Plantar Surgery Post-Operative Rehabilitation
If you are unsure about whether you need plantar surgery, you may want to read through our "Do I Need Plantar Surgery?"" Page.
If you want to know about the types of muscle surgery, you may want to read through our "Common Surgical Procedures for Plantar Fasciitis" Page.
Immobilization & Rest for the Best Recovery
In almost all cases, postoperative care should include rest and restriction of movement for the affected area of the body. For some foot injuries, 'rest' for the tissue can be made easier by immobilizing the foot in a cast or splint after surgery. For some injuries, soft tissue may need to remain immobilized for up to 6 weeks. Long-term immobilization in some cases will help the soft tissue that is forming be strong and healthy.
After Your Surgery
During the first 24 to 72 hours after surgery, the area will be tender, swollen and quite painful. The pain will typically be minimized through pain meds (oral or intravenous) for a short term duration. You may be weak and unstable for a while. You may also have been outfitted for a cast, crutches, brace or some other form of support aid to wear for a period of time. You will be forced to take it slow - how long will depend on many factors.
Right after surgery is when muscle loss easily gets very significant as it does not take long for unused muscle to disappear. This is a major reason why PT is absolutely necessary - you need it to rebuild muscle strength and increase your range of motion (which is typically severely restricted due to the surgery).
It is important to understand that surgery may not bring back 100% functionality of your injured foot, but you should be able to return to most if not all of your pre-injury activities. These surgical procedures are often performed with very successful results. What truly makes a difference is your commitment to a doctor recommended rehabilitation program after surgery as there is always a possibility of re-injuring your muscle even after a surgical procedure.
Ask any doctor and they will tell you that a large portion of the success in your recovery will depend on your level of dedication to regular at-home conservative treatments following surgery. Odds of a successful recovery are further improved through regular attendance of phyical therapist appointments and not overexerting/overstressing the area of concern.
The incorporation of conservative treatments at home (as instructed by your physician or PT) will lessen the chance and/or severity of joint degeneration and atrophy during your rehabilitation process.
Getting Started with Your Post-Operative Rehabilitation
If you have undergone surgery on your damaged foot, then your physician will quickly get you on the path to rehabilitation. Now, the aggressiveness of your rehabilitation efforts and your injury's ability to heal will depend on a variety of factors including (but not limited to):
- your age, overall health and activity level
- the state of your injury before surgery (more severe injuries will require more intense & invasive surgery which will require a longer recovery period)
- the type of surgery you have undergone
- how soon you must return to normal activity
No two rehabilitation plans are alike - but know that the less invasive your surgery is, the quicker your road to recovery will be.
Proper post-surgery rehabilitation is very important, perhaps even more important than the surgery itself. Most patients can leave the hospital or clinic (as is often the case with arthroscopic surgeries) the same day using crutches, a cane or perhaps just a splint. You will be required to follow up with your surgeon and a physical therapist and they will advise you on your recovery.
The goal of a rehabilitation plan is to manage pain and swelling while improving function, strength, and range of motion. Ultimately, the goal is to regain strength and return to full activity. You will most likely spend a lot of time with a physical therapist after your surgery, but as your healing progresses, emphasis will be placed on your personal at-home treatment. The success of your rehabilitation will depend on your dedication to working with your doctor and physical therapist while also managing your recovery on a daily basis at home.
Regardless of what type of surgery you've had (or even if you don't need surgery) your home recovery routine can be improved by controlling initial and on-going pain/swelling, and increasing blood flow to accelerate the body's ability to heal your fascia, muscles, tendons, and ligaments so that you can achieve long-term, positive results. This can be more easily done by incorporating a Cold Compress or Ice Pack and a TShellz Wrap® into your rehabilitation routine. Regular treatment with a TShellz Wrap will provide an increased localized bloodflow while elongating and increasing flexibility of tissue in the treatment area (temporarily - during treatment and shortly thereafter). Not only does the boosted blood flow increase your body's natural healing rate, the increased tissue length and flexibility reduce your risk of further injury. Re-injury and strains that occur during your recovery will setback your healing rate substantially - this is key... if you want to heal fast, increase bloodflow in the area, and do not suffer further injury - and this is the advantage that a TShellz Wrap® can give you. An enhanced healing rate decreases your time spent in recovery, minimizes the growth of scar tissue (due to lower reinjury) and helps prevent a worsening injury over time.
