Penrose Physical Therapy
05
Jan 2016
Jennifer Penrose
Author
Jennifer Penrose

3 DAYS-1 WEEK

  • Strict elevation
  • Rigid post-operative sandal – mobilize full weight bearing (with 2 crutches only if needed)
  • Move toes, ankle, knee and hip
    • Toe lifts: Sit with foot flat on floor, raise toe as far as possible to ceiling and return
    • Toe bends: Sit with toes resting over the edge of a thick book, bend toes toward floor
    • Toe pulls: Pull toe up with hand to pain and hold for 3 seconds, relax
    • Toe pushes: Point ankle and toes down (like a ballerina), push toe down with hand to pain and hold for 3 seconds, relax

1-4 WEEKS

  • Strict elevation at the level of the chest, for 23 hours a day for 14 days (for pain relief, swelling and wound healing)
  • Full weight bearing in post operative sandal (can be removed at night, but put back on when walking)
  • Seated heel raises
  • Straight leg raises

4+ WEEKS

  • At 6 weeks, post operative sandal removed and normal shoe worn (will need to be a generous fit)
  • Standing both heel raises
  • Standing single heel raises
  • Standing lunge
  • Ankle and Calf
    • Plantar flexion
    • Dorsiflexion
    • Peroneal muscles
  • Gait training
  • Optimize load distribution for the whole foot focusing on weight bearing of the first MTP joint and hallux

RETURNING TO WORK

  • Sedentary jobs: return 2 weeks post-op, if able to maintain foot elevated at level of waist, otherwise 4 weeks off
  • Standing/walking jobs: 6 weeks, but may be sooner depending on comfort and swelling
  • Manual/laboring jobs: 8 weeks, but may be sooner depending on comfort and swelling

DRIVING
You need to be able to control the vehicle in an emergency. Can you stamp your foot down on the ground? For left sided surgery and no clutch is required, driving is likely safe at 2 weeks post operatively. For right sided surgery, driving is likely safe at 6 weeks post operatively, once in a normal shoe. If you are unsure, please ask your surgeon or therapist.

References: Adapted from Hallux Valgus (Bunion) Surgery Rehabilitation from the website of Mr. David Gordon, MBChB, MRCS, MD, FRCS (Tr & Orth), Consultant Orthopedic Surgeon, London and Hertfordshire, UK

Click here to download: Bunionectomy

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