Getting Back to Running After A Bunionectomy

Hi, I'm Dr. Molly with Your Goals Physical therapy. Did you just have a bunionectomy and now you want to get back to running? So the ultimate goal after getting that bunion removed was to get back to all the activities that you had been missing out on because of all the pain from the bunion. So now no bunion, no pain. Let's get it right? Let's start running it again. Even if you are still in that healing phase and maybe your bunion is less comfortable than you were hoping for, that rehab is taking a little longer, that healing process is taking a little longer.
I'm going to talk about the considerations and the things that go into getting you from just after surgery all the way back into running. So we're going to talk about that process. Let's get started.
So first let's talk about bunions in a general sense, right? What that ends up being is extra pressure was put on the outside of that first digit, your big toe and you end up pivoting off the side of that big toe versus pushing down on the bottom joint. If this is my foot and this is that pad of that first digit, we would normally be pushing down this way because that's how your toes would be flexing. But when we have a bunion, what that means is that over time we have changed the way that we walk and the way that our foot pushes off the ground to kind of a sideways push. So it ends up moving that toe over into the other toes. When you have the bunion removed, it opens up that joint space a little bit more and allows better movement in that up and down motion.
That does not mean that it is super comfortable, especially right after surgery, because anytime you have bone removed and you change how your joint is going to move, it's not comfortable. It does take a little bit of time to get that range of motion back, to get the swelling to calm down and to get the overall achiness to go away.
I'm here to tell you it will go away and it just takes a little bit of time. Now that we kind of understand how the bunion started, then let's talk about how we get back to running.
Now, running is a very dynamic sport. It requires you to have a whole lot of ankle strength, foot strength, balance, hip strength, core strength. That's why it's such a great exercise because it uses the whole body. So with a bunion, what you're trying to get back to or what you're trying to correct is that walking mechanism that I was talking about. Really the biggest hurdle for people when you're coming back from bunion surgery is changing how your foot hits the ground because nobody thinks about how their foot hits the ground because you don't think about how you walk.
You just put one foot in front of the other and go about your day. So now that you have the surgery and you're having to really be conscious about that, it can make you overcompensate or undercompensated. Especially if you don't have anybody helping you do this because you don't know what normal is and what that even means in terms of how your foot should feel when it's hitting the ground. So the first big thing for anybody who's trying to get back to running after having bunion surgery is “how do I fix how my foot hits the ground?”
I need to make sure I'm pushing off with that big toe. I need to make sure my balance is good, my foot strength is good. It's going to be a different range of motion but I have to have a range of motion in my ankle that allows me to run. So that would be the other thing we have to work on is a range of motion because when you change how your foot hits the ground, it affects everything up the chain. I know we don't think about it, but your foot and your ankle aren't exactly the same thing.
Depending on how your foot hits the ground, it really does change how much range of motion you have and/or need in your ankle. If I turn my foot all the way out sideways, right? If I'm walking and instead of having my foot straight, it turns out and I'm walking forward, my ankle does not have to move that much. The angle between my tibia and my foot doesn't have to be much. If it turns out I can kind of walk and barely move that. But if my foot is forward and I come forward, I need a whole lot of flexibility.
So it changes a whole lot when you change how your foot hits the ground. The next thing is many people who have bunions also end up having that little bit of a knock knee situation where their knees are turned in more than would be considered ideal. So you have to work on that. You have to work on that stability of your knee because as you're walking more normally it's going to affect your knee, your knee muscle strength, your knee flexibility. You may notice that you can feel muscles that you didn't know that you had before and that's not where it stops, right? Then we go up to the hip and you might notice either your hips are tight, your hips are weak, those are things that need to be addressed. Then once you just get strength and range of motion kind of worked out all those changes, then yo

[@user-xw9dv9ud7i]

Hi, thanks for your video. In your experience how long more or les it takes to go back to running or hiking for someone doing exercise periodically?. I got bunionectomy in both feet plus correction of hammer toes in two toes per feet. I don't run, but I used to do long hikes (25 to 30km with at least 1000m up and down per day). Im so looking forward to be back, but feel really weak after 5 weeks post-op.

[@drmollymcdonald]

Hi thank you so much for the message. I'm very impressed by the Km you hike! I live in a city that is flat so I'm always jealous of people who can hike and enjoy nature. It would be very hard to answer your question because there are to many variables. I would say the range would be 3 months to 1 year depending on someone goals and other health variables. Here is why.... Traditionally bunion and hammer toes are developed over time from the way people walk. Speaking generally bunions develop over time when there is pressure place on the side (verses the bottom) of the first toe during push off. Hammer toes develop from the foot trying to grab the ground, meaning part of the foot is not in contact with the ground. This can happen when people walk more on the outside of their foot. It sounds like you had surgery to "fix" the structural changes which is great. Just due to having surgery you will have lots of pain and swelling which limit the amount of strength that can be gained until about 6-8 weeks post- surgery, which is when the tendons and bone have healed. This means that is you just wanted to have less pain walking, fit in shoes then in about 6-8 weeks you will feel pretty good with your daily activities. However, my clients tell me they want to not just have less pain walking they want to fully enjoy their recreational activities. I work with my clients to change how they walk by finding their muscle imbalances in their hip and ankles. And we actively work on changing how they naturally walk to pattern to one that is less taxing on their feet. Some clients make gains very quickly and some take a little more time. There can be a number of reasons for the differences. I hope this helps you to at least know you are not behind in your recovery Your body is still healing from the surgery.

[@beepbopboop3221]

What if I didn't really run before surgery and still have 1 bunion? I don't know how to train my gait. I only know it's off.

[@drmollymcdonald]

I would suggest seeing a physical therapist. Walking requires all the muscles in your lower body to work together. It is not as simply as we all want it to be. Working with a professional will help you identify what is causing your gait to be off, then create a program that address those specific changes with less guessing and frustration for you. If you are in the cypress area I would love to meet with you to talk more in depth about your concerns and goals.