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post - Lapidus weightbearing questions

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Old 09-30-2007, 03:01 PM   #1
Join Date: Sep 2007
Location: nyc
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tessnyc HB User
post - Lapidus weightbearing questions

Thanks for all who have posted their experiences! I have lurked and gotten lots of great info.

Now that I am 7 weeks post-lapidus procedure I have some questions as I approach weight bearing. At the 6 week mark (after 6 weeks NWB) I went to my doctor (foot & ankle orthopedic sugeon) who gave me the following plan: start putting some weight (approx. 35 pounds) on the foot while on crutches for one week, and then start putting equal weight on both feet while on crutches for one week. He expects the following week (8) I should be full weight bearing without crutches. I wear a camo-boot. I use the roll a bout during the day to go to work, so i am practicing walking at home.

To those who have had Lapidus and have become full weight bearing, what is progress like from there. Do you just start walking everywhere without crutches? Do you take your crutches with you? When can you walk up/down steps?

Also, I have the opportunity to go to a rock concert at my 13 week mark. Even though there are seats, there is always a lot of standing on line and standing at the show involved. I know I will be able to get there, but I am concerned about whether at 13 weeks you feel "normal" or whether there is still swelling, pain, and limitations on walking and standing. Don't want to put myself into that situation if I won't be ready for it. What do you think?

Then there is the big toe issue. My big toe and joint are now straight (after years of being bent) and the dr. asked to see if I could bend it---- no, totally stiff! The doctor said I have one month to get the toe bent, or scar tissue will form and it will be stiff for life, so i now have to spend time each day trying to bend my toe just a little at a time. It is very painful. I bend it just a little to the point of pain, then hold it a little. And repeat. After a few days, I am seeing results. But it is scary. What is your experience with big toe stiffness. He prefers I do it myself because he is afraid a physical therapist will push too hard. Do you ever regain full range of motion of the big toe bunion joint, or will it be limited?

thanks for any input!

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Old 10-01-2007, 06:11 AM   #2
Join Date: Apr 2007
Location: NY
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dancergal19 HB User
Re: post - Lapidus weightbearing questions

Hi Tess,

Congrats on making it through the worst part! I had lapidus bunionectomy and osteotomy in April and have been recovering pretty well. When I went to the dr at the 6 week mark he took x-rays and said that my metatarsal was completely fused so he gave me the OK to bear weight. I was really scared to put weight on my foot even though I couldn't wait to get rid of the crutches. It felt weird at first and my foot was tender but I wouldn't say that it was painful, it's just a weird feeling. At first I couldn't walk without the aid of my crutches and my Pod told me that he wanted me walking without them after 2 days. I used them for the first day and after that I felt pretty comfortable walking without them. After 2 or 3 days I was totally crutch free and it felt really good to be walking again!! Walking becomes pretty normal again, especially with the camo boot, that's what I had too. It provides a lot of cushion and protection so you don't have to worry about hurting your foot when you put all of your weight on it.

I think I wore the camo boot for 2-3 weeks and then my doctor switched me to a surgical shoe that only provided minimal protection and support because I didn't really need it anymore. This is when my foot and ankle became a little sore because I was walking a lot more and in the camo boot you can't really bend your ankle so once you switch to the surgical shoe you start using muscles and joints that you haven't used in a long time. Again, it's not really painful, it just feels strange and your foot will be tender. If I were you I would try to gradually increase the amount of walking you do so you don't over do it. I think you'll be totally fine to go to the concert but you might want to wear your camo boot even if you've been wearing the surgical shoe just because it'll provide more protection and comfort when your standing in line, etc (and in case anyone steps on you!).

In terms of toe flexibility, my toe was really stiff like yours is and I started physical therapy around the 10 or 11 week time. My doctor had me doing the same type of toe bending as yours is having you do. I was petrified of touching my foot and bending my toes so I wasn't very good at it. I think this is why my Dr had me go to the physical therapist sooner rather than later. You definitely need to push yourself to do that because my range of motion is now very good but it is still not as good as my non-surgical foot. I don't think it will ever be quite the same but it doesn't affect much (except I used to be a dancer and now it's hard to rise up on my toes because the range of motion is a little bit less).

Hope that helps & good luck!

Old 10-01-2007, 07:14 AM   #3
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KathJack HB User
Re: post - Lapidus weightbearing questions

My bunion surgery was a different procedure and I was able to be WB & bend my big toe much earlier, but I agree that it's important to get your toe flexible. I just talked with a young friend recently who had had a bunionectomy several years ago and didn't have the range of motion she wished she had-- Really regretted not getting PT at the time. I don't totally understand your doctor's concerns because PT's are trained to know how much you should do. If your bending doesn't start showing results very soon, I'd ask the doc to give you a recommendation for PT and then just make sure that they understand that it is important for you to not overdo it. Maybe your doctor could advise them? Congratulations on your recovery so far and best wishes for a full one very soon.

Old 10-02-2007, 03:26 PM   #4
debbie g
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Re: post - Lapidus weightbearing questions

i hope pt is in your near future because it will help with the toe flexibility which is so important.

