What physical therapies for post bunion surgery? - Foot Problems Message Board

RunnerMac · 03-04-2008, 04:56 PM

I have seen several people talk about their post surgery physical therapy and I was wondering what people were told to do.
The only therapy that I have been given to do is to flex my great toe back and forth and try to increase the range of motion. Doctor's goal is to have my toe flex over 100 degrees so I am supposed to push pretty hard on it. It doesn't hurt too bad to do this, but it is a bit uncomfortable. Right now I am up to about 90 degrees, that last bit seems unlikely.
Are other people doing different therapy?
Thanks
Mac

wmkcolors · 03-04-2008, 10:00 PM

I have been told to massage the scar often with vitamin E oil or mederma or something like Eucarin cream often, which helps the scar to become more pliable. You are also supposed to desensitize the scar, by rubbing it with a rough towel or something similar. As far as range of motion, I've also bent the toe area back and forth. I am now trying to curl my toes around a rolled up towel and when I am in the pool I am trying to put more weight on my foot and practice standing on my toes. Last week the physical therapist had me put all my weight on my postop foot, while I stood on a foam pillow. I have to say this hurt alot and the rest of the day my foot ached. Now, 9 weeks post op, I'm always bending my toe and flexing my foot and I'm gradually trying to stand on my tiptoes. Another thing is try to "write" the alphabet out with your big toe. My arch hurts alot, so, I use a tennis ball to massage the arch. While I sit down, I roll the tennis ball back and forth under my arch and up to the toes. My PT use some electrical stimualtion, but I don't know if that really does anything. I'm also carefully practicing walking more aggressively on my foot, to gain my balance again, though this can cause my weak foot to swell still. My PT still says I should ice and elevate, and, that using the ellipitical is okay now. I swim, so, that has been good therapy for me. I also do foot exercises, while my foot soaks in hot water. Hope this helps. I'm still at the frustrating stage and am just glad when I can walk evenly for a few hours.... Compared to 2 weeks ago, I'd say my incision area is less stiff, with the PT, especially with the regular massage, but, progress is slow.

RunnerMac · 03-05-2008, 04:20 PM

Thanks for the information, that is very helpful, how long were you NWB and PWB?

wmkcolors · 03-05-2008, 06:03 PM

I was NWB for the first 2 weeks and I was PWB up to the 6th week. That said, I was still off my feet 80% of the time the first 6 weeks, and I was icing and elevating when I rested. While I was PWB, in the soft cast boot, for 4 weeks, I mainly ran quick errands...nothing strenuous...and I limped....struggled.... My foot swelled and ached. At the 5th week mark, my incision area on my left foot finally closed over, and, I baptized myself, in the pool, early in the 6th week, for a feeble attempt at swimming laps. I'm amazed, as a regular runner, how quickly you can get out of shape. When I started wearing wide shoes, at 6 weeks, I felt week. Now, at 10 weeks, I feel more steady on my feet, but, my foot still aches and swells, though I'm not limping anymore. The regular massaging of the scar tissue and the bending of the toe area and the foot flexing gradually helps ease the stiffness. At 10 weeks, my toe is less stiff, but I have a ways to go. The only shoes that are working for me are my wide hiking boots or some wide TEVAs, sort of like Crocs. Anything rubbing up against the incision hurts, which is why desensitizing the scar tissue is important. I'm hoping at 12 weeks I'll feel stronger. Also, at 8 weeks, I gained confidence that when bending my toe area, I wouldn't break the fusing bone. Before 8 weeks, I was nervous about moving the toe, though I gingerly moved it from 3 weeks on...When did you have your surgery? Patience plays a big role in this, and, as a runner, I'm facing the uphill challenge of rehab, and some depression in not being able to run. I just started PT, at the 8 week mark, so, I'll be happy to let you know what else I learn. I hope to be runnning again, by the summer. Hope this helps, because others have helped me on this board too.

dancergal19 · 03-06-2008, 08:23 AM

Hi Runnermac,

I did a lot of the same PT exercises as wmkcolors mentioned. I was NWB for 6 weeks and started PT around the 8 week mark.

In addition to bending your toe back and forth several times a day, I would do the alphabet, towel scrunches and tennis ball thing that wmkcolors suggested. I also had to pick up marbles with my toes and put them in a plastic container (about 30 or 40 marbles, 3 x a day). If you were NWB and your leg muscles atrophied, you can get a resistance band and put it under your foot and hold it tight near your knees and do leg raises while sitting down in order to strengthen your calf. Have you heard of a bosu ball? It's kind of like those ab exercise balls but cut in half (most gyms have them), you stand on it with your surgery foot while lifting your good foot up and balance for 30-60 seconds at a time.

If you're ready, you can also do toe raises on just your surgery foot and the leg press machine at your gym. If you have one that allows you to lie down completely horizontal, you can use your bad foot and push off it as if you're jumping in the air and catch yourself only with your bad foot. This helps strengthen all of your leg muscles.

Those are the easiest ones to describe. If you're doctor has not suggested seeing a physical therapist at least once or twice, I would ask him/her about it. Also, like wmkcolors said, cocoa butter and vitamin e work great for minimizing scars. And make sure to massage the scars well to remove any scar tissue underneath the skin.