will be and when. I have no idea how that works with your NHS.

Dear Tichou and Colby thank you for your replies. I'm so sorry about Colby's situation and of course, can relate to the disappointment, tho I had my op only 8+ wks ago.

Tichou: I have no idea re whether they drilled holes in the cartilage, not knowing that sort of detail pre-op. I also only found out that they found no cartilage on my 2nd hospital outpatient visit after I explained about the deep pain under the toe that had become evident. Since they found no cartilage, I can only assume they didn't drill any holes!

I am not complaining re the NHS as I have had superb treatment - I just can't believe that maybe this op. won't have worked (tho I guess I should as I know it isn't always a success).....I telephoned gthe consultant's secretary late on Friday afternoon and she was lovely and said she'd speak with him over the weekend and get back to me by phone straight away.

I just feel I CANNOT possibly face any prospect of the more major joint fusion after all this immobility (which is so bad for body, health and morale)! Am I silly to keep hoping that maybe I've just been doing too much at this frelatively early stage post-op???

All I can tell you is that if the bones are rubbing together as yours are due to lack of cartilege, you will have pain. You MUST have some cartilege left for this procedure to be a success. To the best of my knowledge, and I've done a great deal of research on this and have talked with one of the best foot surgeons in the US who did my cheilectomy, the only options after a failed cheilectomy (which yours appears to be) are implant and fusion. There is no way to replace the cartilege once it is all gone.
Sorry.

Thankyou....I can see the sense in this but can you also tell me whether at 8.5 wks post-op I should not under any circumstances have pain? Or could it possibly be that I was doing too much walking and not putting my foot up at all and that could make it worse, at this stage.....?

Colby: Did you go to the 49's doctor? If not, you might want to get a second opinion from them. The first most important thing with a cheilectomy is the right surgeon. The second it your PT afterwards. Like I asked Lisa, did they drill holes in the cartilege? Did oyu do your exercises?

No, I did not go to the 49er's Dr. I went to a Podiatric Surgeon who specializes in sports related injuries as well as surgical reconstruction of acquired and traumatic foot and ankle disorders. He is also the current Residency Director of the SF Bay Area Foot & Ankle Residency Program. Not to mention he needs to have this same surgery himself. I figured if he needs this surgery himself then he sure as heck knows a lot about it!

I did the PT after the first 2 weeks when my bandages and sutures were removed. PT consisted of pulling the toe outward and then up & down. I did this for an hour a day for 6 weeks. I also began walking an hour a day which my Dr. thought was good to do too.

However, I also was not aware or told about drilling holes in the cartilage. When I go see him I will certainly ask about it.

I'm a 38 yr. old male and am too young to give up on running, tennis, etc.. so I'll see where I go from here after I see him again. I keep thinking that I'm still healing and everything will be right again but I'm beginning to think otherwise.

I'm able to wear all the shoes I wore before but in all of them I have a deep stretching pain under the toe joint every time I walk. I also am not able to push off with my right foot while bending down or reaching for something overhead.

Hi Lisa 44,

I am sorry to hear you are still experiencing pain at 8.5 weeks. I had a toe fusion and teh bunion shaved off 9 weeks ago. I was never in any pain becuase of the surgery, it was only when I strated walking, my other toes, ankle and differnt parts of the foot kind of hurt because the muscles were so weak and had shrunk. This was a real bother to me, even the arch of my foot felt tired and would ache sometimes. I found doing the toe and ankle exercises helped a lot and also massaging the surgical area. I was on Ibruprofen during week 7-8 as that was when I walking alot, this helped with aches and swelling.

I am not sure if this is any help, but I hope this all ends for you. A toe fusion isn't so bad, it's only being imobile for so long and then learning how to walk again, there isn't any pain.

