Looking for Information After Bunion Surgery?
- David Tollafield
- Aug 27
- 6 min read
Common Questions & Concerns following Foot Surgery
Since writing the original article, I have been amazed at the positive responses. I set out with Tim Kilmartin to turn your questions into a complete guide. I have shortened this introductory piece to show you at a glance some of the details you might want to elaborate on.
Tim and I have incorporated patient questions into our guide, which we have developed over the last ten years. I must make it clear that this is not complete, but it should raise questions, and I hope you find the content valuable. You will find a new series on bunion (hallux valgus) on my site.
Quality information after bunion surgery is important as so much can be left unspoken and assumed.
After Bunion Surgery - quick guide
Pain peaks at around 16-24 hours, reduces over 72 hours, and can be reasonably negligible by 5 days.
The swelling reduces slowly over 2 weeks, 4-6 weeks, 3-4 months, and 6 months.
Footwear may be tolerated for 6 weeks, but don’t be surprised if it takes longer. Some shoes don’t fit because the foot shape has changed.
Mobility commences slowly after 5-7 days. Two weeks should allow for some walking, which is better with aids. Normal activity can take 6 weeks to 6 months. Returning to heavy industrial work with risk no earlier than 8-12 weeks and for active work, e.g., teaching, 8-12 weeks. Sedentary office work for 3-6 weeks.
Wounds take 2-3 weeks to stabilise, but may take 6 months to reach their optimum strength.
Hygiene can be maintained by careful showering using a special cover rather than a plastic bag.
Numbness may persist for up to 9 months, gradually improving. Massage to reduce the delay in recovery.
PLEASE NOTE DUE TO A VARIETY OF DIFFERENT TYPES OF SURGERY, SOME MAY REQUIRE DIFFERENT POST-OPERATIVE CARE. ALSO CONSIDER FACT SHEETS WRITTEN BY YOUR HEALTH PROFESSIONAL.
The Basics
Pain
You can expect a range of outcomes from mild to severe pain. Now, that’s just as helpful as using a bent penny in a slot machine. The truth is, we all have different pain thresholds. More complicated surgeries may be more painful, but the Scarf-akin is moderate. Take the painkillers regularly as guided—anti-inflammatories with or after food. Paracetamol (acetaminophen) and codeine are useful, but watch out for codeine. It is good, but it can make you feel dizzy and give you hallucinations in rare cases. The big downside is constipation – and this can be nasty.
Swelling
Swelling is both good and bad, a contradiction that requires some explanation. Swelling reminds us of hurt and the need to rest. It stops movement. We do less damage with rest. The swelling goes down in time. Sudden swelling after surgery, when everything seemed fine, is concerning. We must consider the possibility of infection for up to 72 hours. Obviously, an infection can happen later, but we need to talk about this when we get to the wound.
We must elevate the limb to reduce swelling—the higher, the better. This practical act stops nerve endings in tissue from being excited as pressure builds. Keep the pressure down, and the nerves will be calmer.
Exercise & mobility
Once the wound has healed and the pain controlled, you can press the toe against the ground and lift the heel to help create more upward movement. Toe joint mobility can take over six months to return and, in many cases, does not fully flex because it has been placed into a new position after being dislocated for so long.
Stop clots before they happen.
Exercise is essential for when you are not moving and to prevent clots. In some cases, you may have been given an anti-clotting injection and have to follow up at home, but don’t stop exercising. The risk of a leg clot after foot surgery is minor, but it can happen. If you get sudden chest pain and breathing problems, then DO phone 111 or 999 (in the UK). Lung clots are life-threatening.
Aids to help mobility
Remember, you have been temporarily disabled. This means you are vulnerable and can fall over. The first thing you should have are crutches, and these should be demonstrated with practical instructions for correct length and stride when in use, as well as how to go up and come downstairs. Now you can use a walker boot. Chances are you will have a post-op shoe. This allows you to cope with that big dressing, but once it is stripped down at around 2 weeks, the shoe is loose.
A walker boot is great, and I found Aircast secure and adjustable. There are many similar designs on the market. Some services provide these, while others don’t. Many will say you don’t need them, but take it from me as a patient, you will advance far quicker with a boot than not.
My neighbour had a scarf-like item, and she was stuck without it until I recommended that she have one. If you can move around and build up active walking, three positive things will happen.
Circulation increases and flows around the foot and limb
Swelling reduces as the calf pump is activated
wounds heal better with less swelling and better circulation
The downside is –
You can over-exercise and increase your pain
Swelling can increase with overuse
The wound opens up and becomes infected
Return to Work and Normality
Everyone wants to return to normal, and this is as expected. How long does a scarf-akin take to settle? If you are lucky, within a month; if you are unlucky, 4 months. What is normal?
return to walking 1/2 mile
returning to the gym
shopping
going back to work
standing all-day
wearing most shoes in your cupboard
flying to a holiday destination
swimming in water
driving a car with a clutch and gears
Wound
Skin is tough, but not when it fails to heal. If it gets soggy and wet, an infection can thrive. The type of wound for a bunion is either on the side of the joint or on top. A wound takes 2 weeks to stabilise, even with stitches (sutures). Steristrips are thin tapes and may be used with absorbable stitches. If you cannot see any stitches, they will most likely dissolve. Because this form of closing the wound is invisible and beneficial, the strength of the wound depends upon how long the stitch retains its form.
Infection
Infections are characterised by increased pain, swelling and failure of pain medication to work. The wound starts to ooze, perhaps, and the foot feels hot. If you have red streaks going up the leg or feel unwell, this is an emergency and should not be taken lightly, as such a condition can be life-threatening. If the wound opens, seek early assistance for assessment. It is not good enough to have antibiotics prescribed over the phone.
Hygiene & bathing
Limbo Cover(TM) is recommended because you can order them, and they come quickly by mail. They are designed and reinforced for multiple uses and since the original cover, there are more choices on the market. I have used them for hand injuries and foot surgery, and they have a high patient acceptance rate. The version shown is above the ankle, but a lower-leg version also exists for extra security. This author does not recommend using taped-up plastic bags because they leak and tear. Why go through surgery and risk problems for a product designed for the job?
TOP TIP - DON'T USE PLASTIC BAGS FOR SHOWERING. THEY LEAK, TEAR AND NOT FIT FOR PROTECTING YOUR DRESSING.
Massage and care of the incision line
Begin the massage once the wound is closed and appears calm. Use Bio oils or any other skin care product you prefer, as long as there is no infection present. While this helps moisturise the skin, you are trying to break up adhesions around the scar line with the deeper massage. It's pretty sensitive when you set out though, so perservere.
If you need more information or have a burning question, why not use the CONTACT? ConsultingFootPain (David) will answer your question, although I may take a few days.
This article does not replace any information your specialist may feel appropriate, but hopefully, it will take you in the right direction. All surgeons have different ways of approaching post-operative care, but occasionally, patients require a little extra help. And then there is, of course, our new books this year available to meet different requirements.
Now, Tim E Kilmartin and I have captured loads more similar tales from the US and UK in our new book, which is out in hardback and, from 8 January 2025, in paperback and digital format (Kindle and tablet). To learn more, listen to David discussing the book on his site. davidtollafieldauthor.com
The books provide:
Self-help & Diagnosis.
Making a decision.
Consent & Risks.
Patient case stories.
Thanks for reading 'Looking for Information After Bunion Surgery?' by David R. Tollafield.
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