MIS Bunion Protocol

0-2 weeks: Your toes will be strapped in a particular dressing that was placed during surgery. This dressing is to stay on until your first post-operative visit. Please keep this dressing dry. We recommend using a cast bag for this (you may purchase on Amazon).
You will be allowed to put as much weight on the surgical foot as you feel comfortable as long is the pain is a 1,2, or 3/10 on the pain scale. This is what we call “weightbearing as tolerated.”
You may weight bear after the block wears off and you can feel your foot again. Until then, you should not put weight on it. Crutches are not mandatory; however you may use them (or other assistive devices such as a rolling knee scooter or iWalk) if you feel more comfortable. You will be given an Aircast boot (walking boot) after surgery. Any time you are up moving around you need to have the boot on. You do not need to wear the boot to sleep.
2-6 weeks: The initial post-operative dressing will be removed. If the wounds look good, we will remove sutures. We will transition you to a bunion toe spacer, which you will use for 3-6 months. You will be able to get your foot wet in the shower (no baths or submerging the foot in the tub/pool of water). You will still be able to put as much weight as you feel comfortable on the surgical foot (weightbearing as tolerated) and can start to wean from Aircast boot into regular shoes. We typically begin a course of physical therapy at this time to work on range of motion, swelling, and strengthening.
6-12 weeks: You are usually back walking in a regular supportive sneaker, still using the toe spacer. You should be working with PT. You may start to resume low impact activities as pain allows. Low impact activities include walking, biking, swimming (no pushing off the pool wall to turn), and modified yoga (no positions such as downward dog where you are stressing the toe with significant push off.)
12 weeks and beyond: You should be fully walking in regular shoes. You can stop using the bunion toe spacer if advised by myself or my team. You may start to incorporate high impact activities as pain allows (running, jumping, activities requiring pushing off the toes).

Things to consider: Minimally invasive surgery does not mean “no pain.” Post-operative pain is experienced differently by every patient. We find that by taking a minimally invasive approach, patients typically do not experience a significant amount of post-operative pain. Most of our patients do not require narcotic pain medication after surgery. However, if they are needed, most patients only require them for the first day or two after surgery or as the block is wearing off. You will have swelling after surgery. Swelling can persist for quite some time, and it is not uncommon to still experience swelling at 2-3 months post-op. In general, we tell patients to think of the first 3 months as the “acute” recovery phase, where you will have dressings/CAM boot/physical therapy/etc. Most people feel like they are getting back to “normal” and activities they normally participate in around 3 months and beyond.