Good luck :)

I think I was still in Merrell's for about 8 weeks. Then slowly back into regular shoes.
I've 62 now and had it done almost 6 years ago. I jog, dance,wear heels (no 3"ones though!). I'm much better off than before the cheilectomy. Shaquille O'Neal had one when he was with the Lakers. I think he was off for about 8-10 weeks before he played again. So I would say that's an appropriate time frame for getting back into things. The complete healing timeline, according to my doc, is about 12 months...and my experience bears that out.

Thank you Tichou and Dark Light.....that sounds positive and hopeful - however, I am not experiencing relief even now at 9 weeks post-op (it was easier initially at about 6 wks post-op) and I have to admit to it getting worse and sometimes moments of severe pain especially on the pad area under the toe. I would still appreciate knowing, if either of you do know, whether at this stage I really shouldn't be getting this sort of pain! Or whether it can still be seen as "early days" and maybe I wasn't looking after it well enough.....

I must say I can only dread any thought of a toe fusion - mainly due to the amount of time one has to almost exclude oneself from life and put e verything on hold and do NO EXERCISE and all that that makes one and one's body feel (i.e. not a good thing! specially at my age - 63).

It does rather seem that people have very varied experiences post-op and I should shortly know more about what the consultant thinks (from his seceretary) as he's the one who saw what was what when he was operating!

Any more comments or words of advice are always appreciated. Thank you.

Dear Dark Light,

I would appreciate knowing about the course of your experience of the toe fusion from op to now - if you have the time to write about it....as I admit to finding the whole idea of this op and its consequences too much! Also, how you feel about the toe being stuck in one position and whether you're adapting OK etc. I realise its early days for you but it seems you are doing really well.

Thank you in advance, if you have the time to tell me about it all...Lisa44 :)

I think I was still in Merrell's for about 8 weeks. Then slowly back into regular shoes.
I've 62 now and had it done almost 6 years ago. I jog, dance,wear heels (no 3"ones though!). I'm much better off than before the cheilectomy. Shaquille O'Neal had one when he was with the Lakers. I think he was off for about 8-10 weeks before he played again. So I would say that's an appropriate time frame for getting back into things. The complete healing timeline, according to my doc, is about 12 months...and my experience bears that out.

Titch,

I agree, I too think the timeline for healing must be 12 months. My Dr. said 3-4 months but in month 5 right now and the deep stretching pain is still present. I'm active in other ways but sure miss running distances after doing it for years. I keep telling myself to keep positive!

Dear Dark Light,

I would appreciate knowing about the course of your experience of the toe fusion from op to now - if you have the time to write about it....as I admit to finding the whole idea of this op and its consequences too much! Also, how you feel about the toe being stuck in one position and whether you're adapting OK etc. I realise its early days for you but it seems you are doing really well.

Thank you in advance, if you have the time to tell me about it all...Lisa44 :)

Hi Lisa44,

I would be happy to talk about my experience although I am not too familiar of the other procedures to compare it with. It seems many people don't like the idea of a fusion and if I had known that before the surgery I would be very worried.

Now I am wondering whether it really was a toe fusion, basically I had an Exostosis Removal, which is the removal of the bump and a Distal Chevron Osteotomy, a cut was made below the joint, so I apologise if I was wrong. The bone was fused at the toe and is angled slightly lower than the rest of the toes. I do have a good range of motion but I had to do a lot of toe exercises. Prior to the exercises my toes was completely stiff.

I am really sorry if I have given you wrong information. But please feel free to ask any questions.

Thank you Dark Light. I think what you had probably wasn't a toe joint fusion....(which binds the bone together so the toe cannot then move). I also had bone shaved to an angle at the top of the joint....I would be interested to know what exercises you did and what sort of pain you had where and for how long....

Many thanks.

Lisa44

Dear Colby 88,

You refer to still having the deep stretching pain under your toe at month 5 post-op....this sounds like the pain I too have. Have you discussed whether this is sometimes to be expected and need not indicate anything to worry about? And do you have any pain deep in the whole fleshy pad area under and to the left of your big toe at all?

