Thanks! 😊

Although I have done this procedure on hundreds of postop bunions, this one was on a model's foot

Hello, yes indeed! There are definitely reasons why one would like to flex their toes, but if you're talking about basic function of walking, then that's why we consider it not so important. If you were going to have bunion surgery, it is something that I would suggest you make sure your surgeon knows before hand.

Yikes... I mentioned it in passing but didn't emphasise the point. Thank you for responding from a grateful Australian

Also, your articulation is appreciated by me 😊

Hello, it is very common for the surgeons to not give people this information. I have developed this information from my years of working with foot and ankle patients & their surgeons. Often the docs consider it the Physical Therapist job to tell people these things! Some physicians do not believe in physical therapy for bunion surgery. Before you start the exercises you want to know that the bone is well healed. Four weeks is a little early unless you have been using cold Laser to speed healing, so I would wait for your appointment with your doctor and pay attention to how well healed they say the bone is.

Hello, that type of scar will respond to the deep Pressure where you were pretending you were like breaking up a pea, cross friction, massage, ultrasound, electrical acupuncture (google dolphin neurostim units), ultrasound prior to the massage also helps and sodium chloride iontophoresis. Use those keywords when you are shopping around for Physical Therapist near you. The receptionist may not know the specific terms so ask if they can ask the therapist if any of them know these things. Of course, if you live in Northern Virginia or near Virginia Beach come to BioMechanic and we can help you out.

You are so welcome

Hello the number one most common used is dexamethasone sodium phosphate commonly known as Dex. It is a steroidal anti-inflammatory. A steroid anti-inflammatory, when delivered with iontophoresis it has none of the scary side effects that the injection of the same causes. Second most common is probably sodium chloride for scars and lastly lidocaine for pain because the numbness does not last very long.

@@Biomechanicphysicaltherapy Thank you very much

Hopefully you don't need one and you can get your head paint sorted out!

@@Biomechanicphysicaltherapy my legs give out from under me then my hips click and I'm afraid I'll fall. Then pain shots down almost like ItBand

If you are getting cold laser therapy, you can do it as soon as 3 - 4 weeks after surgery. If you are not getting cold, Laser, it is best to wait till 6 to 8 weeks.

Hello, yes it is. The best thing to do would be to find a buddy who can help you stretch. Perhaps a spouse? Or a friend Physical Therapist? I have actually done video calls to train the friend on how to do the stretches. If you still are working on trying to do it yourself the best thing to do is to cross your operative leg up across your non-operative knee and then use either the right or left hand, depending on how you can reach. Wishing you a speedy recovery!💛

Yeah. I know it really hurts. Some say it hurts worse than abdominal surgery. There will be a point in time in the future where it will be a figment of the past. hang on keep healing eat well sleep well and try to get a little bit of cold Laser

Hey @SelfySelf, if you have been getting laser therapy to speed healing then yes. Otherwise no! Your bones have to knit. If you wiggle your bones by walking on it or by mobilizing it then it's not going to knit well and you're gonna make the whole thing last longer. Oh one other thing...I should say if you have only had a chielectomy - meaning if you've only had a bit of bone trimmed off and you have no hardware, you can. In that case you're not waiting for any bones to knit. And it'll hurt, but it won't hurt anything if you mobilize after you've only had bone spurs trimmed off.

@@Biomechanicphysicaltherapy Thank you for your detailed answer! It’s invaluable! ❤️ I have been having laser therapy for 4 days now but I have a lot of hardware so I will wait with these exercises. Many thanks! Last question: can I move my whole feet and the big toe up and down (without force and without using hands)? Can it do any good? Or is it rather harmful???🙏

@@SelfySelf​​⁠ gentle toe wiggles are fine and may even be helpful. If you want to know when you can start stretching, schedule an appointment right away with your doctor and get an x-ray. They will probably ask you why you are there so early. And may raise their eyebrows at you. When my husband broke his ankle, I started laser right away showed up at the doctors office at 4 weeks instead of 8, but I knew the doctor so I got away with it. They were impressed that the bone was already knit. So if your doctor is game for a little experimentation, s/he'll probably go along with giving you an early x-ray. The class three and four lasers can cut healing time in half so instead of having to wait 6 to 8 weeks, you should be able to start very soon. Good luck!

