Hello, my name is Dr. Jairo Cruz Jr. of Advanced Podiatry and I’m here today to talk to you about what to expect after having a bunion surgery.
So, you finally wound up the courage and found the courage to have a bunionectomy done after years of having pain. That’s typically what my requirement is. If there’s no pain, I typically do not fix bunions but if there is pain and symptoms and it’s inhibiting your lifestyle, then I say let’s do it.
So, what to expect after your bunion surgery. Essentially, what you should expect is discomfort and pain. The usual timeframe for that discomfort and pain where it’s quite high is the first three days after surgery. So, what I suggest to patients for immediately —the first three to five days after surgery—is being very nice to the foot, meaning not putting weight on it, icing it, elevating it, just taking your medications as prescribed, and just being really nice to the foot so that you are not in too much pain.
After the first three to five days, there’s a remarkable difference—like night and day— between the pain and usually people say hey, I can actually walk on this.
I do dispense a boot at the pre-op visit or on the day of surgery where you can wear that boot as tolerated. So, some people opt to walk the same day. And that’s okay as long as they’re following my specific instructions which is typically weight to the heel only, so the back of the foot should have all the pressure and not hit the front of the foot where the surgery was performed.
What we’re trying to do is we’re trying to minimize complications. So, if we start to walk on the site of surgery, that causes increased swelling, that can cause complications with the hardware that’s holding the correction in place, we can have wound problems where the incision might open up because of the fact that we’re putting pressure on the skin in that area.
So, if the patients follow my instructions explicitly where I say hey, if you’re going to choose to walk on this because you have to out of necessity, then please put all the weight on the back of your heel. Now, that’s not going to affect the rest of the body very well because you’re walking funny and so therefore, your back might hurt, your hips might hurt, things of that nature.
So, ideally, what the patient would do is again, stay off the foot for 3 to 5 days and then after that transition to the walking boot with the weight to the back of the heel still. So, obviously, the surgery was done, there’s an incision where after the five days we’re walking around in the boot. Some people like to have crutches as a supplement to their walking which is fine, too. Any way, you want to be stable and any way, you want to increase your stability while recovering from this is no problem with me. So, if you need me to prescribe you a knee scooter to roll around on, if you need crutches, if you need a walker, I don’t care. I will prescribe anything to make sure that you do not injure yourself or injure the site because we want you to have a pain-free and also event-free recovery.
So, now, you’re walking in the boot and we’re usually in the boot for maybe between two and four weeks depending on how the symptoms are. some patients are lucky. Some patients get out of the boot at three weeks and they’re able to walk just fine and they have no pain. But this is usually for bunions that didn’t require any hardware fixation.
People with hardware fixation, the bone takes a little while to heal and that’s what we’re waiting for. We’re waiting for the hardware to fix or put in place the bone. But we’re really depending upon the body to heal itself where we made the bone cuts, so that the bunion can heal in the proper position and you can have the best results possible.
So, again, up to four weeks for having the boot. Some may extend into six weeks. It all depends on clinical judgement, and what I see in radiographs, and how you feel.
So, that’s what the first six weeks looks like. It may be four to six weeks of the boot. It could be four. It could be three. It just depends again on the symptoms and what type of procedure was actually done.
Again, run of the mill surgery, four to six weeks in a boot.
After that, it’s going to be transitioning at around eight weeks to a regular shoe and also increasing activity with exercises such as stationary bike or elliptical, or light activity like light walking. It is not advisable to start doing high-impact exercises after this period of time or during this period of time because of the fact that again, you may still injure the surgical site.
Sometimes, after the eight-week period, if I feel that the range of motion of the toe is not adequate, I will send the patient to physical therapy or have them do physical therapy at home. But I at least need two to three sessions of physical therapy in order to teach the patient how to perform these exercises at home. This greatly benefits a lot of things.
First and foremost being range of motion of the bunion or range of motion of the toe. And then, also decreasing swelling in the area because the body is still healing during this time. There is no immediate gratification because the body takes its time to heal whatever it is that we did to the foot, so we have to be patient during this time and allow the body to heal itself.
The typical treatment time again, around 12 to 16 weeks. The patient is usually up and about in a regular shoe doing exercises and performing things that they usually did before the surgery. Some may have persistent swelling, some may have a little bit of pain but nonetheless, these things subside. Some symptoms last six months to a year but they’re usually minimal. If there is something that is painful and causing more pain than usual or a different kind of pain, obviously, we would investigate that and see what is going on. But in general, this is not a common occurrence.
Usual recovery time, again, six to eight weeks of either protective walking with a boot or just protective walking in a regular shoe as tolerated. And then, around 12 to 16 weeks is where you’re really ready to go and start doing activities such as long walks, or elliptical, and biking activities as tolerated.
Overall, foot surgery is difficult just because of the fact that we use our feet to walk. And our body weight alone on the foot is quite a bit of pressure. And when you increase pressure by walking and performing activities, it’s even more pressure to the site and therefore can cause some discomfort. overall, the procedure is fairly simple and fairly easy to recover from. It’s just a matter of being aware that this procedure does take time to heal. And as long as I think there’s no false expectations of immediate gratification, then the patient is quite happy.
I hope you found this video helpful and if you have any other questions, please feel free to call or make an appointment by calling the number (813) 875-0555. We can make an appointment usually the same day if we can fit you in. If not, we’ll make the closest appointment possible to your requested date. But again, you can also visit us at www.thetamptapodiatrist.com and also there are many blog posts and video blogs with regards to foot pathology topics and ailments that you may be interested in.
Thank you for your time.