I believe you also had a cheilectomy didn't you? (any other procedures?) Have you been reassured about the situation or what? It's hard maintaining good spirits when you want to get back to proper movement isn't it. I also wonder, ware you still doing any toe/foot exercises? If so, what ones? And are you still taking painkillers (which?) and are you still walking through the pain? Any info is helpful and I hope things improve with you too beofre long!
Lisa44

Lisa,

I'm still so discouraged with my foot post-surgery that I'm now pursuing outside opinions. My original Dr. moved away so I have no choice anyway! I have all of my x-rays (pre & post-op) on a CD and will be taking them to future appts. as I obtain other opinions of what to do from here.

I'm now 8 months post-op and my foot is worse than before I had surgery. I stayed positive all along but have come to the realization that this is basically the outcome which sucks. I'm even ready to face surgery again (with a new Dr. of course) if something can be done. Prior to surgery I could at least walk without pain, now post surgery walking is painful. I often will have to limp all of the sudden just to go through the motion.

Now that I have my x-rays on a CD I popped it in my computer and was amazed at the before and after. The before looked so much better than the x-ray taken after surgery. I was shocked. The bone looks like it's resting on the other bone whereas before there was a bit of space between the joint. The bones even looked misaligned now.

This is all so discouraging. I was really hoping to be back jogging by now and playing tennis but haven't been able to.

Hope you're doing better.

Dear Colby 88,
I wish I had got back to the site since I had an extra appt. at the hospital for similar reasons - to share what I learnt. The Consultant saw me this time - briefly - and explained that I should pull the big toe back "until your eyes roll" 10 times - and push it forward "till eyes roll" 10 times, 4 times per day every day for several weeks. The urgency was to do this where there was still a window of opportunity (3-6 mths post-op).I hadn't been told this detail. Did it (v.painful!!) and after 3.6 wks, it is improving ++ I no longer have to do this other than one or two deep pulls occasionally...Transformation. Did you do this post-op? I wonder? It is vital, it seems.

Lisa,

I'm still so discouraged with my foot post-surgery that I'm now pursuing outside opinions. My original Dr. moved away so I have no choice anyway! I have all of my x-rays (pre & post-op) on a CD and will be taking them to future appts. as I obtain other opinions of what to do from here.

I'm now 8 months post-op and my foot is worse than before I had surgery. I stayed positive all along but have come to the realization that this is basically the outcome which sucks. I'm even ready to face surgery again (with a new Dr. of course) if something can be done. Prior to surgery I could at least walk without pain, now post surgery walking is painful. I often will have to limp all of the sudden just to go through the motion.

Now that I have my x-rays on a CD I popped it in my computer and was amazed at the before and after. The before looked so much better than the x-ray taken after surgery. I was shocked. The bone looks like it's resting on the other bone whereas before there was a bit of space between the joint. The bones even looked misaligned now.

This is all so discouraging. I was really hoping to be back jogging by now and playing tennis but haven't been able to.

Hope you're doing better.

Just to add to previous latest note from me....I sympathise so much re your huge sense of disappointment at this stage....I would be cautious, though, about assuming that your x-ray looks worse than before the op. We often get that sort of detail wrong, I found - and it'll need full explanatiob - what looks wrong might, infact, be better....

I didn't want my mini-message to sound heartless so have added another one.Most of all I want to know how thorough your toe pushes and pulls were post-op. My under-foot pain eventually went altogether about 5-6 after I had started doing thew specific exercises I mentioned (at 3 mths post-op). I had before only been pulling the toe back UNTIL it hurt, then stopping at that point. It is clear (now that I was eventually told) that you have to hurt it much more than that! It was certainly real agony when I was doing this - for nearly a month. It is clearly the degree of agony that influences the improvement and I wish I'd been told that sort of detail immediately post-op. Now, 5 calendar months post-op, I only very occasionally give the toe one or two good deep pulls - when it feels stiff from, eg lack of movement. I do exercise classes but there are a few things I cannot do yet (pressing upwards via the bent toes on that foot, etc) but it is clearly improving and I walk alot - mostly with little pain only. I have been told that it takes a year for full improvement but this is now much better than it was pre-op, thank goodness!

