Promoting Realistic Expectations For Runners Following Foot Surgery

I have had several runners over the past several months present with hallux limitus and surgery was indicated to remove fragments and prevent further joint degradation. Hallux limitus can sometimes present as a slow, debilitating injury in runners. In these cases, it will be painful enough to bring them into your office but not enough to stop them from running.

Injections will usually allow runners to continue running relatively pain-free only to have the symptoms return months later. My recommendations are to perform a cheilectomy sooner rather than later to preserve as much of the articular cartilage as possible to prevent further damage to the joint. I have seen many patients who have waited until the symptoms are more severe. At this point, the articular cartilage is far too eroded to perform a simple cheilectomy and either fusion or an implant is needed. 

When performing a cheilectomy on a runner or any first ray surgery such as a bunion, it is important to keep in mind the patient’s expectations when discussing the postoperative course. For example, we could simply describe the typical recovery period for a cheilectomy as being three to six weeks. Runners interpret this as being able to return to running without pain in six weeks, which is usually not the case.

While they may be able to start running at six weeks or even sooner, it is common for runners to still experience swelling and discomfort for even up to six months. I really stress to my patients who are runners that recovery can be a challenge when it comes to returning to running without symptoms early but if they are aware of this ahead of time, their minds are more at ease and it makes for a more pleasant post-op period for the physician as well.

Keep this in mind. Spend a few more minutes with your runners and tailor the answers to their questions, knowing that their questions pertain to running and not just walking or performing activities of daily living.