Toe joint fusion

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 tony 22 Jun 2022

Does anyone have experience of toe joint fusion to correct for arthritis damage? 

 Jim B 22 Jun 2022
In reply to tony:

I have had many clients have this procedure, it 100% stops the arthritic pain but you end up with a rigid toe, if you hike and climb a lot then the joints above the one that is fused will end up moving more to compensate for the loss of toe movement caused by the fusion, this is usually not a problem. you could be doing decent hikes and easy climbs 6 months post surgery and it should feel 100% in a year. the first 6 weeks post op you wont be up to much, at 3 months you will be able to walk reasonably. From 6 months things get good.

OP tony 22 Jun 2022
In reply to Jim B:

Thanks Jim, I'm most interested in getting back to running. Hillwalking isn't too bad at the moment, but running is imposibly painful. Sounds like I'd lose quite a lot of fitness if it's 3 months before I'd be back walking reasonably.

 kathrync 22 Jun 2022
In reply to tony:

A friend had a big toe joint fusion recently. He sustained a stress fracture above the fusion a couple of months after the surgery, from trying to get back into running too quickly. He's been fine since recovery from that though. His main gripe is that it's harder to get stiff winter mountaineering boots on!

 tjhare1 22 Jun 2022
In reply to tony:

Nothing to do with arthritis, but I had fusions done on both “index toes” when I was in sixth form. I had metal prongs projecting from the end of the toes for a while, but once they were out and the scarring was sorted I was back to normal pretty quick. Fell running, rock climbing and big-boot climbing are not a problem. Will definitely lose fitness, and to be honest given I could only wear sandals there wasn’t a lot I could do about it (though maybe you could use a rower or gym bike?). This was 10+ years ago, so maybe methods have changed, but if not then prepare to do some work when you’re able to get out again!

OP tony 22 Jun 2022
In reply to kathrync:

Thanks Kathyrn, I've got better at not doing too much too soon after injuries. I shall take your friends experience as a warning.

 Nic Barber 23 Jun 2022
In reply to tony:

May be worth asking someone who knows about whether cycling as a low-impact method of exercise could be used to maintain fitness

 oldbloke 23 Jun 2022
In reply to tony:

Had this done on 4 toes many years ago - for hammer toes rather than arthritis though.  Got back to walking after about 6 weeks but climbing and fell running took 3 or 4 months.  Although not pain free, infinitely better than what went before.

 midgen 23 Jun 2022
In reply to tony:

Dreading the day I have to have this done...both my big toes are in the process of seizing up and getting more painful. Think I have a few more years though.

OP tony 23 Jun 2022
In reply to Nic Barber:

> May be worth asking someone who knows about whether cycling as a low-impact method of exercise could be used to maintain fitness

Yes, I've been cycling a lot to try to maintain some level of fitness while I haven't been able to run (all year), but it's not quite as satisfying as a good yomp in the hills

OP tony 23 Jun 2022
In reply to oldbloke:

> Had this done on 4 toes many years ago - for hammer toes rather than arthritis though.  Got back to walking after about 6 weeks but climbing and fell running took 3 or 4 months.  Although not pain free, infinitely better than what went before.

Yes, better than before is as good as I'm hoping for

 Tyler 23 Jun 2022
In reply to Jim B:

If you can still run and climb post op what do you lose out on? Currently arthritic big toes are my most painful condition but I assumed running would be impossible after fusion as you don’t get any spring off your toe and would basically be limping?

 Jim B 26 Jun 2022
In reply to Tyler:

yes, your gait would change a bit , probably not noticeable when walking but more pronounced when running, recovery times are 3 months to be fair, 6 months to be good (starting to jog etc) and 1 year plus you will not notice it much. At 6 months the fusion should be good and strong. At 1 year your running will be a lot better. You will have to slowly build things up. Keep cardio by cycling, swim, gym, work quads, gluts and gastrocs in the gym. Because the big toe will be ridged the joints in the foot above it in the kinetic chain ( in the foot) will loosen up a bit. Initially maybe use stiffer shoes to give things support before going into a very soft shoe. There is a lot of foot strengthening and balance work you can do using balance beams , different textured surfaces to stand on and various foot workouts. all will be useful. There is no avoiding an initial slowish recovery phase but... your pain will be gone...just build exercise up carefully and everything will be ok. Yes, toe push off will be a bit different and a slight limp could spark of back pain and other twinges but if you keep core and glutes strong, running could be fine. Long distances would be where things might get achy. 

 Tyler 01 Jul 2022
In reply to Jim B:

Thanks Jim, plenty of food for thought 

 papashango 02 Jul 2022
In reply to tony:

Hi Tony, in Feb I had a chilectomy and kessle bonny double attack procedure for big toe arthritis. They offered fusion as an alternative but the surgeon advised the above as it doesn't permanently fuse your toe and can make the pain disappear. 4 and a bit months post op it is definitely better, still painful though and I was advised it may be for up to a year. However I completed the cuillin ridge early June over two days which would not have been possible pre op. 

There was another thread here a few months ago and another poster mentioned the above double procedure - they had it 10 years ago and its been pain free for them since recovering from the op. 

So have a look into it. You can always go for fusion later if this doesn't work. 

Good luck and feel free to reach out.

In reply to midgen:

What rock boots do you use?

 midgen 02 Jul 2022
In reply to purplemonkeyelephant:

Ocun Bullit for bouldering, Evolv nighthawk for grit, katana laces for limestone at the moment. 

Basically anything fairly wide that lets my big toe stay straight, but still perform well. I'd wear the katanas for everything if I trusted them on grit smears! The stiffness really helps take the strain off my toe joint. I haven't found the perfect boot yet.... 

OP tony 05 Jul 2022
In reply to papashango:

Thnks for all that - all sounds quite positive. I have a feeling there's a bit more going on than just the arthritis, but there are obvioulsy options. Time to find a specialist I think.

 PFitz 07 Jul 2022
In reply to tony:

Right big toe fused 25 years ago

Plenty of running since 
Doesn’t bother me one bit, it’s the left leg and foot that cause me mischief…..

OP tony 07 Jul 2022
In reply to PFitz:

Good to hear. Given that I'll be 63 next week, if I'm still running in 25 years, I'll be very happy!


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