Rehabilitation and Exercises for Bunionette

Dr. Julien Lopez offers guidance and assistance in your post-operative care for the rehabilitation and exercises related to bunionette.

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Physical Therapy Sessions for Bunionette

Physical therapy sessions, both for bunionette and other foot pathologies, may be prescribed for post-operative rehabilitation. Dr. Julien Lopez provides regular follow-up to adapt the treatment, ranging from non-surgical approaches to post-operative care. Before discussing post-operative care, especially rehabilitation, it is essential to understand the quintus varus pathology.

Definition of quintus varus

Quintus varus is a deformity of the little toe, also known as "bunionette" or "tailor's bunion." It is a condition that causes discomfort during shoe-wearing and walking. The forefoot consists of five metatarsal bones, with three toe phalanges at their ends. The fifth metatarsal is usually straight or slightly inclined, contributing to the foot's balance. During walking, it moves to adapt to the ground and footwear, thanks to the tendons and cartilage surrounding the bony ends.

Causes

There can be several causes of quintus varus. The primary cause is often hereditary, with most cases being congenital malformations. Other factors that can lead to the development of a bunionette include:

  • Inflammatory joint diseases like rheumatoid arthritis.
  • Neurological conditions, often resulting from a stroke.
  • The development of static foot disorders like high arches or flat feet.
  • Consequences of surgical procedures performed on other toes.

The condition can be aggravated by wearing ill-fitting footwear. Shoes with pointed toes (high heels), rigid shoes (safety or ski boots), or very flexible shoes (ballet flats) can exacerbate the condition and cause inflammation.

Consequences

The most common consequences are friction and pain while wearing shoes. If not promptly addressed, it can lead to painful issues, including:

  • Increased deviation of the fifth metatarsal.
  • Formation of sores, inflammation, or bursitis.
  • Development of corns such as calluses and hyperkeratosis.
  • Stiffness in the toes.

Physical Therapy Treatments

Physical therapy rehabilitation is not always necessary and is recommended or not by the surgeon during post-operative consultations. Sessions may be prescribed for various reasons, such as regaining joint mobility, reducing swelling, or alleviating pain.

Reducing Swelling

Swelling is a common occurrence after quintus varus surgery. It is a physiological response, not a complication, and results from the surgical procedure. Physical therapy is an effective way to combat swelling. It can be reduced using manual lymphatic drainage, a hands-on technique that involves repetitive movements on the swollen area to stimulate the lymphatic system and accelerate swelling reduction.

Recovery of Joint Range of Motion

Physical therapy can also help you recover your joint range of motion. It aims to rebalance your foot, allowing you to regain comfort while walking and wearing shoes. By reestablishing the three phases of walking, you can avoid pain related to pressure on the foot. Physical therapy sessions can also be beneficial in cases of toe stiffness. The therapist's manipulation may be followed by self-rehabilitation exercises, including flexion and extension movements performed while sitting or standing, which can help correct your range of motion, propulsion, and any gait abnormalities.

Orthopedic Treatments

Orthopedic treatments may be useful and prescribed in certain situations:

  • Insoles can reduce friction and distribute body pressure more evenly.
  • Orthotic devices can also be used. Digitubes or toe separators help prevent friction and subsequent inflammation.
  • Custom-made orthoses (orthoplasty) have both rigid and flexible options and serve to correct deformities.
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The informations on the page is provided for information only, it evokes general cases: your situation is specific.

Dr Julien Lopez, orthopedic foot surgeon in Nice welcomes you and advises you for your plantar aproneuritis.

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