Why Some Surgeons Skip Physical Therapy After Lapidus Bunion Surgery – Should You Be Concerned?

If you’ve recently undergone a Lapidus bunionectomy—or are preparing for one—you might be surprised to learn that not all surgeons recommend physical therapy (PT) afterward. In fact, a recent Reddit comment brought this issue to light:

“I just had my Lapidus on 2/14 and my surgeon also said he didn’t think I would need PT. I thought for sure he would want me to especially with being NWB [non-weight bearing] for 6 weeks.”

This raises an important question: Is physical therapy necessary after Lapidus surgery, or can patients recover just fine without it?

Understanding the Lapidus Procedure

The Lapidus procedure is a surgical technique used to correct moderate to severe bunions. It involves the fusion of the first metatarsal bone with the medial cuneiform to stabilize the first ray of the foot and prevent recurrence.

Key Recovery Elements

According to the American College of Foot and Ankle Surgeons (ACFAS), recovery after Lapidus surgery typically includes:

• Non-weight-bearing (NWB): 6–8 weeks using crutches, a knee scooter, or wheelchair
• Gradual weight-bearing: Transition to a walking boot, then supportive footwear
• Persistent swelling: Can last up to 6–12 months post-op
• Stiffness: Especially in the big toe and ankle joints

Why Some Surgeons Skip Physical Therapy

Not all patients are prescribed formal PT after Lapidus surgery. Here’s why some surgeons opt out:

• Fusion eliminates joint motion: Since the fused joint no longer moves, PT for mobility may not be seen as essential.
• Home exercises may suffice: Some surgeons believe that light stretching and walking progression can be self-guided.
• Cost concerns: PT can be expensive, and not all insurance providers cover post-op sessions.

Dr. Patrick McEneaney, DPM, FACFAS, notes in a Podiatry Today article that “while fusion surgery reduces joint motion, surrounding joints still benefit significantly from guided rehabilitation to prevent compensatory movement patterns.”

When Physical Therapy Might Be Beneficial

Even if your surgeon doesn’t require PT, it can be extremely helpful depending on your specific recovery needs:

1. Stiffness in adjacent joints: PT can help loosen the ankle, second toe, and plantar fascia.
2. Balance and gait retraining: Especially after long NWB periods, relearning how to walk properly is crucial.
3. Scar mobilization and swelling control: Soft tissue massage and lymphatic drainage can reduce discomfort and improve healing.

According to the Journal of Orthopaedic & Sports Physical Therapy, early rehabilitation is associated with better long-term functional outcomes in foot and ankle surgery.

Alternatives to Formal Physical Therapy

If PT isn't in your recovery plan, you can still promote healing at home with these strategies (but always consult your physician before starting):

• Toe mobility exercises: Once cleared, begin gentle range-of-motion movements.
• Resistance band work: Strengthen ankle and calf muscles to support gait.
• Massage and elevation: Helps with fluid drainage and reduces swelling.
• Supportive aids: Devices like bunion sleeves can provide comfort and postural support.

If you're looking for relief during recovery, try the Orthopedic Bunion Pain Relief & Correction Sleeve. It helps maintain alignment and reduces pain.

For issues related to bunionettes, the Tailor's Bunion Bunionette Pain Relief Sleeves offer targeted protection.

To ease skin irritation and inflammation, the Jamaica Black Castor Oil Soothing Oil is a natural remedy with anti-inflammatory benefits for bunion-affected areas.

Footwear Matters During Recovery

Recommended Shoe Features Post-Lapidus

• Wide toe box to reduce pressure on the surgical site
• Rocker-bottom soles to support a natural gait
• Adjustability in fit to accommodate swelling
• Good arch and heel support to stabilize the foot

Real-world advice from users can be found in this helpful Reddit thread that discusses post-op shoe options.

Key Takeaways

• Skipping PT after Lapidus surgery is common but not always ideal.
• Fusion limits joint motion, but surrounding areas still benefit from rehab.
• PT can improve gait, balance, and reduce post-op complications.
• Home exercises and supportive devices are effective alternatives if PT isn’t accessible.
• Always consult your surgeon about your specific recovery needs.

Practical Tips for Lapidus Recovery

• Follow your NWB guidelines strictly—rushing weight-bearing can delay healing.
• Elevate your foot frequently to reduce swelling.
• Use ice and compression as directed to manage pain and inflammation.
• Document your progress and communicate changes (pain, swelling, numbness) to your doctor.

Frequently Asked Questions (FAQs)

Is physical therapy always necessary after Lapidus surgery?

No, but it can be beneficial. Some patients recover well with home exercises, while others need professional guidance—especially if they experience stiffness, gait issues, or weakness.

How soon can I start exercising my foot?

Always wait for your surgeon's clearance. Typically, gentle range-of-motion exercises begin after 6–8 weeks, once fusion is stable.

Will I walk normally after Lapidus surgery?

Yes, most patients return to normal walking, though it may take 3–6 months. PT can help speed up gait normalization.

What if I can’t afford PT?

Ask your healthcare provider for a home exercise program. Many PTs also offer virtual sessions or sliding-scale pricing.

Are bunion sleeves helpful after surgery?

Yes, they provide comfort, alignment, and reduce pressure during recovery—especially when transitioning back to shoes.

Final Thoughts

Skipping physical therapy after Lapidus surgery isn’t inherently risky—but it depends on your individual recovery profile. While some patients do well with home care, others may benefit from supervised rehab. The key is to stay informed, listen to your body, and maintain open communication with your healthcare team.

What Do You Think?

Did you go through PT after your bunion surgery? Do you feel it made a difference? Share your experience in the comments below — your story might help someone just starting their recovery journey!

Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your podiatrist or orthopedic surgeon about your specific condition.

Author Bio: Dr. Melissa Grant, DPM, is a board-certified podiatric surgeon with over 12 years of experience treating bunion deformities and forefoot conditions. She is a fellow of the American College of Foot and Ankle Surgeons (ACFAS).