Six months is the point at which, according to the literature:
- you may reasonably expect to be back to 'normal'
- any swelling will likely have subsided
- you can wear 'normal' footwear
- you can resume 'normal' level of activity and sports such as running.
The literature also states:
- you may still experience limitations - especially where an osteotomy was part of the procedure
- swelling can continue for up to 12 months
- you may never be able to wear the same shoes you did before
- you may never be as active as you were before
In my case, I know that I can't expect to resume all the 'normal' activity I enjoyed before the procedure because before the procedure was the injury and the time during which the cartilage in the joint was diminished.
Based on my particular set of circumstances, I can report my progress.
First, a reminder of MY circumstances:
- Age 53 at time of surgery (now 54)
- Trauma injury which flattened the 1st MTP joint 3 years prior to surgery
- Diminished space in joint due to degraded cartilage
- stage 2 hallux rigidus
- used to walking 7-10 miles daily prior to injury
- aim of surgery: provide up to 10 years more before complete fusing of MTP joint will likely be needed; walk as much as possible without pain; reduce/get rid of 'resting' pain (inflammation in joint caused by bone spurs); improve the flex of the MTP joint
- My surgery was cheilectomy to remove bone spurs AND proximal phalangectomy to improve flexion
At six months, I can report:
- Swelling has reduced to the point where I can resume walking up to 7 miles a day in a range of soft and 'harder' walking boots
- Stiffness is still there but reduced
- Sesamoids are all aligned and there's no more sensitivity or feeling of swelling under the joint
- Sensation is returning to the surgery site and where the local anaesthetic was used
- Resumed lunges in yoga - but I take it really slowly
What I can't do, or am still limited in are:
- I can't wear all the shoes I used to before the surgery (but also before the injury). Some shoes just make the toe really stiff and sore or irritate the scar. But I'm really glad I can wear walking boots again (it's winter here, and trainers just wouldn't weather it).
- I'm better walking on even surfaces. When faced with uneven surfaces, I'm conscious that I'm being cautious as instances of sudden unexpected flexion of the MTP joint causes sudden pain. I'm hope this will get better over the next months
- The plantar flexion is still limited
- I have to go really slow when I'm using the dorsal flexion in yoga - e.g. lunges, downward dog.
- The scarring is more sensitive - probably due to the sensation returning in the surgery site. This makes some shoes too sensitive to wear and some yoga poses uncomfortable e.g. child's pose where the dorsal side of the joint is flat on the floor.
- With increased activity, I've realised some other issues that will affect what I can do that have been 'rested' during the recovery period e.g. the meniscus issues in my knee, the ligament and plantar issues in the opposing foot. General wear and tear associated with ageing. I'm in my fifties, so my journey can't be expected to be the same as people having these treatments in their thirties....
Overall, I'm beginning to feel that it's been worth having the surgery. I'm more confident that this will have been a good investment if I can get a few more years before fusion. I'm managing my expectations more - I had hoped to be able to get up to 10 comfortable miles a day over a week or more in order to go on walking holidays, but I'm scaling back my expectations. Seven miles every other day is not bad. And I still have 6 months to go in which more improvement can be expected.
And reaching seven miles a day over my week off at Christmas/New Year in my beloved walking boots is FANTASTIC!
(the low days was when I was travelling)
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