Post-Operative Rehab Phase 1:
Protect your Surgery Site & Start Moving
Each injury/condition will have different challenges for you after surgery. Your surgeon and/or doctor will provide you with clear direction on how to protect your wound and deal with pain so you can achieve a tolerable level of comfort during your recovery.
Directly after your surgery has been completed, you will go through Step 1 of the healing process by stopping the bleeding that has started because of the incisions and work done inside your body. Depending on the type of procedure you have just had, your soft tissue may be sutured together, reconstructed or removed to fix your underlying condition. In any case, as with any injury to soft tissue, there will be some bleeding. Depending on the type of injury you have, your surgeon may even stimulate bleeding during your surgery to trigger the healing process.
Typically, your body will have begun to stop the bleeding as soon as your surgeon has completed the surgery. This means that the veins carrying your blood will close off, and your blood will coagulate (condense to seal the bleeding off) in order to reduce the amount of blood loss in your body. Your body knows to do this automatically because blood is so vital to the healing process. Blood is basically the vehicle for oxygen and nutrients that travel directly to damaged cells - where these things are needed most.
In order to reduce pain, swelling and inflammation your doctor will prescribe an anti-inflammatory drug to be taken during the first 4 weeks after your surgery, or for however long it is needed, depending on your pain level. Your surgeon will also recommend the use of a Cold Compress or Ice Pack on a frequent basis - multiple times per day - to control your inflammation and reduce your pain.
If your surgery was arthroscopic in nature, you should have relatively little bleeding/blood loss. Your doctor or surgeon will check before you leave to make sure bleeding at the incisions has stopped. If you have undergone an open surgery, your doctor and/or surgeon will check your incisions periodically over the next few days of your hospital-stay to ensure that your body has stopped the bleeding on its own and also make sure that your incisions are starting to heal.
After your incisions & repaired and/or removed tissue has stopped bleeding; the area will most likely become tender, swollen, red and hot to the touch - these are all symptoms of inflammation. Step 2 of the healing process is inflammation reduction. At this point you will be home if you have had arthroscopic surgery, or you may still be in the hospital if you have had open surgery. In order to reduce pain, swelling and inflammation, your doctor will prescribe an anti-inflammatory drug to be taken during the first week or 2 after your surgery. Your surgeon will probably recommend use of a Cold Compress or Ice Pack at this stage for 15 to 20 minutes at a time, several times a day, to control inflammation and reduce pain.
Rest at this point is vital to your rehabilitation plan depending on the surgery you have undergone. If you have had arthroscopic surgery with minimal internal wounding from your surgeon, you may be encouraged to start movement early or as soon as possible. Limited movements of the area will be required in most cases after the surgery. If you have had an invasive open surgery, then you may be encouraged to rest longer at first before starting movement. Depending on the type of surgery you have undergone, rehabilitation with a physical therapist will begin 2-6 weeks after surgery.
Your doctor or surgeon will advance you to the next phase of rehabilitation when there is no evidence of inflammation or swelling in the area. If you have had arthroscopic surgery, your doctor may expect that you are able to move the area around pain free before moving onto the next Phase of rehabilitation.
Post-Operative Rehab Phase 2:
Gain Back Range of Motion (ROM) & Increased Stability
After soft tissue starts to heal your muscle(s) will be in a weakened state and will not be as strong as they were previously for some time. This is why you need to be on "re-injury watch" and make the most of your PT appointments and home therapies during your rehabilitation. It would be devastating to "overdo it" at any point during the first few months of rehabilitation as this would most likely send you right back into the operating room.
After the initial phase of your post surgery recovery (when Step 1 and 2 of the healing process is complete), temporary tissue will start to grow around soft tissue that was damaged during your injury or the surgery. Step 3 is the Growth of Temporary Tissue.
Typically - though not always, approximately 2-6 weeks after surgery your surgeon will recommend regular physical therapist (PT) appointments where you will be encouraged to (1) gain back range of motion (ROM), and (2) increase the stability of the recently repaired area. Your PT appointments will be 1-3 times per week, and progression of movement in the recovering joint will be the guide. You will start with gradual, controlled movements in a free (non-forced) way with little weight or resistance - normally with very few repetitions of activity. Strengthening exercises will slowly increase in difficulty (with more resistance) after your surgery. You will be stiff and in pain at first; simple, easy movements may seem challenging in the beginning - but don't get discouraged, your hard work will pay off in the end.
