Food
Start slowly. It's natural to want to eat a lot after surgery, but start with small amounts of your normal food, and eat more as your nausea improves.
Dressing
If you have a cast or splint, keep your dressing on until you return for follow-up (usually about 2 weeks).
Incision
Keep your incision covered for 2 weeks.
Weight Bearing
No weight bearing for 3 weeks. See the recovery timeline below for how weight bearing progresses.
Activity
Stay as active as your pain and swelling allow — without putting weight on your foot. This helps prevent blood clots.
Blood Clots
My biggest concern after foot and ankle surgery is the formation of blood clots. To prevent them, stay active and take one tablet (81 mg) of aspirin twice daily with food for 2 weeks. If you or your family have a history of blood clots — or any other reason for increased clotting risk — you may need more aggressive treatment; please discuss this with Dr. Allred within 24 hours after surgery. What does a blood clot feel like? Blood clots usually (though not always) appear a few weeks after surgery. They typically cause new calf pain and new ankle swelling, and rarely cause shortness of breath. If you think you may have a blood clot, call the office immediately during office hours, or go to the ER after hours.
Swelling
The best way to control swelling is to keep your foot above your heart (sitting up in bed usually does not get your foot above your heart). Controlling swelling dramatically affects healing and complications.
Physical Therapy
You will attend physical therapy. We will arrange it at your first post-operative visit.
Medications
As noted above, I recommend aspirin for two weeks. For pain, alternate over-the-counter ibuprofen and Tylenol — for example, take regular Tylenol, then ibuprofen 2 hours later. Do not take more than the daily dose shown on the label for either one. While taking ibuprofen, I also recommend over-the-counter Pepcid or another antacid to help prevent a stomach ulcer. For prescription pain medicine (narcotics), see below. If you are also taking daily aspirin to prevent blood clots, take your ibuprofen at least 30 minutes after the aspirin — or at least 8 hours before it.
Narcotics
You may need narcotics for a few days, but the sooner you stop using them, the better you will feel. Refills are rarely needed. We do not refill these medications after hours or on weekends, and a refill takes about 72 hours, so please plan ahead. If you take narcotic medications regularly, you will need to make arrangements with your regular prescribing provider.
Post Operative Visits
Call to schedule an appointment about 2 weeks after surgery.
Recovery at a Glance
- No stretching against resistance at any point. This protects the repair and prevents over-lengthening or over-stretching. No calf stretching unless specified in your written instructions — please contact the office if you think calf/Achilles stretching is needed.
- Begin moving your ankle up and down (range of motion) out of the boot to keep it from getting stiff. We usually change you from a splint to a boot at 2 weeks.
- Weeks 0–2: non-weight-bearing in a splint.
- ~2 weeks: return to the office for suture removal.
- 3 weeks: begin using wedges and start slow, progressive weight bearing in the boot for 4 weeks.
- 6 weeks: follow-up; begin transitioning out of the boot into regular shoes. You may begin gentle biking and swimming.
- 12 weeks: begin the elliptical trainer and progress to advanced strengthening.
- 16 weeks: begin higher-impact activities.
- Return to running, sports, and all activities once you can do a single heel rise or a single-leg hop on the surgical side. This may take 6 months to a year.
Precautionary Measures
- To prevent infection, you were given IV antibiotics before your surgery.
- To prevent blood clots, stay active. Walk around your living room once every hour while you are awake, and take aspirin 81 mg twice daily for 2 weeks.
- If you are taking narcotic pain medication (such as Percocet or Vicodin), you may need a laxative to prevent constipation. We recommend an over-the-counter stimulant laxative such as Senna. Narcotics slow the bowel down, and Senna works by stimulating it. Fiber-only products (like Metamucil) usually aren't enough on their own, since they add bulk but don't stimulate the bowel.
When to Call / Emergencies
Call the office or go to the ER if you experience any of the following:
- Incision opens
- Increased redness at incision site
- Pain uncontrolled by pain medicine
- Uncontrollable bleeding
- Fever > 101°F or shaking chills
- Difficulty breathing or chest pain
- New calf pain or ankle swelling
- Painful swelling
If this is a life-threatening emergency, call 911.
Don't know which number to call? Every clinic's emergency and daytime number is on one page — worth saving to your phone before surgery.