Is Physical Therapy Needed After Bunion Surgery? (2022)

A bunion is a bony prominence, or bump, that can form on the inner border of the foot, near the base of your big toe. This condition (also known as hallux valgus) occurs when the first metatarsal bone starts to move away from the second metatarsal bone in the forefoot. The separation that occurs between the first and second toes causes the big toe to angle outward towards the other toes and a bony bump to form.

While bunions are often asymptomatic, occasionally they can cause pain and significantly impact your ability to walk or wear shoes. In these situations, surgery and postoperative physical therapy (PT) are often needed to address your symptoms.

This article will review what bunion surgery is and when physical therapy may be necessary after the procedure.

Is Physical Therapy Needed After Bunion Surgery? (1)

What Is Bunion Surgery?

While bunions may cause your foot to look deformed, this usually is not reason enough to have surgery. Instead, surgical procedures are typically reserved for people whose bunions are causing significant symptoms that do not improve with conservative measures.

Common complaints associated with bunions include:

  • Pain over the bony prominence or on the bottom of the foot, near the base of the first and second toes
  • Chronic warmth, redness, or swelling near the base of the big toe
  • Difficulty walking normally or fitting into shoes due to pain
  • Stiffness in the big toe

If an operation is needed, you will have several options, depending on the condition of your foot and your surgeon’s preference. Common surgical techniques are:

  • Osteotomy: This technique involves improving the alignment of the great toe by making one (or several) cuts in the bones of the foot and stabilizing the area with pins or screws. Adjustments to the soft tissue in the surrounding area are also frequently required to maintain the toe position.
  • Arthrodesis: This surgery fuses one (or more) joints together with pins, plates, or screws to achieve a better toe position and relieve your pain. This option is usually performed on people with severe bunions, advanced osteoarthritis (wearing down of the joint cartilage that protects bones), or a previous failed toe surgery.
  • Exostectomy: This intervention removes or shaves off the bony bump on the inner border of the foot. Because it doesn't improve the alignment of the big toe, exostectomy surgery is usually performed along with another surgical treatment.

Postoperative Physical Therapy

Regardless of which surgery you get, your surgeon will likely recommend you to outpatient physical therapy.

While individual situations will vary, PT typically focuses on several goals for rehab. These typically include the following:

Pain and Swelling (Edema) Control

Bunion surgery can meaningfully reduce pain, but this can take time. In some cases, it may take up to two years for your foot symptoms to completely resolve.

In the meantime, your physical therapist can help jump-start this process by focusing on improving the pain and inflammation that occurs immediately after surgery.

(Video) Post Bunion Surgery Physical Therapy

To do this, cryotherapy (cold therapy) and vasopneumatic compression (inflatable sleeve that uses air to create pressure around an area of the body) may be used to decrease the soreness and swelling in the foot and leg.

Other modalities, such as electrical stimulation (electrical pulses applied to muscles), may also be applied to the area in an attempt to diminish any postoperative edema (swelling).

Finally, manual massage techniques are sometimes performed by your PT in an effort to move any fluid that has developed out of the foot or lower leg.

Gait Training

Avoiding bearing weight on your affected foot is usually required after bunion surgery. While the timeline differs depending on the procedure, this protective period can last for six weeks or longer.

During this time, your physical therapist will work with you to ensure you can safely and efficiently move around your home and community on crutches.

When your surgeon allows you to begin putting weight on your foot, your physical therapist will help you regain a normal walking pattern, or gait. It is not uncommon to limp after a bunion surgery or to develop a tendency to roll your foot outward in an effort to avoid rolling off the affected big toe.

Because of this, your therapist will provide you with instructions and exercises to aid in correcting these common compensations.

Range of Motion

After your big toe alignment is improved with surgery, regaining your range of motion (how much you can move a part of the body) is an important focus. Increasing the movement will help you obtain a more normal walking pattern and can also help improve your balance as you begin to move around again.

To improve the movement in your big toe, your therapist will perform passive stretching techniques (in which an outside agent, such as the therapist or a resistance band, is used to create the force for the stretch) and may also include gentle joint mobilizations (in which the therapist manually moves the joint) to the foot.

A home stretching program typically is recommended to improve your progress between therapy sessions. It is important to remember that if you've had an arthrodesis (joint fusion surgery), you should avoid stretching your fused joint, since the affected area is now permanently restricted.

