Bunions, Treatments, Surgeries...Oh My! The Story of My Quadruple Bunionectomy

BUNIONS

Courtesy Epodiatry.com

Most people, when they hear the word bunion shrivel up in disgust.  They can be unsightly and horribly painful.  Bunions are bony prominences on the base of the first metatarsal, commonly referred to as the big toe.  A bunion on the little toe is called a bunionette.  Bunions form when the big toe (or little toe for bunionettes) pushes up against the other toes, this forces the joint in the opposite direction.  There are many reasons for the toes to behave in this manner. Wearing ill-fitting shoes is the most common cause for bunion formation.  The tightness of a shoe can push toes together creating the bunion.  Medical conditions and misalignment of the bones in the feet either from genetics or injury can also cause bunions.

TREATMENTS

Bunions can be quite painful making it difficult to walk or wear shoes.  Over time if bunions are left untreated the joint can become rigid and stiff causing loss of mobility in the toe.  Treatments include changing to a shoe with a wider toe box for more room, padding and taping of the bunion to protect from friction, medications for pain and swelling, shoe inserts to fix structural problems, and surgery to remove the bunion. Physical therapy can help with stiffness and to prevent or improve loss of mobility.  

It is important to stop a bunion's growth before too much pain and discomfort occurs.  Often switching to a wider shoe can relieve the pressure from the bunion.  Staying away from high heels and dress shoes is a must.  A wide cross trainer is ideal especially if using an orthotic (shoe insert) to help with realignment of the bones in the feet.  For minor cases, store bought orthotics are fine however, they are not custom fitted and every foot has its own unique shape.  Custom made orthotics from a foam mold of your feet is highly recommend.  Most podiatrists and some physical therapist can fit a foam mold of your foot and send it off for custom orthotics. 

A bunion's growth can be delayed or even stopped, however the bunion will not completely go away.  If all other treatments have failed, a bunionectomy (surgery to remove the bunion) may be suggested.  This was the case with my bunions.  

MY QUADRUPLE BUNIONECTOMY

Yes, you read correctly, I had two bunions and two bunionettes removed a year ago.  In May of 2010, my right foot was operated on and then in June it was the left's turn.  I also had screws placed into my metatarsals to straighten them and protect my bones until they healed.   Two more surgeries ensued in September and October to remove the screws.  As you will see below, my bunions weren't as prominent as the ones above.  However, they were extremely painful and I had very little mobility.

Left foot:  Slight bony prominence on big toe is a bit hard to see for its not as big,  but the bunionette is clear.  Also, note how the bunion on my big toe was pushing it down and in.  That positioning was limiting my mobility. 

Right foot:  Obviously this was the worst one.  Both bunion and bunionette are easily noticeable.  My big toe was pressed into my second toe almost like fingers being crossed. 

My bunions were due to my inherited structural defect of both my feet.  I was born with inward alignment.  30 years ago, the only way to fix this problem was surgery to correctly align my bone structure.  My parents weren't willing to put me through it and hoped I would "outgrow" the problem.  That didn't happen, I just learned to deal with crooked feet.  A lifetime of walking on crooked feet has left me with many feet problems that will require the rest of my life to correct them to prevent becoming disabled.  My metatarsals lie inward and almost touch either when they should be straight up and spread out.  This inward structure created the bunions.  

I had pain that would come and go for many years.  Finally after being fed up with ending my night in tears due to so much pain, I started seeing a podiatrist. After an x-ray the problems became clear. I'll never forget my doctor placing his hand on my foot saying, "I'm so sorry but we're going to have a long relationship with each other.".  

Before this visit, I had already adapted to wide boxed cross trainers. Wearing any other shoe was too painful.  The next step for me was custom orthotics and physical therapy.  Physical therapy was prescribed to help recover strength and mobility in my toes as well as for other issues that I was having with my feet.  The hope was that the orthotics would properly align my feet and relieve pressure from the bunions and the therapy to rehabilitate them.  

My physical therapy treatment involved massaging my toes to increase blood flow that would assist in healing.  The manual movement of my toes would help stiffness.  I also picked up marbles and crinkled towels with my toes to facilitate movement and strength.  I did these exercises at therapy and a few times a day at home for several months.  However, my job required me to stand and walk on concrete floors for 8-10 hours a day.  Then pain was relentless. The worse the pain became, the more I lost mobility.  Finally, my doctor decided that in my case, surgery would be beneficial.  

The sides of each foot were cut open, the bony prominences sawed off, and screws placed into the first metatarsal for straightening and stability as the bones healed.  Also, my second metatarsal on both feet grew tumors from the constant rubbing together of the bones.  While my feet were open the tumors were removed as well.  After my bones were healed the screws were then surgically removed.  Afterward, the 7 month healing process was long and painful.  

Here are my recovery pictures:

One week post-op:  Lots of bruising from the toes being shoved out of the way.  You can see where the tumor was on the second toe from the bruising on its base.  

2 weeks post-op:  A soft cast was placed over the surgical area to protect the bones.  

Post-op boot.  There's a wedge at the heal that prevented me from stepping on the surgical area.  It didn't stop the pressure from being felt when walking though. 

About a month post-op.

Left foot one week post-op

I stayed this way for 3 months! 

Mode of mobility. 

Today, I can run and wear wide boxed cross trainers and podiatrist approved sandals without pain in my toes.  I still can't walk or stand for long periods of time without restrictive pain but its not due to bunion problems and thats a bit of relief.  Through the physical treatments I mentioned above and yoga I was able to regain a flexibility and strength in my toes. 

1 year and 2 months after 1st surgery:  I went down 2 shoe sizes after the removal of the bunions!

PHYSICAL THERAPY 

I cannot stress enough that if it wasn't for physical therapy and yoga, I would have never gained back mobility and strength in my toes.  I built up a lot of scar tissue on the inside of  my bones that really stiffened up the joints.  Physical Therapy and the flexibility of yoga really got me moving again. Below is a video that demonstrates the marble picking up exercising that will strengthen the muscles in the feet and help you practice flexibility.  In the beginning this exercise for me was so tiresome and painful, I could only do it once a day along with my other exercises.  A week later, I was able to build up to twice a day to eventually the ideal three times a day.  Do as you feel comfortable but remember to see results you must pick up these sets. 

YOGA

Transitioning into downward dogs is a great way to get those toes flexible and to rebuild strength in your feet.  Yoga has many benefits for the body from flexibility and strength to weight loss and regulating systems within the body. DO NOT do any yoga moves post surgery without the approval of your surgeon. I did not attempt yoga until my bones were completely healed.  Bunionectomies are very traumatizing to the bones.  Too much pressure on the foot can break the metatarsals involved.  Again, I stress gaining doctor's approval before practicing any yoga routines that require the use of your feet.   I've included a video to instruct you how to do a downward dog and other transitioning positions that can build strength and flexibility in the feet. Keep in mind, the toes will be weak and stiff.  These poses do not have to be carried out to their full strength and stretch to obtain results. The cinematography focuses more on the strength of the body versus the feet.  So try to pay attention to how the feet and toes move! 

In conclusion, if you stumbled upon this blog for your bunions or post-op recovery from a bunionectomoy I hope you found my experience helpful.  If you have any questions please feel free to ask in the comments below and I will answer best to my ability.  REMEMBER, always consult your doctor or physical therapist before adopting any new exercise program.