Hello! I'm trying to decide between surgical options or no surgery. I'm 57 years old and have lots of travel…

Alignment of the foot is dictated by connective tissue not the skeleton. If you debone a fish, it does not change form. In general, the body parts with more joints have less successful outcomes. The fact that 3 different doctors have 3 different surgical plans, for me, is a red flag. It is a challenge to obtain effective non-surgical treatment of the feet because most PT's do not have extensive training in treating the foot, and non-surgical podiatrists don't have the rehab training of a PT. I can say this as I educate both PT's and Podiatrists in non-surgical, corrective functional foot treatment. I have spent the last 15 years specializing and teaching foot and ankle. If you are interested in learning how I treat feet multidimensionally, I would be happy to share my website information.

Have you tried a shoe with a rocker bottom and a carbon plate or really stiff sole that it doesn't bend? I have walked on my little toe for many years and finally went to wide width shoes even though I don't need a wide width and my toes have naturally spread enough that I don't walk on my little toe any more. I also have functional hallux limitus and cuboid syndrome so I need a stiff sole shoe with a rocker bottom that doesn't allow my foot to bend when I walk.

I had a Taylor’s bunion and had surgery on it back in January of this year. During surgery, the surgeon broke my 5th metatarsal, shortened it and added a plate and screws along with a bone graft from my heel. I TOTALLY underestimated the recovery. Foot surgery is no joke. I would exhaust all other means prior to having surgery again. I’m now at a little over 6 months out, still have a little bit of pain and still walk with a noticeable limp (some days are worse than others). I have read where it could take as long as a year to get back to ”normal”. Do I regret the surgery? I’m not sure yet, but just know that the recovery can take a while. Good luck!

You might consider doing one of the online foot programs...like "Gait happens" or "Petra Fisher"...there is a lot of free content. And, altho I know we are taught "orthotics orthotics orthotics".. wearing minimalist/barefoot shoes has shown me WHERE my gait issues are. And, wearing minimalist shoes slowly taugjt me that almost none of my toes were working. The programs will teach that a lot of the foot issues we have originate higher up. Even if you end up doing surgery, you will have gotten your body in a better place beforehand. It took me a while to be able to tolerate minimalist shoes. And, most of my walking is done on my farm (so natural surfaces) not concrete. But I do A LOT of walking. I can wear my barefoot shoes for a few hours in town now. I am 59. I have significant bunions, and several years ago I tripped and dislocated my 2nd toe, and tore the plantar plate. I lost nerve enervation/control of that toe, and all movement. So I lost the power to use my toes to "push off" while walking. A few years later - high grade hamstring tears (altered gait.) Like you, I wore excellent shoes+orthotics. Now I cant tolerate a conventional shoe AT ALL. My feet are re-discovering their natural movements. I cannot recommend this enough. It may seem impossible, but its not.

Your feet sound like mine. I use toe separators...you can find various ones on Amazon, and wear Chaco Z sandals and boots. If I wear them most of the time, I can wear other shoes some of the time.

ALL surgery carries risk. And that’s the risk you take if anyone messes with your feet. Think long and hard about having surgery. It may make things worse. As for myself, I will only consider it if and when I’m desperate and can’t walk without a lot of pain. I’ve read far too many post-surgery foot horror stories…

Update 9/17/24 I have a new diagnosis for my ongoing metatarsal pain - Morton's neuroma. According to my new doctor yesterday's MRI shows no evidence there was ever stress reactions/fracture as was my prior diagnosis. None of the other doctors suggested there could be a different diagnosis when I still had pain after 7-9 months. I'm going to have surgery to have the neuroma removed and two toes fused with permanent implants. Other doctors had said 3, 4, or 5 toes, so different answers everywhere I go. I will be NWB for two weeks and then in a post-op shoe for four weeks. After that he expects me to be able to wear my regular gym shoes with orthotics, i.e. swelling is not expected to prevent this. The surgeon says I should only need pain meds about one week, which means I wouldn't be off work too long since I work from home using a laptop. While I'll have two toes with a joint which doesn't bend and may have some numbness where the neuroma is removed, if this can decrease my pain from walking by some large percent it will be worth it. I've been trying to resolve toe problems for about 18 years now and metatarsalgia for nearly a year. Continuing to be a couch potato to avoid pain isn't a good solution for me. Some of my concerns are: 1. I get frequent random muscle cramps throughout my body, no known cause, but can't imagine dealing with these on my leg or foot during recovery. My primary care has been no help other than to run some tests showing no problems. The surgeon seems unconcerned. 2. Getting around the house - last time I was NWB I was 18 years younger and many pounds lighter plus in better physical shape. It was easy to do on crutches then and scooting up and down stairs, plus my foot was safe in a hard cast. 3. Keeping surgical site safe from being bumped by cats, little grandchildren ages 2, 3, 4, and 5, and random anything that can happen even my own clumsiness. Protecting the surgical site at large family holiday events 3-7 weeks post-op. 4. Keeping foot dry when bathing/showering. Previously I could put my foot up on the side of the bathtub with a cast cover, not sure I'll be nimble enough for that now plus how to use a cast cover without putting any pressure on the foot and toes? Or using a shower chair in the shower which has a shower door but the shower head is stationary. 5. Decision to make - knee arthritis gel injection series due in October - do it before surgery or a month or two after? Part of me thinks I don't need this before since I won't be walking around much, part of me thinks it would be easier to get around if my knees aren't killing me, too. 6. Anything I should buy or do or have on hand to help during recovery.

