I have a too short first metatarsal due to surgery about 7 years ago. In addition, my second and third toes are longer than my big toe.
Dr Blake's comment: A short first metatarsal is like removing the third leg off a tripod. If the first metatarsal is short, it tends to be above the ground, and as you move forward the lack of support on the first metatarsal will cause your arch to collapse. You can also develop a compensatory supinated gait which allows you to stay on the outside of your foot, but it is jarring to the knee, hip, and back.
I was never able to walk correctly afterwards. My foot turns outward and now my second and third toes curve toward my big toe. Also, the tendon in my big toe may be too short now. There is pain under my knee on the same side as the tendon in my big shortened toe.
Thank you very much for the video on spica taping for big toe joint pain. I had a family member spica tape my big toe last night and oh what relief! I was able to walk better today than I have been for a long time.
I am now in the situation where I need both knee and foot surgery.
Can you give me your thoughts about whether I should have knee replacement surgery or foot surgery first? Is there a correct order in which to proceed?
Dr Blake's comment: Foot surgery typically requires a period of weight bearing on the tibia with a device called a RollaBout. You I am attaching a video I did of the device. If you think that your knee can tolerate that for several months, do the foot surgery first. However, we mainly recommend to our patients to have the knee surgery first since the walking is so limited for 3 months, and then when the knee can tolerate the RollaBout, go ahead with the foot surgery.
Also, are there any other things I can do to provide relief while walking? Any thoughts on surgical procedures that may help and non-surgical things that I could do that may help.
Dr Blake's comment: I spend all day trying to take feet like yours and design inserts to help balance out the weight. Based on gait abnormalities, I work with a physical therapist to make gait changes, and add appropriate strength and flexibility work. Go to the AAPSM website for a local podiatrist that can help you start. I am not a surgeon, so advice regarding surgery may be worth what you pay for that advice!!! I hope this helps. Rich
Thank you very much again for the spica taping video.
The patient responded again.