Balance and Strengthening

After a lengthy period of non-weight-bearing, the muscles in the lower leg atrophy (decrease in size and become weak) and your balance reactions are frequently diminished. This weakness can impact your ability to walk, negotiate stairs, or navigate uneven terrains.

Physical therapy helps you improve the strength in your toe, ankle, and lower leg muscles by focusing on resistance training exercises that target these important areas. Proprioceptive (balance) training is also used to help increase your stability when you begin to move around more.

(Video) Recovering from Bunion Surgery

Typically, a home exercise program is created for you. Activities will progress and become more challenging as your strength and balance improve from week to week.

As time goes on, your therapist may also incorporate more sport-specific conditioning drills and exercises into your rehab if getting back to running, jumping, or exercising is a goal of yours.

Summary

Recovery after bunion surgery can be a lengthy process, and physical therapy can be critical to regaining mobility as your foot heals. Physical therapy after bunion surgery involves pain and swelling management and gait training early on. It eventually will include stretches to improve range of motion and exercises for balance and strength.

A Word From Verywell

While a painful bunion can make every step you take seem challenging, surgery can be helpful in resolving your symptoms. It is important to remember, however, that surgery is only the first step in your recovery. The physical therapy you receive after your procedure is often critical to helping you regain your independence and return to the activities you love.

If you’d like help finding an experienced therapist or have questions about the PT you will need, be sure to speak to your surgeon before your bunion operation.

3 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Massachusetts General Hospital. Physical therapy guidelines for hallux valgus correction (bunion reconstruction).

  2. American Academy of Orthopaedic Surgery. Bunion surgery.

  3. Chen JY, Ang BFH,Jiang L, Yeo NEM, Koo K, Singh Rikhraj I. Painresolution after hallux valgus surgery.Foot Ankle Int. 2016;37(10):1071-1075. doi: 10.1177/1071100716653084

(Video) Exercises for Post Bunion Surgery

Is Physical Therapy Needed After Bunion Surgery? (2)

By Tim Petrie, DPT, OCS
Tim Petrie, DPT, OCS, is a board-certified orthopedic specialist who has practiced as a physical therapist for more than a decade.

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FAQs

Do you need PT after bunion surgery? ›

While bunions are often asymptomatic, occasionally they can cause pain and significantly impact your ability to walk or wear shoes. In these situations, surgery and postoperative physical therapy (PT) are often needed to address your symptoms.

Do you need PT after foot surgery? ›

Absolutely! Physical therapy after foot surgery is one of the best ways to prevent an injury from recurring. Physical therapy provides post-operative patients with the strength and mobility they need to get back to doing the things they love to do without fear of the same injury occurring.

Can physical therapy help a bunion? ›

Physical therapists help people with bunions reduce their pain, increase the function of the big toe, improve muscle strength, and restore walking ability. Physical therapists are movement experts.

Do you need physical therapy after Lapiplasty? ›

Do I need physical therapy after this procedure? ​Some patients do, some patients don't. It depends if the great toe joint is stiff after surgery, which in most cases, it is not.

What happens if you don't do physical therapy after foot surgery? ›

By avoiding physical therapy, you'll miss out on learning flexibility exercises. The decreased flexibility after surgery can keep healing from occurring as fast. This is because inflexible joints and tissue tend to have less blood flow, which means fewer nutrients can get to the ankle to run the healing process.

How long is physical therapy for bunion surgery? ›

Physical Therapy can take roughly six weeks, but as always, it depends on the person, their pain tolerance and rate of progress.

How do you rehab after bunion surgery? ›

Post-operative Treatment Schedule

Elevating your foot above heart level for at least three hours per day. Limiting your time in a sitting position to a maximum of four hours a day (including meal times) Icing your foot to reduce swelling as much as possible. Walking as little as possible.

How do you rehab a toe after bunion surgery? ›

Gently and firmly flex the big toe upwards until resistance is met and moderate discomfort is experienced. Hold the toe in the up position for 10 seconds and then flex the toe all the way downwards. Hold for 10 seconds in the down position.

When should you start physical therapy after surgery? ›

Most doctors are now recommending that physical therapy start immediately after surgery. You'll begin with simple exercises involving flexing and stretching and move on to more intense exercise as you recover.

