There was a major breakthrough over the last two weeks - probably resulting from the combination of the very active exercising (swimming, running, badminton games), and the time that elapsed sing the surgery, allowing for natural healing. First, I noticed that the swelling decreased significantly; for the first time (for two years!) I have been able to see the dorsal tendon running to the toe over the affected joint. Second, the range of movement has significantly increased now (although it is not as good as the other toe yet). Third, the pain is minimal, I could run 4 miles non-stop @ 7 mph yesterday, and I could probably make another 3-4 miles - there was no pain while running (but obviously I am not as fit as I used to be before the surgery, I still need to rebuild my level of general fitness). And the nocturnal pain I wrote before about is gone.
I came to the point where I am very happy about the outcome of the surgery (4 weeks ago I was not so sure of this). My advice to all of you who undergo a similar procedure - do not give up, and move and exercise as much as you can (i.e. as much as the pain allows - but do not ignore the pain).
30 July, 2012
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I am now 10 weeks post op, and exactly where you were at this point. I'm running nearly pain free (started running at 5 weeks post op) and I find the more active i am, being careful not to overdo it, the faster I'm healing. I barely notice the slight discomfort, if any, I have from the surgery. I wish I could do something about the scar that's there. But it actually acts as a reminder of how brave I was to do what I did.
ReplyDeleteStill so very grateful for this blog!
Marilyn
This blog is amazing. Thanks so much for writing it. I am 3 weeks post cheilectomy and orthotomy. I am not able to find normal shoes / running shoes to fit my foot but my physiotherapist told me not to wear the post op shoe anymore! My pain is still worse than I was expecting though reading this blog has been encouraging. Knowing I'm the same as most people.
ReplyDeleteIt's been 11 weeks since my bilateral cheilectomy (2/6/2017), and I'm blown away by how similarly my experiences have tracked others. Just a week ago I was feeling in a funk about the fact that (1) I was experiencing lingering random pains, (2) a constant nasty skin-level sensitivity on the top of my left foot that made pulling socks over my feet painful, and (3) unresolved swelling that restricted me to wearing sneakers, really stretched out loafers, and sandals.
ReplyDeleteI'm happy to report that somehow, things have resolved. Three days ago, I experimented on pulling on some tightly fitting loafers and... success! They fit snugly, and I have no pain (although they do feel tight). I get infrequent and random twinges of minor pain at night sometimes, and I have metatarsal soreness in both feet that is about 50% of what it has been in the past 2-3 weeks. In other words, I now officially feel better than I did pre-op.
I gave up competitive badminton several years ago, but based on Parsifal's experiences I may just take it up again...
In terms of activity, I've been bicycle riding pretty actively (40-80 miles a week), walking a lot, and I did one 4 mile run a couple weeks ago that set me back a little bit. Since that run, I've used the weekends to rest my feet as much as possible, which seemed to help. And by rest, I mean that given a choice between physical activity and not, I chose not, but I didn't actively avoid walking or doing things that needed doing.
I'm still not at 100% and can make the incision sites painful if I massage them too vigorously (which I continue to do to stimulate blood flow). The scars go through cycles of being really noticeable to barely visible. Sometimes they itch a bit. Overall, very manageable.
I am at 10 week so post surgery on Saturday, and I had my follow up appointment today. Unlike the last appt where I learned the osteotomy hadn’t healed, this went went well. The bone has progressed a lot and is almost completely healed, so the doctor released me. He said take two more weeks off from tennis until week 12, and I can then do whatever I want.
ReplyDeleteToe feels pretty good, and there is less pain than before the surgery, but he did tell me to up the ROM excercices. I honestly have done none since my six week, and I started it up again today. I will say that my toe feels great immediately after the excercise, so there is probably something to loosening up the joint and scar tissue.
Finally, I started taking vitamin supplements after my nonunion scare, so I would recommend vitamin D/calcium going into this. It is unclear if it really helps, but my bone healing made a lot of progress in 4 weeks. I’m off to Europe for the next two weeks startimg tomorrow, but I will give a new update when I’m back and start playing tennis. Merry Christmas and Happy holidays all!
I am a trying-to-get-fit again 49 yo old man who is finishing week 10. The pervasive fatigue has disappeared; I have great dorsal flexion ROM, and OK plantar flexion though my squeezing muscles are still week. I've done some 5 minute treadmill jogging, but am still not ready for anything more serious. I have PT 2x/wk, where we crack up scar tissue and do ROM stretches -- now in 360 degrees rather than just up and down. Some of those are so painful I break out in sweat. Every step still hurts, but the surgeon, who I saw again in week 9, said it's due to the swelling, cold Chicago winter, and healing still going on. Another few weeks of PT, then it will just be nature taking its course.