@@Biomechanicphysicaltherapy Thank you for all your help and advice! I have done an x-ray today and it looks good:) Thanks for being so supportive ❤️ I feel relieved after seeing the x-ray. I have had a Lapidus procedure performed and I was worried that something may be wrong because of the pain (different than in the case of chevron procedure on my right feet). It looks fine, the doctor says It is nice but still I am a bit unsure now if my doctor did his job well because I only have pins/screws in the metatarsal bone and nothing in the toe!!!:( I am truly worried that without a pin it may get back to its wrong position and deform soon…

Hi, of course it's very hard to diagnose over the phone but the thing that stuck out to me was the shin pain. Makes me wonder if it's coming from your back. And on nerves, lots of funny pains, even if your back doesn't hurt. There have been many people who have come in for knee pain that I was able to take the knee pain away and a single visit by fixing their back alignment using muscle energy technique. You can see a physical therapist with without a prescription many of us have special licenses where you don't need to see your doctor first. Seeing a doctor would be helpful though maybe you would like to have some hip x-rays?

​@@BiomechanicphysicaltherapyThank you. I do see my GP shortly and will ask for orders for imaging.

@@ginabisaillon2894 I guess the reason why I don't mention walking in the video is because I'm just about all diagnosis have pain during walking. So maybe it's just not a diagnostic criteria. The way you describe your pain does sound like it's in the joint. But that doesn't mean it's arthritis. It could be malalignment in the hip joint, which would be the muscle energy technique to fix the alignment of the large hip bone, or it could be the joint or it could be a pinch from bone overgrowth. The easiest one for physical therapy to fix is if someone knows muscle energy technique they can fix your SI joint where the large hip bone joins the tailbone and that align the hip socket. If that is done, and your pain is instantly gone or diminished then that would be her diagnosis. Physical therapy can also help. It is arthritis because we can do things to decrease the pain in the joint. An x-ray might show you arthritis, but is not necessarily the source of your pain. You can have a positive x-ray for arthritis and have no pain. so after talking this through it sounds like you should try a physical therapist who knows manual therapy or an osteopath and osteopathic physician would also be able to do the correction of the hip socket alignment.

@@Biomechanicphysicaltherapy the x-rays indicate no arthritis. I will try physiotherapy when I get to Mexico this winter - here it's just too expensive and for the government service there's a long waiting list.

Hey, sorry no. That joint is fused. But once it's well healed 8 to 12 months you should even be able to run on it.

Hello, is it a raised scar? It may be getting irritated on the surface and then peeling. Yes, there is a treatment. The silicone sheets that I talk about can encourage remodeling. The original is Cicagel by Cicacare, you can find it online or order it from your pharmacy. There are knock offs done by companies like band-aid and Neosporin. The difference is the thickness of the silicone sheet.

Yes it’s a raised scar…I really appreciate this feedback

@smg4102 as with all things, Hoka has changed over the years and now makes lots of different styles of shoes. Originally they had like two styles with a lot of pronation control and lot of cushion. Unfortunately, sometimes the cushion allows too much side to side motion, which can then irritate the posterior tib tendon. Not sure if one can go back and put a little subtitle or a little blurb on an old video to say "well maybe not so so much anymore"! 😂

Hello yes you want to envision smashing the scar like it would be smashing a pea. So that you break down the height of the scar tissue.

@@Biomechanicphysicaltherapy my scar seems flat except after I shower it’s more dark than hard and raised. Any tips there.

@@allthingsreview777 Hello. That is because it has lots of vascularization. There is a pulsed dye laser that would make that scar look great. It would be cosmetic of course. I have not got a PT remedy for the vascularization.

@@Biomechanicphysicaltherapy thank you for all the replies!could this maybe fade on its own?

Hello sounds like SI joint sacrum probably a little twisted and the pain across the top of the hip is muscular pain from some muscles being overworked due to the strain of the hip bones being slightly out of line. I would definitely find a practitioner who does muscle energy technique And get that sorted out you will be very happy. If it's been going on long time, it will take a bit of maintenance and you may find yourself and PT kind of regularly to keep yourself but PT takes less than an hour, most people think it's worth it to keep things in line. Plus, remember the long-term consequences of potentially deteriorating a joint and then having arthritic pain later so I think it's worth it.

