Non-surgical bunion rehabilitation concerns:
1. Pain: The causes of pain include: bunions, first metatarsal phalangeal arthritis, seed bone dislocation, nerve compression, etc. Physical therapy and manual therapy
2.Deformity: Conservative treatment cannot cure deformity, but can prevent or slow down the development of deformity. In milder cases, toe pads can be used. In severe cases, orthopedic braces can be applied, and customized orthopedic insoles can be used.
3. Limited mobility of the metatarsophalangeal joint: The limited mobility of the first metatarsophalangeal joint can be treated with active or passive training or joint release by the patient.
4. Gait: Due to pain or stiffness of the first metatarsophalangeal joint, patients may adopt a pain-avoidant gait, especially a lack of forefoot advancement, training of the intrinsic muscles of the lower leg and foot, and forefoot walking to restore the patient’s gait.
Post-surgical bunion rehabilitation concerns
1. Depending on the type of bunion surgery, the time the patient is allowed to bear weight/propulsion of the forefoot varies, and the patient should consult the surgeon or rehabilitation physician for the specific time.
(1) Propulsion in the gait cycle can be done after surgery, and high-intensity movement can be resumed in 2-3 weeks: soft tissue surgery; 1st metatarsal phalangeal joint replacement; osteotomy; arthroplasty (Keller).
(2) Wear a forefoot weight-free shoe for 2-6 weeks after surgery, gradually put on weight and do propulsion, and do not do high-intensity sports for 8 weeks after surgery: chevron partial osteotomy; Scarf osteotomy; Ludloff
Osteotomy.
(3) Immediate postoperative weight-bearing, no propulsive movements for 4-6 weeks postoperatively, no high-intensity exercise for 12 weeks postoperatively: Akin procedure.
(4) No weight-bearing for 6-7 weeks postoperatively, forefoot advancement for 10 weeks, and no high-intensity exercise for 12-16 weeks postoperatively: the Akin procedure.
No high-intensity exercise for 12-16 weeks: metatarsal base osteotomy (juvara); metatarsophalangeal joint fusion; metatarsocuneiform joint fusion (Lapidus).
(5) Intraoperative bone grafting, no weight bearing for 3 months after surgery: metatarsal base osteotomy, bone grafting; metatarsophalangeal/metatarsal cuneiform joint fusion, bone grafting.
2.Common techniques for rehabilitation after bunion surgery
First metatarsophalangeal joint and interphalangeal joint mobility training: active or passive training, 1-2 times a day.
(1) Lower limb muscle strength training: resistance training, apply elastic band or sandbag, each action lasts 10 seconds, repeat 10 times as a group, 1-2 groups per day.
(2) toe grip training: toe grip towel or small objects, 1-2 times a day, 15 minutes each time.
(3) toe grip training: standing on both feet, leaning forward, 1-2 times a day, 15 minutes each time.
(4) balance training: 1 time a day, 15 minutes each time.
(5) Forefoot propulsion training: forefoot walking, once a day for 15 minutes each time.
The above rehabilitation techniques are applied progressively, depending on the patient’s surgical modality, allowing for weight bearing/propulsion time.