There are two stages of post operative rehabilitation in foot and ankle surgery.

Hospital

Whilst in hospital, you will usually be seen by a Physiotherapist for:

  • Appropriate footwear.
  • Gait aids (ie crutches).
  • Exercises to do at home in the early stages.
  • Assessment of your ability to safely manage your post-operative instructions before you go home.

Once you have passed the early recovery period, your rehabilitation will be tailored to your exercise goals and achieving a full recovery of the operated foot.

Elevation, 'Non-Weight Bear', Partial Weight Bear and Rest

During the early recovery period, you may need help at home. You must follow your post-operative instructions from our team to allow a good outcome.

It is important to rest and keep your foot elevated above the level of your heart for 23 hours a day for the first 2 weeks after your surgery. Elevating of your foot will encourage healing and decrease the chance of wound infection and break down. It will also help with pain and swelling.

In addition to this, some surgeries will require you to ‘non-weight bear’ for anywhere between 2-8 weeks from the time of surgery. This means you can rest the affected leg on the ground with no more than one kilogram of weight through that leg.

In some cases you will only be required to ‘partial weight bear’ (eg. 50% of your bodyweight), after surgery. A reasonably good way to understand this is to weigh yourself and then place only one leg on the scales with increasing weight until it reaches half your bodyweight.

We advise using the time leading up to surgery to anticipate issues with following your post-operative instructions and prepare accordingly. For example, if you live with family who are dependent on you. Options may include home help assistance through your local council, respite care or a period of inpatient rehabilitation after your surgery. This should be discussed with our team at consultation.

Exercises after Bunion Surgery

This video is a collaboration with the Principal Physiotherapist and Head of Strength and Conditioning at the Australian Ballet. They developed this program for their dancers who as a result have a much lower injury rate in their feet.

These exercises also apply to my patients undergoing rehab after bunion surgery, bunionette surgery or 2nd toe surgery. Note, this video does not apply to great toe fusion surgery.

GEKO

Mr Goldbloom is selectively encouraging some of his forefoot surgical cases to use the GEKO device to help with getting you through your initial 2-week post-operative period.

This device is used to reduce post-operative swelling which can be a long term source of frustration and increase the risk of wound complications.

Mr Goldbloom still expects you to be elevating your leg for 23 hours a day during this period.

How does it work?

When we are walking, there is a veno-muscular pump that pumps the blood from your foot and leg back up to the heart. This pump is activated when the calf muscle contracts.

When lying down and elevating post-surgically, this pump is not activated and the blood has a tendency to pool in the foot and leg leading to increased swelling.

The GEKO device sits high up on the calf muscle of the affected leg and triggers a nerve to contract the calf muscle and replicate activation of the pump. This results in an increased blood flow compared to when just elevating alone.

The device weighs 10gs and is easy to fit and to remove.

Mr Goldbloom’s team will be in contact with you prior to your surgery if they believe that your surgical rehabilitation will benefit from the use of this device. The overall cost is $150 for multiple single use GEKO devices This can either be fitted by the nursing staff in the hospital or pre-purchased in the rooms where you will be instructed on how to fit the device yourself.

i-Walk 2.0

Following surgery, there are a few options for ambulation. A hands-free option is the i-Walk 2.0.

This is suitable for people with:

  • reasonable strength and coordination.
  • the other leg is still fully functioning.


The i-Walk device has a 90 degree splint for the lower leg to rest on. The bottom of the i-Walk then functions as a peg like substitute for the foot and leg.

It is worth trialling the i-Walk prior to your surgery to make sure that you have the balance and coordination required.

Pre-injury Ability

  • Average or above strength and balance
  • No gait abnormalities such as a shuffle or a limp
  • Ability to get up or down stairs without using a hand rail
  • No neuropathy of the feet or legs
  • No diabetic ulcers of the unaffected limb or any other conditions that may affect your proprioception


Capacity

  • Between 147cm and 198cm (the i-Walk 2.0 is adjustable to cater for these heights)
  • Weight of less than 125kg
  • Maximum thigh circumference at the top of the thigh is less than 71cm


Other requirements

  • Injury is only to one leg or foot
  • Injury is below the level of the knee
  • You can bend the knee of the injured leg to 90 degrees (casts and boots can still be worn with this device as long as the knee can still bend)


The i-Walk 2.0 is suitable for the following injuries and conditions

  • Foot fractures
  • Ankle injuries
  • Achilles tendon ruptures
  • Tibia and fibula fractures
  • Post-surgically for many conditions (check with your surgeon’s rooms)

Risks of Foot and Ankle Surgery

No surgery is risk free. General risks of surgery include infection, blood clots and complications related to the anaesthetic. Numerous precautions are taken to reduce risks and your surgery is meticulously planned to ensure the desired outcome. Some precautions taken are the administration of antibiotics to reduce the risk of infection and blood thinning medication is given to prevent blood clots. Mr Goldbloom will talk to you about general and specific risks related to your surgery at consultation.

When to Contact Mr Goldbloom’s Office

If you experience any of the following, please contact Mr Goldbloom’s room on 0493 051 985

  • Wound feels tender and hot. (Please note pink antiseptic is used during your surgery. Your leg will stay pink for a few weeks.)
  • An odour or discharge coming from your dressings.
  • Your dressings are showing an excessive amount of fresh blood.
  • Your dressings become very blood stained, wet, too loose or too tight.
  • Fever and a general feeling of unwell
  • Prolonged, uncontrolled or severe pain.
  • Calf pain or swelling.
  • Swelling that is not reduced with elevation of the leg.
  • A change of colour in your toes or toes become cold.
  • Side effects due to the medications you have been prescribed.

If your concern arises outside of normal working hours Mr Goldbloom’s team suggests you choose one of the following options depending on how urgent you feel your situation may be.

  1. Attempt to contact your local doctor if they run an after hours service.
  2. Contact your nearest Emergency department.
  3. Present in person to your nearest Emergency department.
  4. Contact Mr Goldbloom via the Hospital switchboard.