How long does it take to walk normally after bunion surgery? ›

13) Normal walking will not be a part of your routine for at least 8 weeks after surgery. Expect mild pain and restriction of movement (bending) of the toes for 8 weeks or more. Normal shoes may not be possible for 8-16 weeks after surgery depending on swelling.

Do you need physical therapy after big toe Fusion? ›

If you have a Cartiva or joint fusion performed, you will need physical therapy. With the Cartiva surgery, physical therapy is necessary after surgery to regain motion of the toe, break up scar tissue, and to decrease swelling.

Should I wiggle my toes after bunion surgery? ›

Sleep is more important. o If you had surgery on your toes, don't wiggle them. It's fine to move your ankle back and forth as long as it doesn't hurt. Don't worry about wiggling your toes.

Is Lapiplasty better than regular bunion surgery? ›

Corrects all three deformities: Since lapiplasty corrects all three shifts in the metatarsal bone that lead to bunions, it is much more effective at treating them than osteotomy or any nonsurgical bunion treatment. This way, lapiplasty restores your foot and the big toe to their normal alignment.

How long does stiffness last after bunion surgery? ›

You will have pain and swelling that slowly improves in the 6 weeks after surgery. You may have some minor pain and swelling that lasts as long as 6 months to a year. After surgery, you will need to wear a cast or a special type of shoe to protect your toe and to keep it in the right position for at least 3 to 6 weeks.

Is Lapiplasty recovery painful? ›

The post-op recovery process has come a long way in the past 5 years. Pain is minimal after the Lapiplasty 3D Bunionectomy with early weight bearing and return to activity.

Is physical therapy worth it after surgery? ›

Physical therapy is a vital part of recovery after surgery. Not only can it help you heal faster, improve your flexibility and range of motion and minimize scar tissue development, it can help you manage pain levels without excessive use of prescription narcotics.

What happens if you don't do physical therapy? ›

Slower Recovery: Missing a physical therapy session will ultimately increase the time you will have to spend in recovery. The reason for this is because the exercises and activities that you will be engaging in a treatment session are designed to help you regain total movement ability.

Can I rest my foot on the floor when non weight bearing? ›

The term non-weightbearing, sometimes prescribed simply as "N.W.B.," refers to restrictions placed on you immediately after surgery. You will be advised to avoid putting the surgically repaired foot on the floor. This typically means no weight whatsoever, not even for a second or two whether standing or seated.

How long do you wear boot after bunion surgery? ›

While recovery after bunion surgery takes about six to eight weeks, full recovery from bunion removal surgery can take an average of four to six months. For the first two weeks following your surgery, you'll wear a surgical boot or cast to protect your foot. You should avoid getting your stitches wet.

How long does it take to weight bearing after bunion surgery? ›

After 6 weeks you can typically fit in a normal sneaker, depending on your level of swelling and comfort. Midfoot Fusion: If you are a candidate for the more formal bunion correction, you will need to be non-weight bearing for about 2-4 weeks, meaning you cannot put weight on the operative foot.

How do I start weight bearing after bunion surgery? ›

In mild to moderate cases of bunions, patients are allowed to be weight bearing immediately with the help of a knee scooter or surgical boot. They are also allowed to walk in a surgical boot /shoe. The time it takes for bones to set/mend in the corrected position generally takes six weeks.

How do you break up scar tissue after bunion surgery? ›

Recovering from Bunion Surgery - YouTube

Should I sleep in boot after bunion surgery? ›

You may sleep without your boot once you are 4 weeks from surgery. after surgery you will be allowed to bear weight on your foot as tolerated in your boot. This may change based on skin healing or other added procedures. Use your crutches, walker, or knee scooter for a total of 4 weeks after surgery.

Why is my big toe not straight after bunion surgery? ›

Hallux varus is a new structural problem that uncommonly occurs after bunion surgery. With hallux varus, the big toe deviates in the opposite direction and the big toe points in (away from the other toes).

How many times a week should you do physical therapy? ›

A typical order for physical therapy will ask for 2-3 visits per week for 4-6 weeks. Sometimes the order will specify something different. What generally happens is for the first 2-3 weeks, we recommend 3x per week. This is because it will be the most intensive portion of your treatment.

How does physical therapy help healing? ›

Physical Therapy Promotes Healthy Pain Management

In contrast, physical therapists use ultrasound, electrical stimulation and hands-on techniques to restore blood flow to affected tissues. This improves tissue functioning and significantly reduces patients' experiences of pain.