At about 6 to 12 weeks (depending on your type of surgery) you still need to allow for healing from the surgery. Although you may be feeling much better and your pain is reducing, repaired soft tissue at 4 weeks is typically only 20% healed. At 8 weeks it will be about 40% strong and after 12 weeks a tendon is approx. 60% as strong as a normal tendon. The point where the pain decreases yet the tendons and muscles are still weak is a VERY critical point. This is the stage where you need to be very careful about re-injury.
At Home Stretching/Exercise - Your therapist will encourage you and tell you just how important it is to commit to regular exercise at home as well as in the clinic. You should be doing home exercises up to 3 times per day. They will give you exercises and guidance based on your overall soreness level and your morning discomfort.
We typically advise our clients to apply a TShellz Wrap® treatment to help loosen up before stretching (or exercise). Applying a TShellz Wrap treatment for approximately 10 to 20 minutes (finishing 15 minutes before exercise) will help increase elasticity and flexibility of tissue in the area of treatment. Improved flexibility Apply a TShellz Wrap treatment for approximately 15 to 20 minutes (finishing 15 minutes before exercise) to help increase elasticity and flexibility of your tendons, ligaments and muscles. The increased elasticity will help minimize tissue tears and scar tissue growth that may be incurred during stretching. Overall, we advise TShellz Wrap® treatments before exercise (or work) to help increase ROM and decrease re-injury risk.
Controlling post-exercise swelling and inflammation is crucial during any phase of rehabilitation. Any sign of swelling or inflammation after exercise may be an indication of minor re-injury to muscles or other surrounding soft tissue. Control your inflammation immediately after exercise, for at least 15 to 20 minutes, with a Cold Compress or Ice Pack. If you don't treat swelling immediately after finishing exercise, you may experience a setback in your recovery.
Your doctor, surgeon or physical therapist will advance you to the next Phase of rehabilitation when you show measured improvement of range of motion (ROM), strength, stability and flexibility in the affected joint. The level of improvement will depend on the severity of your injury and the type of surgery you have had. For example, if you have had a relatively simple arthroscopic repair of tissue, you may be expected to move your joint around to show your muscles/tendons are functioning well before moving to Phase 3 of your rehabilitation.
If you have questions, call our office at 1-866-237-9608 (toll free continental US).
Post-OP Phase 3:
Gain Back Full Capability
After temporary tissue has grown (Step 3 of the healing process), this temporary tissue will go through different stages of conversion into healthy, normal, flexible tissue. This is Step 4 of the healing process (Complete Tissue Re-Growth). Before converting into healthy tissue, temporary tissue will often become tough, dense, fibrous scar tissue. Scar tissue has an unorganized, inflexible tissue structure, which makes it brittle. Scar tissue will provide your injury with more long term fusing power, but will also stick to surrounding healthy tissue and even bone. The growth of this scar tissue is what stiffens the joint, restricting movement and flexibility.
This Phase of your rehabilitation will focus on an increase in activity level in order to regain full range of motion (ROM) and muscle strength in the area. Continued exercise and activity will break up and soften scar tissue.
Use a TShellz Wrap® BEFORE exercise/stretching and use a Cold Compress or Ice Pack after exercise. This protocol will go a long way to maintaining overall tissue stretch-ability, reduce re-injury risk, and treat any pain, swelling or inflammation due to overexertion of your muscle(s). If you are noticing any recurring inflammation, you can continue cold treatments as recommended by your doctor.
Your doctor or physical therapist will advance you to the next Phase of rehabilitation when you have regained full ROM (range of motion) without pain. You may also have to pass clinical exams or tests of your muscle strength, balance, stability and flexibility in order to be cleared for Phase 4.
Post-OP Phase 4:
Return to Regular Use & Activity
Depending on your injury, the type of surgery you've had, and the level of commitment to your post-operative rehabilitation program, you may be able to return to daily household activities 6-12 weeks after your surgery.
When your overall condition and range of motion has improved, your doctor or physical therapist may clear you for a return to work or athletic activity. In many cases, they may recommend that you continue muscle strengthening and stretching instructed during your rehabilitation in order to maintain healthy ROM of the affected joint. Additional cardiovascular exercise will also be encouraged. If you are an athlete or have a job that requires extensive physical capability, your doctor or physical therapist will likely advise a very gradual return to previous activity.
