It seems pretty standard. My surgeon has done a lot of these and knows my athletic background so I think he would have brought it up. Googling turns up nothing but stuff like picking up a pencil with your toes and toe spreads, I don't need a pt for that.
DTM, if you were my patient, I'd tell you to wait a bit more than 3 weeks to begin low impact exercises. I'd likely tell you to wait 1-2 more weeks before trying much of anything that stresses the toe. Then start a slow progression of partial weighbearing activity.
Again if you were my patient I'd say do all the leg machines you want but just not bearing wt., leg EXT/curls etc. some stationary bike but easy, easier than you describe.
Let this thing heal up then try to progress. at 3 weeks the stuff he cut is still healing. Listen to your body, if it causes increased pain and swelling it is too much right now.
Yeah Vin, it's glaringly obvious that it wasn't ready for what I did on Friday. I'm not doing shit on my feet for at least 7 days and probably longer. No gym membership so leg extensions, etc. aren't happening. I've been chipping away at a front lever for awhile now and going to stick to that.
So after my last post things were progressing well until about 35 days post-op when the incision swelled back up a bunch out of nowhere. Saw the doc a week later and he said I most likely had some stitch abscesses from the internal stitches not dissolving properly. So, onto antibiotics for the next seven days. It started feeling better within 1-2 days and improved substantially over the course of the treatment. Started hitting the spin bike again and doing some longer walking with no ill effects. Eight-week follow-up was wednesday and was told I'm now good to go. I did some light squatting and a few minutes of easy running yesterday and it felt fine then and today. Time to get back in shape....
Skied the bird for about 5 hours yesterday and no issues with the foot whatsoever. Stoked!
That's hudge! Get it!Quote:
Originally Posted by Dantheman
So I basically had two stitch abscesses, one at the distal end of the incision and one at the proximal end. At my appointment last week the proximal one was completely gone but the distal one was still there a little bit. We decided to give it some time and see what happened. It pretty much stayed the same through tuesday and then started to swell back up tuesday night. So, as much as it pains me to do so I'm back on antibiotics for a while.
5 month follow-up:
Did a 10.5 mile, 1,800 ft techy trail run in 91 minutes at a mellow pace last weekend. No issues with the foot whatsoever on the run. Pretty much back at my old lifting PRs too and feeling really strong on my bike. I'm almost exactly a year out from the original injury that started this nonsense and could not be happier that I seem to have finally put it behind me.
No IT band issues either, but that only ever presented itself going for >2 hours though so that remains to be seen somewhat. Honestly though, I think the main cause of my IT band issues was all the flat road miles I ran last winter training for Salt Flats. Screw that shit, never again, unless it's intervals I'm only running high vert mountain trails for the rest of my life.
Glad to hear it DTM.
[QUOTE=Dantheman;3998629]5 month follow-up:
I just finished reading your thread and am afraid I have the same issue you describe, although not as bad - yet. Symptoms started last winter skiing / hiking in WY & MT and was brutal making turns. Pain went away in summer but still "clicking" sensation in 4th toe. Pain came back this summer while skiing / hiking in Chile and now seems worse as weather is getting colder. Did you find temp. a problem for your issue? Did you learn of any preventative ways to cure before geeting to your point of surgery?
I can't really speak to temperature effects. Mine started in late spring/early summer, and when the weather got cold it was bad enough I was laying off it completely.
You basically have 3 options for non-surgical interventions:
-Different footwear and/or neuroma pads: Footwear changes may be an option for summer, but probably not for skiing. Neuroma pads did nothing for me, but YMMV and since they cost almost nothing they're worth trying just to see. Make no mistake though, any nerve damage bad enough to be symptomatic is probably irreversible. You can do your best to keep it from getting worse, but shoes and pads won't "cure" anything.
-Dilute alcohol injections: These are supposed to kill the nerve in situ, but my surgeon's opinion was that they were a scam.
-Cortisone injections. Cortisone injections also did nothing for me. They may help if you identify symptoms very early, but anything beyond very minor damage to the nerve is irreversible. IMO, if "brutal" is how you would describe the pain level, the cortisone injections are a waste of time and money.
If you get surgery I highly recommend finding a well regarded foot/ankle specific ortho who works with athletes. The biggest factor in whether or not the surgery "works" is what the surgeon does with the end of the nerve. According to my guy, lots of podiatrists just snip it right above the neuroma and call it good. This can be OK in sedentary people, but if you are active it can often lead to a stump neuroma (google this) that can be as bad as the original neuroma. My surgeon removed the nerve well above the MTP joint and inserted the end into one of the intermetatarsal muscles. The nerve end has more space there and being inserted into the muscle reduces stump growth, supposedly.
Also, take the recovery seriously. I needed to be on the couch with the foot elevated >90% of the time for the first 3-4 days or it would throb horribly, and I had to keep it elevated the majority of the time for another week or so. After I got out of the ortho shoe and got the stitches out (2 wks) I had to take it very easy for a couple more weeks still. You really need to be off the foot as much as possible for 1-2 months, which isn't too bad if you have a desk job but could be tough if your jobs requires you to be on your feet. Full recovery expect 3-6 months depending on how seriously you take the recovery and whether or not you have any complications.