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Sunday, June 23, 2013

Foot Strengthening After Multiple Foot Surgeries: Email Advice

Hi Dr. Blake,

I have had quite a journey that I never expected to deal with in my life time. I would like some advice about physical activity based on the surgical procedures I have had. When I was 20 yrs old, I had a routine bunion surgery on my right foot. Due to an ineffective surgery, the bunion returned and even had a bump on the top of my foot causing pain at the site of the bunion. I decided at the age of 30 to fix the problem so I ended up having another surgery where it was determined I had hypermobility and had the head of the metatarsal joint shaved down to fix the bunion. The surgeon also had two screws placed on the top of my foot to help with the hypermobility. Well, that didn't last long even though I was on non-weight bearing cast for 4 months as the problems returned 10 fold. I was running about 33 miles a week and general cross training. At the age of 40, I went to a Podiatrist and he could see several problems going on with my right foot. He determined that I do have hypermobility, hallux valgus and my sesamoid bones were completely destroyed. He had to go in and replace the greater toe joint with a Hemi toe implant, fuse the second toe joint, remove the sesamoid bones and remove the screws as they were causing extensive pain as they rubbed against my shoes. Ultimately after 3 surgeries, my left foot ended up having a collapsed arch and I had to have surgery to fix that with pins and a cast for 2 months. I have a bunion surgery for the left foot next summer (As a result my left foot is now 3/4" longer than my right foot!). So, I have had some problems with my feet you could say. =) I am a really active person, I use orthotics, hapad metatarsal pads, and I did receive physical therapy. So far, my right foot has been feeling good, however, I did have extensive discomfort while it was healing. My right big toe is stiff with limited mobility and it's difficult to move and PT helped in a limited amount. Due to my biomechanics in my feet have changed how my weight is distributed I do see some calluses on the outer edge of both feet, but is very minimal. I have curtailed my running and now use an elliptical trainer, I do engage in weight training and watch my diet.
What kind of activities do you recommend with all of the surgeries I have had? What other kinds of foot strengthening exercises can I do to continue my healing process and any recommendations do you have for me at this time? I have tried to find your blog on metatarsal doming, but with no luck. My podiatrist is excellent but I would like other opinions as well. I appreciate your time in reading about my extensive surgeries and you providing advice on my case. Thank you!

Dr Blake's comment:
Hey, Thank you so very much for the email. You are right to think about focusing more on non impact sports like elliptical, cycling, swimming, and moderate running. Sounds like your orthotics or changes in biomechanics have gotten you to the outside of your foot. Continue to work with the orthotic maker to try to keep you centered. The better your core, the less collapse into your arch you will have. The better your foot strength, the less stress on your bones and ligaments. You could easily improve your foot strength by a magnitude of 2 or 3 by daily going through 3 exercises each evening. I will place in my labels all the foot strengthening posts in a minute. I will also place under this email that I will officially post within the hour. I hope this helps. Rich

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.