UPDATE 7/21/2024 I began PT and I saw my long-time podiatrist Dr. T. regarding all recommendations and questions. In the PT eval the therapist observed me walking away from him, toward him, next to him, and noted gait issues that exacerbate my pain, so we are working on that plus strengthening and flexibility. PT barefoot on hard surfaces feels odd to me after avoiding barefoot walking for 20 years, and with hard surfaces causing metatarsal pain. But with or without surgery improving gait seems necessary. Dr. T. continues to recommend conservative treatment, but if I wanted to go ahead with surgery recommends dorsiflexor osteotomies of the second, third, fourth metatarsals as well as possible arthroplasties versus fusions of the second, third, fourth digits. **** I brought up suggestions I'd gotten from here and other places. He said the big toe is not the cause of the problems & wouldn't recommend surgery on it, no need to lengthen calf muscle, doesn't prefer fusion, always thinks PT is a good idea. Here is some information from my post-visit notes including my diagnoses X-rays show plantarflexed metatarsal heads 2 through 5 as well as triplanar deformity of the hammertoes second through fifth digits bilaterally. Patient also has a mild hallux interphalangeus with alteration of position of the first digit Bilateral foot and ankle pain Hammer digit syndrome with overlapping of the second digit onto the third and third digit on the fourth on the right foot Fourth and fifth digit pain right lower extremity Triplanar deformity of multiple digits of the lower extremity especially affecting the fourth and fifth digits Plantar fasciitis bilaterally Posterior tibial tendinitis bilaterally Metatarsalgia bilaterally stress riser and fracture third and fourth metatarsals right foot Lisfranc injury right lower extremity 2006: Treated nonsurgically Equinus deformity bilaterally Osteoarthritic changes of the bilateral lower extremity Right foot: Decreased range of motion. Deformity and prominent metatarsal heads present. Left foot: Decreased range of motion. Deformity and prominent metatarsal heads present. ++ Positive pain on manipulation of the affected right lower extremity specially over the third and fourth metatarsal shafts right foot with forced dorsiflexion and range of motion. ++ Hammer digit syndrome with hammering of digits 2 through 5 bilaterally: most affecting the second and fourth digits on the right foot Hammer digits, second through fifth digits. Dorsally contracted digits 2-5 with flexion contractures of the proximal interphalangeal joint's and distal interphalangeal joint's and extensor contracture of the metatarsophalangeal joints. The digits are semi-reducible in nature with positive arthritic changes affecting the digits and alteration with subluxation of the second through fifth metatarsophalangeal joints. Plantar fascial pain: Pain on manipulation of the medial calcaneal tuberosity bilateral feet. Positive pain on forced dorsiflexion and range of motion. Positive pain on compression side to side over the origin of the plantar fascia. -- pain elicited with performance of the windlass mechanism --Previous Lisfranc injury with residual pain right lower extremity Patient shows arthritic change with degenerative joint disease noted to the following joint: Affecting the ankle joint and all joints distal to that surveyed. -- This shows asymmetrical joint narrowing, loss of flexibility of the joint, pain with manipulation and mobilization of the joint, decreased range of motion, coarse crepitus, impingement of the joint. ++ Gastrosoleus equinus bilaterally: Decreased ankle joint dorsiflexion and plantarflexion. --decreased mobility of the subtalar joint and ankle joint with knee both extended and flexed. Positive stiffness of the anterior ankle to the bilateral lower extremity. --Muscle strength alter to the bilateral lower extremity.

Animal wool to separate toes