Houston Methodist. Leading Medicine

Foot FAQ

Question:

I had bilateral bunionectomies against my family's wishes. They wanted me to do one at a time but I knew I would never go back once I had the first surgery. I don't want to let on that I'm having any problems because I don't want to hear, I told you so from them. But the truth is, I am still having quite a bit of swelling in my feet and some trouble walking. What can I do to get over this?

Answer:

The first thing to do, is let your surgeon in on your secret. He or she will keep your confidence. You can treat the appointment as a routine follow-up while still getting the help you need. The physician will assess what might be causing the swelling and treat you accordingly. You may need some medication. Sometimes exercise is needed to get the fluids moving from the feet back into the main circulation. There are therapists who specialize in a type of massage designed to help move lymph fluid and reduce swelling any where in the body. Lymph is the fluid found between the cells of the human body. It flows through the entire body through special lymph vessels and filters out toxins or waste products from cellular metabolism. After any kind of surgery (and especially surgery on both sides of the body), fluid can build up. Microscopic damage can occur to the lymph vessels during surgery slowing down the regular flow of lymph fluid. Decreased movement and inactivity add to the problem. The lymph system doesn't have a pump of its own like the heart, which pumps blood through the blood vessels. Instead, the lymph fluid moves in response to muscular contractions. Since physical activity and exercise is often limited after bilateral bunionectomies, this type of swelling called lymphedema can develop. The lymphedema specialist will use very gentle hand movements over the skin to get the lymph fluid draining again properly and move any areas where it has pooled (such as in the feet and ankles. Ask your doctor to refer you to a lymphedema specialist. Early intervention can help clear up the problem quickly and keep the swelling from becoming a chronic, lifelong problem. This type of swelling can occur after any surgery and should not be viewed as the result of making a choice that was right for you. What's important is that you get the care you need when you need it. Reinhard Schuh, CM, et al. Rehabilitation After Hallux Valgus Surgery: Importance of Physical Therapy to Restore Weight Bearing of the First Ray During the Stance Phase. In Physical Therapy. September 2009. Vol. 89. No. 9. Pp. 934-945.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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