It’s been just under a month since my surgery and two weeks since my first post-op visit. This is the first chance I’ve had to really start looking at a recovery phase. For the first two weeks, I was basically in a boot and not moving around significantly. The biggest transition into week three was starting to not use the boot. The doctor recommended transitioning to my hiking shoes that have a carbon fiber plate at the end of week three and also start some post-op PT in terms of passive stretching and bending of my big toe. My Hallux Limitus recovery begins!

Wound Recovery

Week 3 recovery
Week 3

Overall I’m pretty happy with how the wound is recovering. There seems to be a significant improvement over the last week and basically, the wound is closed well. After the dressings were removed there was still considerable bruising around my foot and its still clearly got swelling. Most of the bruising has now gone. Both on the side and top of the foot. There is still some swelling but the doctor said that might last for several months.

hallux-limitus-week-4
Week 4

You can see at week 3 there is still substantial bruising on the top of the foot. There was also a lot of bruising on the instep that almost went back to the heel. The good news is I could finally have showers and get rid of some of the final remnants of whatever they coated my foot in.

By week 4 you can see the wound has healed up very well. The bruising has almost gone. The swelling is definitely still there and I’ll be keeping an eye on this as start to work on the PT. Overall I’m pretty happy with the results so far.

Sensations

Over the whole experience, there have been some weird nerve experiences. These include the occasional feeling of wetness, like the incision, is bleeding, pain right at the junction of the nail and nail bed on the big toe, and once quite some pain in the little toe. These have all diminished considerably and the only one that is left is some off feeling where the nail meets the nail bed. There is also some bruising left there. But that sensation is much less than it used to be. Overall pain level has increased a little. But this is more due to starting to move joints and bend my toe.

Mobility

Mobility has really increased in the last two weeks. I have my hiking shoes – Altra LonePeak 4.5 with a carbon fiber insole in the left shoe. This has been fantastic. With the carbon fiber insole, the shoe is very stable and I’ve been out walking pretty normally. At the end of week 3 I was walking the dog 3 miles without much issue and at the end of week 4 have done five miles and could easily do more. This is excellent as it starts to just get a general level of fitness back. The carbon fiber insole has been really critical to getting out and about.

However, the insole does not let the toe bend much and that defeats the purpose of having the cheilectomy in the first place. So in addition, I’ve started stretching the toe – first passively and no more actively. There is definitely some pain and stiffness in doing this and it will take much more work to get the ROM back to where I want it. The swelling isn’t helping so I am taking some ibuprofen to help with that – rather than with any pain management. Now that the wound has pretty much healed I might look at using some Voltaren cream rather than Ibuprofen- just because it’s a little more targeted.

Inside the house, I can work around in bare feet but now have to start to make a conscious effort not to use the outstep of my foot – both to get my toe bending and get my gait back to normal.

Tips

As I get back to normal activity, here are a couple of tips that have really helped.

hallux-limitus-shoe-lacing
Wide toe box shoe lacing
  • The carbon fiber insole has been a life saver. With that in my show I pretty much feel that I could walk as far I did before the surgery – this is great for getting a general level of fitness back.
  • I keep a dressing on the wound – this is mainly to provide some padding and stop it rubbing on whatever shoe I am wearing.
  • I’ve been playing around with the lacing technique on my right shoe and the best has been one that keeps the laces relatively loose and the front – and allows the wide toe box of the Altra’s to accommodate the little swelling

The next stage of my Hallux Limitus recovery is to really work on the ROM. I’ll be really focusing on PT and both upward and downward motion. The Hallux Limitus Facebook Group has some great PT exercises.

Here are the links to Part 3 and Part 5.

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