DO let me know the detail of your post-op exercises....I wish you well and am hoping for you.....I must also write to the hospital to feed-back how necessary it is to tell patients the DETAIL of the required PT that is needed as its so easy not to do it enough. Of course, I feel hugely relieved that there is real progress now and I won't have to have another op as yet and this one has not failed after all. Good luck to you with your further advice. Pl. let me know, though re what you have been doing PT wise and whether it was extremely painful but you persisted - or what. BW Lisa.

Hi all,

I'm about to go under the knife tomorrow...8am GMT. I've had enormous difficulty in deciphering the medical "mumbo-jimbo" of the doctors(mine also has a thick french accent)/surgeons/consultants/nurses, so I'm not COMPLETELY aware of what stage my Hallux Limitus is...as no one has told me.

Can anyone advise on what stages 1 to 4 actually mean, and what the associated generic guidance is for rest, recovery and exercise for each of them.

gulp. Feelin' a tad nervous about it all now.

Yours faithfully, hopefully and...pain free(ish).

Garlaj

Dear Garlaj43,

In haste, to wish you all the best and to reassure you! But most of all to tell you to ASK ALL THE QUESTIONS YOU NEED TO (BEFORE the op, as you might be a little drowsy post-op). You must ask what stage Hallux Limitus you are (for information) and MOST OF ALL - Please, please, please make sure you ask for ALL the real DETAIL as to the post-op exercises you must do. This is the single most important thing for a successful outcome in the future.

I learnt this only JUST in time - and only because I asked for an extra appointment urgently when things were getting worse nearly 10 wks post-op. I was then told the detail of the exercises I should have done. Thank goodness, just still in time to get a better result. I understand that there is a last window of opportunity for this at 3-6 months post-op. The exercises MUST be regular and you MUST keep stretching beyond hurt every time. Backwards AND forwards is vital apparently. Best of luck and don't worry! just promise yourself you will do those agonising stretches as necessary! Lisa

Here are the stages brief:

Stage 1: Vague, intermittent joint pain. No bone spurring.

Stage 2: Increased frequency and duration of pain. Mild bone spurring (dorsal bunion).

Stage 3: Pain with all activities. Large dorsal bunion. Limited range of motion.

Stage 4: Significant pain with any range of motion of the joint. Enlargement of the entire joint. Rigid, stiff toe.

A cheilectomy is most effective for those in stage 2 and early stage 3.

Good luck tomorrow. :jester:

Hi Lisa,

Thanks for your response. It is now 14th June (my Cheilectomy - which I'm sure was late stage 2 and early stage 3 Hallux Limitus) happened early on the 11th June.

I was asked to stay the night of the 11th in hospital, but I think that was more to do with my reaction to the General Anaesthetic etc than my feet. Quite surprisingly, I'm relatively pain free (no throbbing or sharp stabbing pains etc) and I can put my whole body weight on my feet....so I can hobble around home quite effectively. However, I am being careful, and spending most of my time on the sofa (which for me, is hard to do) and keeping my feet elevated. On Tuesday 17th June, I will have my bandages changed, and the Physiotherapist said that I should be able to start getting into normal, loose fitting and wide shoes after that point.

Whilst on the subject of Physiotherapists, I feel that I got a really bad explanation of what on earth I'm meant to be doing with my toes in the context of "making them better". In fact I got virtually nothing from them other than being shown how to use crutches. Great. I was apparently meant to follow the instruction on the outpatient's note....but all it said was follow instruction from the Physiotherapist...who had said "get some loose shoes on after bandages are changed, move your toes using your fingers"..and that was about it.

Any advice on what exercises I should be doing, and when I should be doing them? In spite of asking at the hospital, I feel I got a realtive "brush off" from the staff.

