Four weeks after bunion surgery, patients typically experience increased mobility and progress in rehabilitation. While individual experiences vary based on the specific procedure and personal healing, general expectations exist for this milestone.
Typical Healing Progress
Swelling in the foot remains common, though significantly reduced compared to the immediate post-operative period. Minor swelling can persist for several months, or even up to a year, as tissues continue to heal and remodel.
Pain levels typically decrease considerably, becoming more manageable with over-the-counter pain relievers. While some discomfort and stiffness are normal, severe pain should have subsided. The incision site should appear well-closed and dry, with early scar tissue formation. Gentle scar massage may be initiated if cleared by a surgeon to help improve tissue flexibility.
Sensations such as numbness or tingling around the surgical area are common. These nerve-related symptoms often occur due to nerve manipulation during the procedure and typically resolve gradually over several months as nerves regenerate. Occasionally, a feeling of pins and needles or a tight sensation in the foot may be present as healing progresses.
Resuming Activities and Movement
Weight-bearing status varies considerably depending on the type of bunion surgery performed. Some procedures may permit full weight-bearing in a surgical shoe, while others might still require partial or non-weight-bearing with crutches or a knee scooter. Gradual increases in activity levels are advised, with short walks around the house becoming more feasible.
Footwear usually involves continued use of a surgical shoe or walking boot to protect the healing foot. A transition to supportive athletic shoes or wide, soft-toed sneakers may be considered between four and eight weeks, based on the surgeon’s guidance and the patient’s comfort. High heels or restrictive shoes are not recommended for several months, as they can impede proper healing and potentially lead to recurrence.
Physical therapy and specific exercises are often a regular part of the recovery regimen, having frequently started around two or three weeks post-surgery. These exercises focus on restoring range of motion, improving flexibility, and rebuilding strength in the foot and big toe. Examples include gentle toe curls, heel raises, and assisted toe stretches, performed as directed by a therapist.
Returning to work with a desk job might be possible around four to six weeks if the foot can be kept elevated. Driving, especially if the surgery was on the right foot, typically requires waiting at least six to nine weeks for traditional bunionectomies, ensuring the ability to perform an emergency stop safely. Low-impact activities such as swimming or cycling may be introduced around four to six weeks, but high-impact exercises like running are generally restricted until at least 12 weeks post-surgery.
Essential Care at Home
Meticulous care of the surgical site is important to prevent complications. Keeping the incision clean and dry remains a priority. Once the incision is fully closed and cleared by a healthcare provider, gentle scar massage using a moisturizing cream can help improve the pliability of the healing tissue.
Managing residual swelling and discomfort is an ongoing aspect of home care. Elevating the foot above the heart level remains a primary strategy to minimize fluid accumulation. Regular application of ice packs, applied for 10-20 minutes with a barrier between the ice and skin, also helps reduce both swelling and pain. Adhering to prescribed pain medication schedules and using over-the-counter options as advised helps maintain comfort.
General self-care practices support the body’s healing processes. Ensuring adequate rest and sufficient sleep contributes significantly to recovery. Avoiding smoking is also advised, as it can hinder bone healing and increase the risk of complications. Following all post-operative instructions provided by the surgical team is paramount for a smooth and successful recovery.
Signs Requiring Medical Attention
While recovery progresses, it is important to be aware of certain signs that may indicate a complication requiring prompt medical attention. Increased pain that is sudden, severe, or not relieved by medication warrants immediate contact with the surgical team. Similarly, any significant increase in redness, warmth, pus drainage from the incision, or red streaks extending from the wound could signal an infection. A fever accompanying these symptoms is also a concerning indicator.
New or worsening numbness or tingling in the foot or toes should be reported, as should any change in the color of the foot or toes, such as becoming cool or pale. Persistent or significant swelling that does not improve with elevation is another sign to monitor. Calf pain, swelling, or redness, particularly if accompanied by shortness of breath, could indicate a deep vein thrombosis (DVT) and requires urgent medical evaluation.