Scar tissue may plague you for weeks, months and maybe even years after your surgery depending on your level of activity and the amount of conservative treatment you have undergone during your rehabilitation. Scar tissue will be a major problem as scar tissue can easily build up quickly and its hard to get rid of.
Even if you have been cleared to get back to activity, you still must be careful with the activity you take on. You need to keep in mind that your joint won't be back to 100% for some time (recovery rarely reaches 100%) and so continued stretching with exercises and stretches, treatment with the TShellz Wrap® and a Cold Compress or Ice Pack during flareups of swelling will maintain good health of the post surgery area and significantly reduce your risk of re-injury.
A Post-Operative Recovery Summary:
Your success to recovering from surgery is up to you. Many of our past clients have found the following points to be quite valuable during their recovery period.
- listen well to your physician, and remember to stick to your conservative treatment plan. Using these therapies every single day will help maximize the opportunity to heal and minimize the amount of scar tissue that will grow in the wound.
- know that frequent use of a Cold Compress or Ice Pack will help reduce the swelling very quickly. Much of the pain you feel will typically be from the swelling, and you'll be surprised how fast pain drops once the swelling is down. Scar tissue growth is further inhibited by a reduction in inflammation (swelling restricts blood flow - tissues die without blood and scar tissue grows in its place)
- Consistent use of the TShellz Wrap (a safe, carbon fiber mesh, fda registered medical device) is intended to help reduce scar tissue growth, increase flexibility in tissue and increase blood flow to the treatment area (thereby accelerating the body's own healing process).
- use the TShellz Wrap before physical activity or stretching. Heat emitted from the TShellz Wrap will help connective tissue in the application area elongate, and stay elongated for some time after treatment. It will also temporarily increase the flexibility of soft tissue, meaning that it helps improve range of motion while simultaneously reducing your risk of re-injury which is exactly what you want when trying to recover from tendon and muscle damage.
- stretching, as assigned by your PT or doctor can not only help get rid of scar tissue, but also promote growth of healthy, flexible tissue.
We believe the use of TShellz Wraps® for boosting blood flow to in the area of application is one of the most under-utilized home treatment options available on the market today. We have client after client that have tried many options out there and have been amazed at how effective and fast the TShellz Wrap treatment can relieve pain and increase blood flow in the treatment area.
The intent of TShellz Wraps are to significantly increase bloodflow to tissue in the treatment area - period. With regular use of the TShellz Wrap:
- Your pain will be reduced.
- With increased blood flow, soft tissue in the area will most likely recover at an accelerated rate*.
- Due to increased warmth, soft tissue in the treatment area will have an enhanced range of motion and increased extensibility*. This should translate into a reduced rate of injury occurrance as soft tissue becomes more flexible.
(*Chapter 9 of "Therapeutic Heat and Cold", 4th edition. Ed. Justus F. Lehmann, M.D., Williams, and Wilkin)
Attach the TShellz Wrap®, plug it in and let the Energy Pad do the work!
*Know that every personal soft tissue injury is unique and the TShellz Wrap may not work for everyone. This is why we offer a 60-day money back return on all our TShellz Wrap devices. Our high quality wraps are registered with the FDA as medical devices which meet high manufacturing standards.
Expectations for Long-term Recovery
Rehabilitation after your surgery is just the beginning of your recovery process. Even after you've had surgery to fix your injury and deal with the build-up of scar tissue, it is improbable that your soft tissue will heal 100%. From this point forward, it is more important than ever to be careful with your recovered injury. It is almost a certainty that the area will be weaker now, and your risk of re-injury is just that much higher because of this.
Manage Your Symptoms On A Daily Basis To Prevent Re-Injury
It's simple to manage long-term healing of your muscle injury with conservative treatment methods that can be conveniently used in the comfort of your own home. If you are looking for an all-natural pain management and long-term healing solution that is ergonomically designed to provide exceptional long-lasting relief, speak to your doctor today about incorporating TShellz Wrap into your treatment plan.
The application of a Cold Compress or Ice Pack can help decrease post-operative pain and swelling while also managing pain from occasional inflammatory flare-ups (re-injury).
During your last few stages of rehabilitation, while you are undergoing PT and focusing on improvements to your range of motion, it is important to maintain healthy blood flow in the area. Strong and healthy tendons and muscles need a solid blood circulatory system and this is exactly what our TShellz® Circulatory Boost Wraps are made for.
