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Saturday, October 27, 2018

Cheilectomy: Exercise Program Post Surgery

My wife Patty's Wish came true: Sunset, Champagne, and Santorini on 60th Birthday!!! 
(4 Years Ago)

Hello Dr. Blake,

I am writing to you from Santorini,… Eventually, I have not avoided the operation and I had cheilectomy in my right big toe. Stitches were taken out 2 weeks ago and it seems everything is fine. I have started wearing mainly my training shoes and also I walk every day, for about half an hour.

My doctor said I do not need any physiotherapy, he only told me to do one simple exercise 2-3 times a day, for 3-4 minutes, it would be sufficient. I am attaching a photo of my foot doing the prescribed exercise.
Please, would you be kind enough to propose me any kind of additional exercises you deem necessary so that to perfect my toe mobilization, apart from the one I am sending you?
Best Regards,

PS I was glad, that you had attended the conference in Santiago de Compostela, which is one of our favorite places in Northwest Spain. Think about revisiting Greece, so that you visit the island of Santorini.

Dr. Blake's comment: The image below shows good motion, but it is only a stretch on the bottom structures of the foot and you need to get the weight on the lower part of the toe (you are bending the joint closest to the toenail more than the one you need to be stretching. 
And yes, if we get back to Greece, for sure we want to go the Crete and Rhodes, we will want to spend several days again on Santorini!! Unbelievable place!! You can not take your eyes away from the vistas!! We stayed at Canavas Suites in Oia Village. 

We definitely want to do self-mobilization as shown in this video. No exercise should evoke pain, however. 

You should also strengthen both the Extensor Hallucis Longus and Flexor Hallucis Longus.

If you want to learn how to do theraband progression, see my video on posterior tibial exercises. It will be the same principle for any muscle. 

For the extensor, put your back against the wall and assume a sitting position with the knees at a 45-degree angle. Then do 2 sets of 10 of pulling your big toes up into the air slowly, leaving the rest of the foot on the ground. When 2 sets of 10 get easy, try 2 sets of 15, gradually getting to 2 sets of 25.

I also think building up to 2 minutes of single leg balancing helps tremendously. And gradually increase the height of 2 sided heel raises to get the achilles working well. Like with sesamoid injuries, you sometimes have to protect the big toe joint by building a well to offload. Good luck Rich


  1. I am very thankful for your help... very enlightening comments.

  2. I just had this surgery 3 weeks ago and it's still pain in the join like before. Is this normal

  3. Nice post! This is a very nice blog that I will definitively come back to more times this year! Thanks for informative post. foam roller exercises


  4. Good post thanks for share information. Lee Priest

  5. Thanks for the advice. I had my surgery 3 months ago but I was dealing with post surgery bone infection for another 5 weeks. Now the infection is clear out, so I need to do something, as I feel numbness still between the toes. It's very uncomfortable feeling and also my shoes selection is still very limited. Just curious how long this would last and what set of exercise would be the best.


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.