Thanks,

Jonathan

Here are the stages brief:

Stage 1: Vague, intermittent joint pain. No bone spurring.

Stage 2: Increased frequency and duration of pain. Mild bone spurring (dorsal bunion).

Stage 3: Pain with all activities. Large dorsal bunion. Limited range of motion.

Stage 4: Significant pain with any range of motion of the joint. Enlargement of the entire joint. Rigid, stiff toe.

A cheilectomy is most effective for those in stage 2 and early stage 3.

Good luck tomorrow. :jester:

Hi Misfish90

I think I am (was) definately at stage 3. Whether I was within the early or late stage, is hard to stay. I hope for my sake it was the former rather than the latter!

Quite surprisingly, when I brought up the subjext of Hallux Limitus/ Hallux Rigidus with the Chief surgeon and his doctor side kick - when they were on their rounds visiting the patients, I asked about whether I had Rigidus or Limitus...and they kind of looked at me with a little confusion on their faces and said "we only know of Hallux Rigidus"...which was a little worrying. I wondered then if in the USA if the terminology used is different o that used in the UK?

Dear Jonathon (Garlaj43)

Here are the exercises I was eventually told to do urgently - which saved the situation:

At about 2-3 wks post-op steady your foot with your right hand (if you're right-handed) on its inside and pull your big toe gradually back until it REALLY hurts alot and you are finding it very difficult to bear. Hold it for a bit then gently push it forward and DOWN the opposite way (that'll hurt too) and hold it. The consultant told me "you must pull and push it until your eyes roll each time". This was vital information because I'd just been told to 'stretch it back a bit every so often'. This is NOT adequate!! And this was why my toe was getting WORSE. The consultant told me I MUST do this, each way, ten times each way and FOUR lots of this PER DAY. Every day. When I did these, I did breathing exercises as for childbirth pain. But it is SO worth it!

The reasoning seems to be that the toe has stiffened up completely and, being post-op, needs repeated stretching of all the tendons and muscles, regularly, until it is truly stretched. I am still doing this sort of stretching every so often - but only sometimes when it feels stiff and hurts. Then I can REALLY tell the difference as it becomes looser for a bit. The consultant explained that it takes a year for full improvement.

This is the most important, vital information I was NOT given initially. I'm SO glad I went back for an extra appointment when things were getting worse, otherwise I wouldn;t have known. I must contact the hospital now to let them know this, so that others don't get told inadequate information!

GOOD LUCK with your recovery. Don't give up on it, however uncomfortable. You will be ensuring your future comfort and mobility by agonising for several weeks/months now. It really does work - to encourage you, I;ll let you know that I finally felt a real difference in all the discomfort and pain I was having when trying to walk, when I'd been doing these awful stretches for three and a half weeks. And now I continuie to do them but much less frequently.

Let me know how you get on. By the way, I understand that Hallux Limitus and Hallux Rigidus are the same thing. Best wishes! Lisa.

Thanks for your advice Lisa. Much appreciated.

I think I will wait until I have the bandages removed by a nurse on the 17th June before embarking on exercises that may give me an idea what it's like to go through the pains of child birth :)!

I'm currently wiggling them as much as I can within the tight bandage I have on now...and occasionally full weight bearing. As soon as I feel my feet getting very warm (or swelling slightly) I'm back on the sofa!

Good grief I just wish I wasn't so impatient with this sort of thing!

Again, many thanks.

Jonathan

I was given about the same exercise though I was told to pull it out and then up and down. It is to keep scar tissue from forming and freezing the joint. And it didn't hurt that much for me...was sore more than anything but if just pulled gently but steadily it wasn't as bad.

Dear Garlaj43,

Of course, wait awhile till you start the exercises! Your physio should advise you when to start, even if (s)he doesn't give you enough detail about them.

The other REALLY important thing to do.....is PUT YOUR FOOT UP....ALOT! Whenever it feels remotely tight or awkward, sit down and put it high up and leave it there. You are going to find this bit difficult I think! But it sure is worth it. Eventually, you'll know that you need to do it. But if you don't do it enough, you'll also know.

