A bunion is a large, painful bump that appears on the side of the big toe, forcing the toe to bend inward toward the neighboring toes. A bunion is a deformity of the big toe joint that sometimes requires surgery to repair and alleviate pain. After surgery, it is important to slowly build strength in the foot and the toe through exercise and physical therapy.
Rest Before Therapy
For the first week or two after bunion surgery, it is best to let the foot recover, rest and heal. You don't want to stress the recovering joint too often, so physical therapy doesn't generally start until about three or four weeks after the surgery. Physical therapy exercises are done slowly, gradually increasing as the foot recovers. Your physical therapist may recommend the use of tools, such as marbles or a band to increase strength.
Range of Motion
After surgery, the big toe joint can become stiff, giving you a reduced range of motion. It is important to move and flex the foot and the big toe with range of motion exercises, as they can help alleviate stiffness, reduce scarring and reduce recovery time. Beginning around three to four weeks after the bunion surgery, you can start some gentle range of motion exercises with a physical therapist. The physical therapist can help you gently flex and hold the toe, performing multiple sets several days a week. The frequency and intensity of these exercises will be increased in the following weeks, and typically last for at least seven weeks after the bunion surgery.
Final Stages of Physical Therapy
By about the seventh week of physical therapy, it is time to increase the exercises and make them a little tougher. Instead of just stretching the toe, you should make it work against gravity and body weight. Physical therapy at this stage involves weight-bearing exercises, such as standing up on the toes for about 10 seconds. Walking uphill to flex and strengthen the toe is also usually included in physical therapy.
Exercising on Your Own
You can also try these exercises on your own without regular physical therapy appointments. Talk to a doctor about exercises that he can recommend that you do at home--be sure to get details on how often to do them. You can also meet with a physical therapist for an initial appointment, and get information on what exercises to do, how often to perform them and how to gradually increase your exercises. Then, keep up with your exercises and physical therapy at home.
Pain and Healing
Even with physical therapy, you can't slip into your same old shoes just yet. Avoid wearing high-heeled shoes until your doctor says it's OK--typically, you have to wait at least six months. Expect some swelling and discomfort in your foot for about six months, so wear comfortable shoes that won't irritate the foot as it heals. Your doctor can also prescribe medication to ease pain and inflammation in the foot as it heals and recovers.