What is the fastest way to recover from bunion surgery? ›

To speed up the healing process, patients can take an active role in strengthening and healing the foot with a few simple recovery tips and tricks.
  1. Reduce pain and swelling. Pain and swelling around the toe and foot are inevitable. ...
  2. Wear wide shoes. ...
  3. Physical therapy.
Dec 14, 2020

How do you rehab after bunion surgery? ›

Post-operative Treatment Schedule

Elevating your foot above heart level for at least three hours per day. Limiting your time in a sitting position to a maximum of four hours a day (including meal times) Icing your foot to reduce swelling as much as possible. Walking as little as possible.

What exercises should I do after bunion surgery? ›

FIRST AND SECOND WEEKS AFTER SURGERY: Rest, elevation. No exercises are necessary. THIRD AND FOURTH WEEKS AFTER SURGERY: Manually-assisted Range of Motion Exercise *Perform this exercise 3 times a day for 20 minutes. Grasp the big toe near the base of the toe close to the big toe joint.

How long after surgery do you start physical therapy? ›

After surgery you can expect to have pain, swelling and inflammation. You will also be expected to begin physical therapy the day of or day after your surgery. Each day and week to follow you will find some things will be easier and some things are still difficult.

How long does it take to walk normally after bunion surgery? ›

13) Normal walking will not be a part of your routine for at least 8 weeks after surgery. Expect mild pain and restriction of movement (bending) of the toes for 8 weeks or more. Normal shoes may not be possible for 8-16 weeks after surgery depending on swelling.

How long should my foot hurt after bunion surgery? ›

You will have pain and swelling that slowly improves in the 6 weeks after surgery. You may have some minor pain and swelling that lasts as long as 6 months to a year. After surgery, you will need to wear a cast or a special type of shoe to protect your toe and to keep it in the right position for at least 3 to 6 weeks.

How long do you have to wear a boot after bunion surgery? ›

While recovery after bunion surgery takes about six to eight weeks, full recovery from bunion removal surgery can take an average of four to six months. For the first two weeks following your surgery, you'll wear a surgical boot or cast to protect your foot. You should avoid getting your stitches wet.

How long does it take to weight bearing after bunion surgery? ›

After 6 weeks you can typically fit in a normal sneaker, depending on your level of swelling and comfort. Midfoot Fusion: If you are a candidate for the more formal bunion correction, you will need to be non-weight bearing for about 2-4 weeks, meaning you cannot put weight on the operative foot.

How do you break up scar tissue after bunion surgery? ›

Recovering from Bunion Surgery - YouTube

What happens if I put weight on my foot after bunion surgery? ›

Putting any weight on an operated foot or ankle can damage the repair that's been done. Bones need time to heal. Plates or screws that may have been added during surgery need the bones to heal around them. Adding weight too soon can interrupt this important internal healing process.

Should I sleep in boot after bunion surgery? ›

You may sleep without your boot once you are 4 weeks from surgery. after surgery you will be allowed to bear weight on your foot as tolerated in your boot. This may change based on skin healing or other added procedures. Use your crutches, walker, or knee scooter for a total of 4 weeks after surgery.

Why is bunion surgery so painful? ›

The shape of the foot is changed and the patient's weight moves over to the next toes during walking. The bones for the second and third toes were not designed for bearing so much of the body's weight and they react with pain due to stretching out and compression of the tissues around these bones.

Is physical therapy worth it after surgery? ›

Physical therapy is a vital part of recovery after surgery. Not only can it help you heal faster, improve your flexibility and range of motion and minimize scar tissue development, it can help you manage pain levels without excessive use of prescription narcotics.

How many times a week should you do physical therapy? ›

A typical order for physical therapy will ask for 2-3 visits per week for 4-6 weeks. Sometimes the order will specify something different. What generally happens is for the first 2-3 weeks, we recommend 3x per week. This is because it will be the most intensive portion of your treatment.

Can physical therapy cause more pain? ›

While many patients perceive physical therapy as a process that increases pain (with physical therapists sometimes referred to jokingly as “torturing” patients), the reality is that physical therapy's purpose is to reduce pain, not increase it.

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4. Is Physical Therapy Needed After Bunion Surgery? Chicago, Oak Brook, Lincolnwood, IL - Podiatrist
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