Look after it really well - like something you treasure! Cos at the end of the day, amazingly, even one big toe problem can reduce us to such limitations we never even thought of. So: to recap:

CORRECT exercises.......the right number of times regularly....and FOOT UP a great deal - for the first few weeks at the very least.

IT'S WORTH IT, I promise! And I found out the hard way.

Very best wishes,

Lisa.:)

P.S. Garlaj 43

Dear Jonathon,

I just wanted to add: PATIENCE is also one of the most important things for the next several MONTHS.

It's vital and a priority. I also understand that, once you are walking about with greater ease, you can trust yourself re what you can or can't do. You won't damage your toe by doing too much - it'll just mean an even longer healing time.

Assume it'll be a year, eh? For this reason, the hospital always give people following their final post-op out-patient appts an "open appt" which they can take up anytime within the following year. So, you see, it is true. Do what's needed for a year - (the first 6 mths are the most crucial - my consultant told me that if I hadn't started to do those exercises in that way properly in the 'window of opportunity I still had open to me' (between 3 - 6 mths post-op) then it would be pointless.

I'm just telling you this so you take it seriously and then it'll work out well for you.

Let me know how it goes and if you need encouragement with it!

Lisa.

Quite surprisingly, when I brought up the subjext of Hallux Limitus/ Hallux Rigidus with the Chief surgeon and his doctor side kick - when they were on their rounds visiting the patients, I asked about whether I had Rigidus or Limitus...and they kind of looked at me with a little confusion on their faces and said "we only know of Hallux Rigidus"...which was a little worrying. I wondered then if in the USA if the terminology used is different o that used in the UK?

Hallux Rigidus/Hallux Limitus is the same condition. The only difference is that stages 1thru 3 are often called Hallux Limitus since there is still limited movement of the toe whereas by stage 4 the toe is completely rigid, ergo Hallux Rigidus.

Well I have just come back from the Doctor's surgery having had my bandage removed from both my feet.

There appears to be little bruising, and there are two little puncture wounds on either side of my big toes. Healing has gone well, no infection, and only very very minor bleeding from one of them (nothing to worry about according to the nurse). Overall, the initial healing has gone well, and relatively pain free. Happy days!!

Both feet have swelled quite a bit though, so I think I'll actively take regular steps around my home followed by big doses of "feet up an' rest".

Still no need for pain killers....which is nice. I can now slip on some normal open toes sandals without too much discomfort and gobble around for England! However - I've not really started the "bending toes" exercise - which I'm sure will be a different experience.

I've got my post operative appointment in mid -July, and am hopeful that the progress I make between now and then will be good.

I have also asked for a physiotherapist to call me and to run through my exercises in more detail (ie start times for exercises etc), but Lisa - thanks for your help in describing the WHAT I need to do and HOW I need to do it.

Still furstrated with not being able to move around/ go outside a lot - but it has only been 6 full days since my Op.

Will continue to post updates for anyone out there who, like myself, found it a veritable quagmire to understand what to expect pre-op and post-op, and hopefully some will find it useful as I did.

Bye for now...

Wow - your recovery seems to be going amazingly!

I still cannot walk in all shoes and could only manage a different pair from very old, soft trainers - recently. You should, I'm sure - be very pleased with what you've been managing so far.

And it sounds like you're doing all the right things.

Try not to feel impatient - and rejoice that you can even hobble around at this early stage.

If you persist correctly and do the right amount of the exercises, regularly - plus resting the foot up whenever necessary, I'm sure things will go from strength to strength. But do think months rather than days - and then you can be even more pleased if it all improves quicker than this.

I have to say that, having stopped completely doing exercices many weeks ago (I am now 7 months post-op) the toe has started to hurt again sometimes - increasingly frequently. I have therefore started doing the stretching pulling/pushing exercises again, though not as often as before. It CLEARLY helps give pain-free periods so I will keep doing so whenever it feels right. And I will take advantage of the 'open' appointment that is available to me until next April - if necessary.

