Walking After Bunionectomy: 3 Benefits of Early Weight-Bearing
Posted by Jenn F. on Monday, June 29th, 2015
Bunion surgery is not what it used to be. New procedures and fixation techniques have allowed patients to move to a special surgical shoe or walking boot for physical therapy right away, with full recovery possible in just six weeks. As fellow surgeon Dr. Luke Cicchinelli from Arizona put it: “Bunion surgeries have been performed for more than 100 years. Techniques used today ensure minimal pain, earlier and improved mobility, and decrease the likelihood that a bunion will return later in life.”
There is still a divide among foot and ankle surgeons as to whether to send bunionectomy patients immediately to physical therapy or to advocate a period of “taking it easy.” Here at The Center for Podiatric Care and Sports Medicine in NYC, we have seen great results advocating post-surgery physical therapy. Today we’ll discuss the three main benefits of early weightbearing following bunionectomy.
Heal With Less Down Time & Disability.
While there is no way to “speed up” the bone mending process, we can make life a little more pleasant for patients by advocating early physical therapy. It’s much easier to get around without the anchor of cast and crutches. Most people agree that a surgical shoe is much more comfortable than a cast. Some people are able to get back to work sooner if they have relatively sedentary jobs.
We’ve had patients tell us that the hardest part of recovery is having to “take it easy” and “just relax,” when they are normally very active, busy people. There is a feeling of “cabin fever” that hits when you are sitting indoors on the couch, reading or watching TV for hours and hours each day. A little bit of fresh air is much more preferable to your mental well-being during recovery!
Avoid Limb & Health Complications.
Cast and crutch use can cause unanticipated consequences, such as lower limb muscular atrophy and upper extremity fatigue that must be remedied with weeks of physical therapy. Using these devices shifts a person’s biomechanics and makes normal walking very awkward once the devices are removed. Furthermore, immobility following surgery can cause swelling or life-threatening blood clots in some patients. Therefore, we advocate an early walking program for most patients.
Improve Flexibility & Range of Motion.
As Lower Extremity Review magazine points out, research indicates that early weightbearing and physical therapy “can significantly improve range of motion” and overall outcomes. It’s much easier to keep soft tissues flexible than to fix them after they’ve had an opportunity to tighten. An article published in the September 2009 issue of Physical Therapy demonstrated that a 45-minute rehabilitation program once a week for four to six weeks showed significant improvement in range of motion and function. “We noticed that patients who underwent hallux valgus surgery didn’t use their great toe for push off, even though the deformity was corrected sufficiently,” said lead author Reinhard Schuh, MD. Therefore, beginning “passive range of motion exercises” starting two days after surgery was necessary to restore function in the foot.
Another study conducted by researchers at the Weil Foot and Ankle Institute in Des Plaines, Illinois concluded that: “The advent of screws and proper screw fixation eliminated the need for complete immobilization. Patients are able to return to activities and start physical therapy earlier, which has tremendous benefits.” Patients underwent once or twice weekly physical therapy sessions of 30-45 minutes and found that the physical therapy group “significantly outperformed” the control group in foot function, pain reduction and alignment.
Early Weightbearing Considerations
Early weightbearing is feasible for most patients, but you may not be a good candidate if you have osteoporosis, you are normally very sedentary, you smoke, you use non-steroidal anti-inflammatory drugs, you are morbidly obese, or you suffer from neuropathy and cannot feel your foot. Naturally, you don’t want to just take it upon yourself to resume all regular activities right after your bunionectomy. You’ll want to work with an experienced team of podiatric specialists who are trained in facilitating quicker and more successful recoveries.
NYC residents will find such a team at The Center for Podiatric Care and Sports Medicine. Our board-certified NY foot surgeons have performed more than 15,000 operations over the years. You can trust that our compassionate health care professionals will take you from the consultation and non-surgical interventions, through surgery (if necessary) and a complete recovery. Contact us to schedule an appointment with our bunion experts.
If you have any foot problems or pain, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. Geldwert, Dr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.