Toe pain after bunion surgery

by Karen
(Chicago)

Hello,

I am a physically active 56 year petite woman (weigh 104 lbs), recently had two separate bunion surgeries, one in January & the other in March of this year. Both were very successful in that I have full range of motion even with arthritis. My doctor strictly advised me to limit my exercise (until last month, September, he gave me the go ahead) to types that do not have me jumping up and down or putting pressure on my toes. I've been good until about 3 weeks ago when for the first time did about 15 military push-ups & some planks (up on my toes. The next day both my big toes were hurting so bad I had to ice them and walk very gingerly.

My question is how long does the healing process take for the foot to not have this kind of pain? I've read that it can take up to one year to recover fully. Not sure my feet will ever be able to take what they did before. I stopped running 5 years ago due to knee pain, but would like to go back to a low impact Aerobics class at some point.

Thank you.
Karen


RESPONSE

Hi Karen,

Bone remodeling by the body after a procedure such as bunion surgery can take upwards of one year. If you also had an osteotomy where the first metatarsal bone or even the big toe bone were surgically broken and reset (re-angulated) this too has to be factored in to the equation.

You are fortunate that you have a good range of motion in both your big toe joints; that is very encouraging.

The mistake you made was attempting to do push-ups and planks. Any exercise that attempts to excessively bend the big toes upward is almost certainly going to cause pain in the big toe joints, particularly those that have been diagnosed with arthritis.

My guess, and it is only a guess since I cannot examine you is that even though you do have motion in the big toe joints, you probably still have some degree of limitation in that motion. In other words, your toes do not bend up as much as they might have thirty years ago. That is to be expected.

When you attempt to do exercises that put excessive pressure on the big toes to bend upward, you are eventually going to reach a point where the toe is being forced beyond its ability to bend upward and the end result will be pain.

I am not even sure that this pain really has anything to do with the bone healing process, unless you had implants put in, but you do not mention that so I assume you did not have them.

I think it is more a case of putting too much demand on the big toe joint and the end result is the pain you experienced.

Like everything else, as we age, sometimes we have to make changes in our lifestyle to accommodate the changes that our bodies go through.

Your feet are no exception. I think your surgeon would agree that the purpose of you bunion surgery was to allow you to function pain free in your day to day activity but that when you place the big toe joint in a position where the demands placed upon it are greater than its ability to respond, there are going to be issues.

So it is not a case of not being able to exercise, it becomes more of a case of finding exercises that do not over stress the big toe joints. Finding that compromise will allow you to continue exercising without doing further damage to your feet.

If you have any questions regarding your surgery, you should contact your surgeon.

Marc Mitnick DPM
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