Wishing you all the very best with yours - and do let me know how it goes in the future!

Lisa.

Well it's now coming up for two weeks since my bi-lateral cheilectomy on both big toes, and the swelling continues to subside.

I went for a short walk yesterday and whilst my left big toe appears fine and is going from strength to strength, my right one is painful. I think I overdid things a little yesterday, and it needs to be a relative day of rest today.

Also I have a very localised area of 'pins and needles' feeling in my left big toe - which I've put down to some minor nerve damage...hopefully things will improve in time!

I've tried doing the 'wiggling big toe' exercise and the movement on both big toes is still very lmited...even when I push to a high level of my pain threshold. IS this limited amount of movement so early on after the operation normal? Or is this an indication that the operation hasn't been as successful as I thought? The mind boggles - and I don't seem to get much of an answer from my physio either.

I would welcome any thoughts on the limited movement after such a short time (since I had my op on the 11th June)!!!

Dear Garlaj43,

I think you are expecting the moon! It is fantastic that you have managed to go for a walk at all at two weeks only post-op!

Re the exercises: I think I didn't even BEGIn to start any for at least 2 weeks post-op and probably more like 4 wks. But the earlier the better. However, please don't expect miracles. It's great that you are stretching the toe a little at this stage. Of course the toe couldn't be expected to have much movement. That comes very gradually over the next months.

I was told that wiggling the toes does nothing stretch-wise. It is absolutely not the same as the pulling and pushing that you must do increasingly. I, too,m did some wiggling joyfully and felt good until the doctor explained to me that that is not a stretch at all - in any way!

Just keep doing the exercises and hold the stretch when it really really hurts but don't expect much real flexibility yet. Do the exercises come what may()its easy not to do them cos they are very very, painful!) - but also take real care not to over-walk and to put your foot up and keep it rested - alot at this stage. You should get a feel for how often you need to do this.

Don't worry about pins and needles and numbness or extra pains at this stage - as you say, it is VERY early days for you yet. Just keep going and when you notice that you can stretch the toe back - and forward/down a bit more, then extend the exercise a bit more.

The whole long process is GRADUAL and requires real perserverance! But it sounds like your op has been a real success (provided you do do the exercises for the next several months!!) as you are already able to do so much.

Good luck and keep patient!! (at this stage, rest of the toe is extremely important and will help the healing which I've been told take A YEAR). Don't forget this! You have got a long way to go yet but you might well feel the benefits far earlier than I did.

best wishes,
Lisa.

I began my exercises at 2 weeks when I had my stitches out. Pull out gently and move up and down...and do it often. I found it was easier when I took a bath and let my toe "warm up" in the bath water before pulling on it. Doing your exercises is required for a good recovery...no buildup of scar tisue, etc. Good luck!

Garlaj43,
I plan on having the same surgery on both toes.. I work so how long do you think you are off work

D08,

I had my Op on the 11th June. I had my feet elevated for around two weeks. However, around the 13th I could hobble around reasonably well with crutches. I had my bandages removed around 16th June, and continued to hobble around. Around 2-3 days after that I could at last put on some open- toe sandals, and I did away with the crutches. Hurrah! I was signed off work by the doc for two weeks, but went back to work (working from home) on Monday 23rd June. I think two weeks off is the norm (to allow healing of the site and swelling to go down), however - depending on individuals operations I'd say anywhere between 1 and 4 weeks would be a normal range of time. I put on some soft Camper trainers yesterday and things were reasonably comfortable! Which was nice!

I have had conflicting advise on exercises, some say start after two weeks, my doctor says don't start any particular exercise until my post-op with the surgeon (15th July) as the site needs to heal a degree before pushing things. DO check whether your surgeon will operate using key hole surgery (mine did - and I think that this process allows the patient to recover much quicker).