@@Biomechanicphysicaltherapy Thank you so much, best regards, Richard,

Hey, I know. I have answered your question in full on your other comment.

@peekaboots01 yes podiatrists know what to do with this problem but podiatrist have different surgical allowances in different states. So it depends on where you live whether a podiatrist is allowed to operate it on on it. You could also seek out an MD who is a foot and ankle specialist and they will be able to correct it for you. It sounds like yours is severe enough based on your description that you would be a surgical candidate. Although it would hurt for a little while you would be much happier when it was all over and no more bright red ball on your toe. Orthotics can help a little bit right now but since it sounds like it's very severe. I'm not sure how much. The orthotic must have a forefoot post and a first Ray cut out with fill in and you can tell your practitioner that. Orthotics will help with recovery afterwards and will give you many years on your new toe. If you don't wear orthotics after the surgery, you risk it gradually returning because the reason for the bunion is your foot mechanics. The orthotic fixes the reason why you developed the bunion in the first place, but it would take five or 10 years for it to begin to reform.

Thanks!

Hi! Well at eight weeks, your bones have only just fully healed so now would be the big progression of activity. So definitely I would not have expected to run by now. I would expect you to be able to run in months. The first goal is to be able to walk comfortably. One of the most important things after surgery to be able to walk is wearing shoes that will protect your foot. It sounds like physical therapy could definitely help because we can speed the healing. Take down the inflammation. Decrease the pain and give you pointers on where you should be and what you should be doing. If you need help and you are far away, you can schedule a video consultation or maybe call around to your local physical therapists and see if anybody has treated people after bunion surgery. Don't lose hope I know it's frustrating and I know it's slow, but you will get there!

Hi, it's an indication of inefficient transduction of sound waves and it is called cavitation. Cavitation is what makes the little air bubbles. If your patients are still feeling results, I'm sure it's fine. If not, I would have your equipment inspected.

Glad it helped! LMK if you need anything.

Get a uric acid test to rule out gout. I have gout and halkux limitus 😢

Hello, iontophoresis will definitely help with swelling but not with bone healing. The thing that will help with both swelling and bone healing is the MLS class IV Laser. Any cold laser will help but the original ones were class three and the class for as much more power. You can search for one near you on the Internet. I know the company that we bought one from has a search tool like that in the name of that company is cutting edge.

Is Iontophoresis safe while bone is still healing? I have 4 more weeks to 12 weeks was going to wait until then but I would really like to continue treatment if I can for hyperhydrosis on my feet. Thanks

Hello yes the iontophoresis for the hyperhidrosis is safe while you are healing. The only thing you wouldn't want to do is use the dexamethasone sodium phosphate because dex can impede healing.

What is dex? I’m not using or putting anything in the water.

Hello, 12 weeks is very recent... it is okay for you to do controlled exercises and yes these are fine for you. My advice is, respect your pain, don't push it too hard, ice it when you do. If you do too much and keep yourself in pain all the time you might end up in a chronic pain situation. But it is not chronic pain now and is not a harbinger of chronic pain. It is early days yet, be nice to it for 6 - 9 months more.

@@Biomechanicphysicaltherapy thank you very much for the response. It’s very encouraging and I appreciate that.

Gracias por ver!

Glad you like it!

Hello @leevize6045 I am sorry to hear that. It is possible that the nerves will heal. There is a laser on the market, MLS Laser by Cutting Edge Technologies that is the only proven thing to heal nerves. It is also possible that you have a little bit of innervation left in which case physical therapists can help stimulate those muscles to be able to lift the toe again. Good luck to you.

You could have more than one thing going on. But the other thing I’ve discovered. When the inflammation or problem has gone on for a long time, the whole darn thing hurts. So as soon as you get under treatment and start getting the pain and the inflammation handled, the pain will start to get more specific from where it actually started as. Maybe you can remember which pain it was when it first started? Or you could try to find a good Physical Therapist with an MLS cutting edge Laser to decrease your inflammation and help focalize it.

Here you go…www.dolphinmps.com/dolphin-vns-for-covid-19/

Yes, if your toe is fused, you can no longer move it either direction

Hello, it would be best if you do this twice a day. You might want to start with a professional PT to see how hard you are supposed to push. Best to do most stretching in first 6 months so get started right away!

Glad it was helpful!