ReplyDeleteHere are my tracking statistics = week 11 end
ReplyDeletegeneral joint movement for walking (qualitative measure ):
pre op 25%
week 2 40%
week 4(end) 60%
week 7 (end) 85%
week 9 (end) 90 % but on ocassional days a bit of stiffness
week 11(end) 95%
target 90%
Pain
pre op 1-4/10 but after exercise 4-7/10
week 2 5/10
week 4(end) 2-3/10
week 7 (end) 1-2/10
week 9 (end) 0-2/10- mild pain only when I walk fast with full stride and on ocassional days - some days pain free
week 11(end) 0-1/10 practically no pain mostly zero
target zero
flexibility upwards (pull)
pre op 0-5 degrees - awful
week 2 40 degrees
week 4 (end) 40 - 45 degrees - good
week 5 ( end 45 degrees - excellent
week 9 (end) 45 degrees - excellent achieveable 90 % with tendon as well as pull
week 11(end) 45 - 50 degrees
target >40 degrees
in surgery surgeon said he had this to 90 degrees but i cant see how he ever did that - my good left foot has 45 degrees movt and thats all i need
flexibility downwards (using tendon)
pre op 40 degrees - very good
week 5 20 degrees - very poor
week 7 end - good but not as good as pre op
week 9 (end) 30 degrees not as good as pre op
week 11(end) 35- 40 degrees not as good as pre op but v marginal
target 40 degrees as pre op
I am off to China tomorrow and im very happy with the results of the surgery - the main difference since my last post is that the recovery was foremost in my mind each day - now i am hardly aware of it as it - no pain ROM excellent - there is room for more recovery but it marginal
i am still having physio - which is HIGHLY RECOMMENDED and walking 10000 steps a day - i will start running when i return in week 12 - that will be an amazing experience having missed it for 3 months
Today marks 11 weeks since my bilateral cheilectomy. I'm definitely doing better than I was at my 2 month update, although I had to go read that to remember how it was going then.
ReplyDeleteI stopped using the Dynasplints two weeks ago, since they had done all they could for my range of motion, and started doing my own PT-at-home exercises from protocols I found on the internet. That has pushed the ROM further, and I think I'm at 70 or 75 degrees on the left (dorsiflexion) and maybe 65-70 on the right. Plantar-flexion harder to measure--maybe 10 or 20 degrees? But the IP joint has 90 degrees--not sure if that counts for anything. I've been doing 20 repetitions in each direction of pushing to the point of pain and holding for 3 seconds, and standing at the edge of a step and bending all my toes down as far as I could, 20 reps for 3 seconds, and 20 double heel raises. Three sets a day. Painful, but then my feet feel much better afterwards.
When I saw my massage therapist a week ago, he added some more exercises to get my toes moving more independently (the big toe vs. the other four), so I do "toe waves," where the big toe is held either up or down, and the other four toes wave back and forth, and also towel scrunches with my toes. Since I'm still waking up with some swelling and stiffness in the morning, he showed me a calf stretch that can help with lymphatic drainage, and that's been helping my feet start the day off better.
If I do a ballet class or a long barefoot walk on the beach, that "counts" for a set of exercises that day. I can get through a basic ballet class fairly well, but it's easier if I've taken ibuprofen beforehand, and I feel like I've forgotten a lot of the technique and haven't gotten my strength back yet either. But I can get up higher on my toes than before, and that was the goal. This past week I tried going all the way down for grand plies, and that was ok--I felt it more in my knees than in my toes.
I walked on the beach yesterday, and that's less painful than before--I can walk farther and roll through each foot more easily. That was the morning, and I tried to do a ballet class on zoom in the evening, but that was too much for my feet, so I stopped. Today I've only been doing the toe exercises and walking in rocker bottom shoes, and I've taken time to put my feet up and relax.
For now, my daily exercise consists of either riding my bike 11-12 miles (including up a steep hill), a brisk walk for >4 miles, sometimes including 1/2 to 1 mile of walking barefoot on the beach, or a 1 1/2 hour ballet class. Plus 2-3 sets of toe stretching and strengthening exercises.
As far as regular life beyond my recovery, my physical stamina seems to be completely back, so I'm feeling less overwhelmed by things in general, and the recovery is less front and center as my main focus than it was before. The exercises are less painful and take less time, although I'm still somewhat shaky and out of breath after each set, from the effort and pain.
I wish I had known how active of a recovery this is, and how much effort it takes to regain good range of motion and flexibility in my feet. I also wish I'd realized how gradual the process is, but that wasn't for lack of people telling me how long it would take. I thought I would somehow be completely back to everything by now.
I am very, very glad that I had both feet done at the same time!
I'm nearing the end of week 11. I'm not sure if I'm having a breakthrough on all fronts--my dorsiflexion ROM measurement was actually down a bit at my last PT appointment, I'm still having some pain here and there in the joint and also further along the metatarsal area of my foot, and there is still some swelling. However: no sharp pains that wake me up, my foot is maybe less painful in the morning than it used to be, and swelling seems down from where it was a few weeks ago.
ReplyDeleteThe nice thing is that some of my physical activity is approaching what it used to be pre-surgery. Most days, I either go on long walks or ride my bike indoors on the trainer. I walked an average of about 1-1.5 miles a day pre-surgery; I'm back to averaging almost 1 mile a day. My limp is gradually receding, and I had my longest post-surgery walk this week (some of it on my local hiking trail). And I am slowly getting back to harder bike workouts. In terms of day-to-day life, I am also getting to a point where I'm not thinking so much about the surgery, or needing to compensate for my foot when doing things around the house. (I am still wearing rocker-soled Hokas indoors and outdoors for support.)