I will try going back to work (into the office) next Monday 7th July and see how that goes (so that's 3 weeks and 2 days at home). If you're standing a lot (or if your work is of a physical nature) you'll probably need nearer 6 weeks off I reckon.

Incidently, pain subsided very quickly post-op, however walking is still (mildly)painful, my toes are still stiff (from having the condition) and I'm obviously using muscles/tendons that I haven't used for about 3 years (since I had the condition). I can walk around 1km before it starts really hurting.

I've been lucky so far. I think my progress is really good. It'll be 1 month since Op on 9th July. By end of 2 months, I think (hope!) walking will be a lot less painful. By end of Sept, I hope better still.

This is just my personal experience though, but I think others may have had very different experiences.

Hope this is useful!


Garlaj43,
I plan on having the same surgery on both toes.. I work so how long do you think you are off work

thank you.. it was very helpful.. My job is pretty much sitting all day. We have lost 2 people at work so I wanted to wait until the new ones are trained.

Dear Garlaj43,

I now realise why you have made such a miraculously quick recovery post-op! You had keyhole surgery.

That must be VERY different to non keyhole surgery, which I and many others had - involving a long and deep cut with associated scraping off and sawing of bone and consequent involvement of tendons etc - requiring, I feel sure, the serious exercising stretches both back and forward-down, which have been described.

I'm envious because it does sound like all's going well for you - which is great.

I have started having trouble again some month after I stopped the exercises because all seemed so much better - and I have had to make another appt. at the hospital to see what's going on. It's dispiriting ++ and I am again doing the painful stretches. Anyway, enough about me - I wish you good luck!

PS: If anyone reading this has experienced a return of the toe pain (under and over, deep or sudden) well after finishing doing the required exercises and after a month of it feeling so much better, I'd be really grateful to hear....and about the outcome! Thank you.

Hi Lisa 44,

re: your following point:-

PS: If anyone reading this has experienced a return of the toe pain (under and over, deep or sudden) well after finishing doing the required exercises and after a month of it feeling so much better, I'd be really grateful to hear....and about the outcome! Thank you.

....Well here I am on 3rd September, with a return of toe pain under and over...deep and sudden. it isn't the same pain - and is slightly less painful - but still a bit of a shocker considering I thought I was progressing so well. Got a 3-month follow up with the surgeon in 2 weeks - so we'll see. I just don't seem to have got my muscles/tendons to flex to the extent I thought I might. Pain is intermittent though and I'm hopeful of it easing over time. footwear is a problem too. Sandals - no worries....hardy walking boots - pain within a few mins walking!

Have you had any other feedback on this at all?

Hi Garla 43,

My old message was quite a while ago...and I eventually made an extra appt. at the hospital as I was perplexed and rather losing heart. Infact they were well pleased with the movement and said it would probably continue to improve but that I should do the pulling and pushing exercises when I felt it stiffening up or feeling less mobile or hurting - and keep walking as much as possible - that would NOT do any harm. I am therefore doing occasionaly pushing and pulling and my toe is def. improving gradually. I hope you will take heart from this!

My op was nearly 10 months ago now. I still can only walk in certain shoes (they need width and lots of cushioning and firmness, underneath - but that's a small probem and even that is improving - tho some shoes are completely out - incl. my walking boots. I can wear seasoned wide trainers and an Ecco walking sandal for a bit. Nothing else for m ore than mins. But I am feeling much more hopeful and positive about it all now.

Remind me when your op was and keep doing those exercises every so often asnd only wear comfy shoes and gradually, things should improve - increasingly. It really does take time, so please be hopeful!

Lisa Robinson.

Hi Lisa,

Operation was on 15th July, so my 3-month follow up may be hopeful. Off on hols in a few weeks - where walking is/has to be involved! That'll be a test I'm sure, still no pain - no gain I suppose...I'll let you know how the ol' 3-month review goes!

Cheers

Jonathan