Old 10-02-2007, 03:54 PM   #5
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zapfamily HB User
Re: post - Lapidus weightbearing questions

Hi there - I am one week behind you Tess - I am six weeks post op from lapidus surgery. Last week at 5 week mark my doc removed the cast and put me into a cam boot - still no weight bearing. As of this week, 6 weeks, I can touch my foot down very lightly and I finally got the okay to drive - INCREDIBLE! I wear my camo put and use crutches to get to car - and then I change into a surgical shoe for driving. It's time consuming but I don't mind - it is so wonderful to drive!

I was so pleased last week when I finally saw my foot - the swelling and bruising were minimal and my foot looks so good with that huge bunion gone. I had severe pain on the ball of my foot - which is why I had the surgery - and I'm not walking yet but I keep pressing it where the pain was and so far I think that pain is gone! Thank the Lord! My ankle is very weak and the top of my foot is very sensitive - I think all those weeks in a hard cast got the best of it. I am trying to draw circles with my ankle several times a day and i already feel it getting stronger.

I have my first physical therapy session tomorrow and I can't wait to get on with it. I know I will probably have a lot of healing in front of me as I start to walk with full weight...but I feel really good and very hopeful that the worst is behind me. By the next week or so I will be walking full weight with a surgical shoe but I'm sure that I will be taking stairs one at a time and still spending a lot of time with my foot propped up.

I'm still using the roll about as well around the has been my lifesaver -but I'm looking forward to packing it up soon and putting it in the attic!

Happy healing........keep us posted about your progress

Old 10-02-2007, 06:24 PM   #6
Join Date: Sep 2007
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tessnyc HB User
Re: post - Lapidus weightbearing questions

Thanks so much for all your advice!

I am pushing on the big toe a number of times a day and I have much more range of motion than I did last week, but I am concerned that I am having a lot of trouble getting it to bend up (as opposed to curl down). After hearing your advice I think I will call my dr. after the weekend, talk about what I have achieved with range of motion is, and ask if he would send me to a PT to help move me along.

When you finally do walk, how long before you are walking without assistance, without needing to elevate your leg, etc? I am looking forward to walking without crutches 8 days from now (yay!!), but I am concerned about pain, inflammation, feeling pressure, etc. I think I may take my crutches with me at the beginning even if I don't need them all the time, just in case I need to lean. And also as a visual warning to people that I may need assistance/special consideration.

Right now, with the roll a bout, my problem is obvious and everyone is friendly and helpful. Did anyone find that after they looked "normal" that it was harder to get help?

Also, after you are able to walk without crutches, when can you walk up and down some steps? any wisdom is appreciated.

zap-- you are behind but sound ahead in some ways. after a week flexing the ankle, you will find a huge difference. the ankle bounces back really well. happy healing to you too!

Old 10-02-2007, 07:50 PM   #7
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zapfamily HB User
Wink Re: post - Lapidus weightbearing questions

I asked my doctor many of the questions you are asking....and this is what he said: Once the bone has fused and you are ready to bear full weight...PAIN and SWELLING will be the main indicators of what you can or cannot do. I think for the next 6 to 8 weeks we will still be healing from this surgery....maybe even longer. That means listening to the pain level, grabbing every opportunity to elevate the foot, and taking it slow (maybe this is the year I will do all my christmas shopping on-line )

Stairs will be a slow process I can tell. I go up and down the stairs in my house on my rear end...and I will be doing that for weeks I'm sure. I'm actually pretty good at it! I carry my roll about with me as I go up and down and look at it as my "workout." When I do start taking the stairs on my feet I will take the stairs slow, good foot first on each step. I hope your job does not require a lot of walking and really need to take that slow.

A PT will know how to work the toes...and again...listen to your pain level! I think the crutches are a great indicator for folks to give you some space...but I'm sure you are just as anxious as I am to not use them anymore. My doctor said I should not use them for too long because it is important to get my gait back and full use of my legs. I heard that walking backwards (in a safe place of course) helps to eliminate any limp you may have.

Take care....hope this helps

Old 10-02-2007, 08:08 PM   #8
monster bunion
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monster bunion HB User
Re: post - Lapidus weightbearing questions

Hi zapfamily and tessync,
So glad to hear you are both weightbearing now! I kept notes on weightbearing. At first, my heel was very sore but it does get better. Also I had a bruise on the inside heel and bottom of the foot which was probably from the cast. I used crutches for six days. For the first three days, I would take 10-20 steps,foot exercises, then ice, then rest and do this about four times a day. Then on day 4,5,6, take 100-200 steps, foot exercises, ice, then rest about four times a day. On day 7 I was able to go out to lunch, Jamba Juice and dinner with the cam boot. If the foot gets sore, I took two tylenol 325mg to sleep. I think I started to drive at about three weeks. Don't try to overdo it and I always kept my foot up on a chair still if I was not walking. I'm at 15 weeks and the foot does not mind being down but I habitually just prop it up anyway. Good luck to you both and happy walking.

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