My Lapiplasty® Big Toe Joint Fusion™ Journey: Weeks 4-7

By: Dr. Mindi Dayton

I'm happy to be back to share my experiences during weeks 4-7 of my Lapiplasty Big Toe Joint Fusion recovery. I apologize for the delay in posting; life has been busy, and I kept telling myself I needed to write this update. But, as you can imagine, things can get hectic!

Recent Highlights

In a nutshell, I had my first plane flight post-op on December 15th, just shy of four weeks after surgery. I wore my boot and had minimal trouble navigating the airport. Thankfully, I had TSA PreCheck, which allowed me to keep my boot on during security. To my surprise, the boot did not trigger the metal detector! This is great information to share with my patients.

After the airport, I walked around the Mall of America in my boot. It was slow going, but my foot felt great. However, my left hip and thigh were a different story. I took plenty of breaks, didn’t push myself, and was able to finish my Christmas shopping, which I had been putting off.

Transitioning Footwear

At around four weeks, I transitioned to my post-op shoe for clinic days, where I do very little walking. I continued to wear my boot for shopping until just before five weeks. Honestly, the boot was more comfortable for longer distances than the post-op shoe due to gait considerations. By five weeks, I started wearing my tennis shoes. I began with my Altra Paradigm without any insert or liner to accommodate my foot, Incrediwear compression sleeve, and sock. The Altras worked well because they are wide in the toe box and have a good amount of height in the forefoot.

The first few times I hesitated to "shove" my foot in, feeling like it wouldn’t fit. However, I realized it was more about fear and the unfamiliar sensation. After taking a deep breath and pushing through—both literally and figuratively—it worked out fine. Our minds can be powerful tools that sometimes hold us back due to fear. I knew I wouldn't harm my fusion site, yet I still felt nervous.

Holiday Celebrations

Christmas was wonderful. We hosted our family and enjoyed a fantastic meal together. Unlike Thanksgiving, where Paul and our son took care of everything, Paul and I tackled the Christmas meal as a great team!

After the busy holiday season, we decided to treat ourselves to a getaway in Las Vegas for some warmer weather, delicious food, and a little Three Card Poker as a late birthday celebration for me. (No, we didn’t win big—but if you haven't tried Three Card Poker, it's a fun game that requires no prior knowledge and allows you to play for a long time with minimal money.) I wore my Altras throughout the trip, even with my dress clothes for dinner, and we had a fantastic time. We walked the strip at a slower pace than usual and took several breaks to enjoy the Vegas atmosphere. I did find myself limping quite a bit, not because of discomfort, but it was an involuntary response. This was frustrating and led to discomfort and muscle pain in my left (non-surgical) outer thigh.

Lessons Learned

I could walk more normally with less of a limp when I took longer, more natural strides. The shorter, "protective" strides I had been using to walk flat-footed led to more of a limp.
The 5th toe (where I had a hammertoe correction) really is the worst! Patients often mention it bothers them the most, and now I understand why—it truly does!
I really need a pedicure!

In early January, I was able to wear my New Balance 860s (which are slightly narrower in the forefoot than my Altras) without an insert, and I had no issues. I’m still wearing tennis shoes out and about, and I walk barefoot or in my Hoka slides at home. I feel like I could comfortably wear other shoes and my snow boots if it weren’t for my stubborn 5th toe!

Last week, I had the opportunity to travel to St. Thomas in the Virgin Islands for a meeting. I continued to wear my tennis shoes and felt great walking around. I brought along a pair of sandals that I had tried on at home, which felt comfortable then. However, by the end of the day, my foot was too swollen to fit into them since I hadn’t worn my compression sleeve that day. So, back to the tennis shoes it was. During some downtime, we walked along the beach barefoot, which was wonderful, especially since we were getting hit with snow back in Iowa. Paul captured some good video of me walking, which I’ll post on YouTube.

Now, at just shy of eight weeks, I've noticed that stairs are easy to navigate both up and down with a fairly normal cadence. I still have a slight limp if I don’t pay attention to my walking. It’s not a conscious decision to limp; it has become somewhat of a habit. I’m working hard to follow my own advice to patients: focus on heel-toe walking and maintaining a normal gait without putting extra pressure on the outside of my foot. Each day, I find myself thinking about it less and less.

7 Weeks Post-Op Update

I loved walking on the beach and feeling the sand between my toes!

Current Foot Status at 7.5 Weeks:

No pain at all, regardless of how active I am at the Lapiplasty Big Toe fusion site.
My 5th toe is a little tender at times, but it looks so much better than before surgery!
There’s still some swelling in my foot and ankle depending on the day, activity level, and whether I’m wearing my compression sleeve. Some days, the "cankle" is quite noticeable!
I still experience a mild numb feeling between my big toe and second toe, but this has improved significantly. I notice it most when my foot is a bit swollen.
Pushing off of my big toe feels a little "weird," but it’s not uncomfortable or painful.

What’s next? I plan to start some early lower extremity exercises next week during week 8, both on the treadmill and in the home gym. I’ll keep you updated on how that goes and share any new lessons learned!