As I go into week 8 from the date of the cheilectomy and osteotomy to treat hallux rigidus stage 2, I'm mindful that this is supposed to be a big turning point. In my notes that I was discharged with it states,
"You should return to your normal daily activities (and stop the PT exercises) after 8 weeks, although exercising the joint from time to time may still help."
Now I'm a bit literal, so I'm tempted to follow the guidance to the letter. But I actually think my PT has really only just begun. Maybe that's because I had the osteotomy, maybe the guidance is pretty good for cheilectomies on their own. And as for getting back to 'normal' activity, well, given that normal activity was much reduced due to the condition of hallux rigidus in the first place, this could be a little difficult to measure (and since I'm not a runner, and I'm in my mid fifties, it puts me a little at odds with the experiences of many in blog posts and discussions I've read).
So given all the above, let me take a look at where I think I am as I come up to the coveted 8 week mark. For a start, I've begun a regime of dedicated, mindful walking in order to get myself and the foot back into shape. After nearly a couple of months on the couch (well, not really, but certainly not doing my usual activities) I'm pretty out of shape.
So I started with a 1.5 mile concerted walk (about 3K) and immediately discovered that the area around the incision scar is really suddenly sore. It hasn't been up til now so I guess I put this down to 1) doing more and 2) getting more sensation in the area (hitherto I've not been able to feel anything there following the anaesthetic).
So, I applied a good protective plaster and stepped out again and yesterday (a little past 7 weeks post op) I walked 3 miles (5K) in my specially appointed Merrell trainer/walking shoes. Apart from feeling pleased and not having any major issues with the toe (bar a kind of bone pain towards the end), the biggest gob-smack was all the aches I've got everywhere else!
My hamstrings were so sore last night, as were my glutes. And I had to rest between achieving 1.5 miles and getting up to 3 because the tendon in my other foot was inflamed! Goes to show just how much fitness you lose lying around for a couple of months! I guess also, being mid-fifties now means that healing and recovering fitness takes a little longer (I read somewhere that for an osteotomy, calculate one month per decade of life for recovery - so that's 5.5 months for me).
Anyway, the burning pain I used to always have walking from the bone spurs is obviously gone - yay! - and I had very little discomfort with the scar protected. Sometimes I'd feel a bone pain - like what I used to have when I was a kid (the doctors called it 'growing' pains), so I guess that's the bone knitting back together again after the osteotomy.
I did some research and am now doing some lunges to try to incorporate the 'bouncing' exercise on the toe in a dorsalflexion and have deployed a tennis ball (now that the dog's to old to be interested in mauling it) to roll around the ball of the toe when I'm sitting at a desk. This has the added bonus of massaging the scar tissue inside at the same time as giving the plantar flexion a little work out. I know from other injuries in the past that scar tissue is a major barrier to regaining motion and left unchecked, I guess its no different with a toe, if the scar tissue isn't addressed then a decent range of flexion in either direction isn't going to happen on its own.
I'm in the UK and had the surgery in the NHS, but that meant one appointment with the podiatry surgeon following surgery and then I was discharged with no PT (unless I seek it out and pay for it myself) so I'm mindful I'm going to have to take care of this over the next few weeks (assuming the bone is healed enough).
You can read a little about this topic in this post about scar tissue management.
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