Reduced blood flow slows down your recovery process. If your soft tissue is always starved for more blood flow, it will be at a higher risk of re-injury which will undoubtedly set back your healing progress.
Use a TShellz Wrap® regularly to prevent re-injury and keep your muscles, tendons and ligaments elastic and flexible. Healthy blood flow is vital to the healing process after surgery. Your blood flow is what brings oxygen, nutrients and energy (things needed to heal) into your damaged tissue. Blood flow promotes tissue re-growth, strengthening the delicate work your surgeon has done.
Regular treatments with the TShellz Soft Tissue Wrap is intended to increase localized blood flow for up to 4 hours with just one 20 minute application! There simply isn't a better home product on the market to enhance your body's natural healing process and provide long-term health benefits.
Scar Tissue - We Need It For Kick-Starting Tissue Repair in the Foot, But After That It's Nasty Stuff
Fascia, tendons, ligaments, muscle and forms of connective tissue are all meant to be soft and flexible, ready to work and move significant forces in everyday activities. When I say force, I mean try to imagine the amount of force that your plantar fascia handles on a daily basis. Try to image the amount of tension put on a plantar fascia when you stumble during a walk and put a load equal to 2 times your body weight on one of the balls of your foot.
Your foot is very complex, having a large number of bones, muscles and over 200 ligaments. The foot performs multiple functions and is the joint built to handle the most force while also performing as a shock absorber during movement. This is why soft tissue injuries that occur in the foot are very difficult to completely fix - once a tear has started, the connective tissue is weakened substantially and scar tissue begins to grow in the foot.
Scar tissue grows in damaged tissue when it tries to heal; little tiny band-aids that overlap each other to bind tiny tissue tears together. With this added scar tissue, fascia, muscles, tendons & ligaments become rigid, less flexible and unable to handle the forces that it once could. If you're suffering with scar tissue now you may feel the effects with stiffness, tightness, weakness in the foot. Worst of all, you will feel sharp bursts of pain if you move the joint too much - this pain is from scar tissue tearing away from what it has attached to.
Scar tissue is something that will be present in your soft tissue before and after your surgery - it can be minimized through use of minimally invasive surgeries (arthroscopic) but never completely avoided. As with nearly any surgery, the surgeon will weigh the costs versus the benefits of performing surgery on each particular case. Your surgeon will determine if the anticipated outcome from surgery will be successful, despite the build-up of scar tissue that you will develop as a result of the surgery. Overall, the surgeon may be able to remove a lot of the initial buildup of scar tissue around the injury and in doing so, achieve a positive outcome from the surgery.
On-going issues with scar tissue can result in soft tissue tears and an increased chance of strain to nearby tendons, muscles and ligaments (as they are now handling higher forces due to overcompensation).
Scar tissue is one of the MAIN reasons why a chronic foot injury has not healed and your Range of Motion (ROM) is reduced from what it once was.
Scar tissue will form fast to deal with a soft tissue strain, and this scar tissue will attach to EVERYTHING in the area, including the surrounding healthy tissue as well. This can result in a fusing together of soft tissue that shouldn't be fused together, and this will cause extreme pain when you move the area - it is literally ripping scar tissue. This is why PT is often painful - the therapist stretches your foot, forcing the scar tissue bonds to break so you can regain your range of motion.
Scar tissue is a major problem as it is difficult to treat and can cause your injury to become chronic - taking months or even YEARS to completely heal!
Minimize scar tissue growth and reduce risk of re-injury to your plantar fascia by:
- (1) increasing blood flow to the foot and
- (2) increasing the elasticity of soft tissue in the area and
- (3) elongating soft tissue in the area.
You can accomplish all three of the above goals by treating yourself consistently, every day with a Plantar TShellz Wrap.. Overall, continued treatment with the TShellz Wrap will maintain good health in the treatment area and significantly reduce risk of reinjury.
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MendMeShop Sesamoid TShellz Wrap®
This wrap is designed to:
- increase extensibility & flexibility of metatarsals/sesamoid/toe areas during treatment & for a short while after
- increase blood flow in the application area
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MendMeShop Plantar TShellz Wrap®
Augment your recovery while reducing risk of re-injury. A Plantar TShellz application is intended to:
- increase extensibility & flexibility of bottom foot fascia during treatment & for a short while after
- increase blood flow in the application area
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