Bilateral forefoot reconstruction

Phased rehabilitation after bilateral forefoot reconstruction, from non-weight-bearing in CAM boots to graduated return to normal footwear.

Typical timeframe: Most recovery in the first 6 months

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Phase 01 · Weeks 0 – 6

Phase I – Maximum protection

0 – 3 weeks: elevate in bed with at least 2 pillows under each leg.
0 – 3 weeks: non-weight bearing for 3 – 6 weeks per physician's instructions.
0 – 3 weeks: pain relief, aspirin and Vitamin C for 6 weeks.
0 – 3 weeks: CAM boots on for transfers — can be taken off for bed.
0 – 3 weeks: transfer to wheelchair using CAM boot and resting on heels.
Weeks 3 – 6 (review with surgeon then): CAM boots for all ambulation.
Weeks 3 – 6: may be allowed to start weight bearing on heels in the CAM boots and use a walker.
Weeks 3 – 6: continue to use a wheelchair for longer trips — outdoors etc.
Weeks 3 – 6: mobilise feet and ankles — passive and assisted — and start Achilles stretches.
Weeks 3 – 6: do daily ankle motion exercises to prevent stiffness — moving the ankle up and down and making circles.

Phase 02 · Weeks 6 – 12

Phase II – Start-up walking

Review with surgeon, have an x-ray, then continue.
Continue to use CAM boots for ambulation.
Wean off the walker gradually, aiming to be fully independent walking at week 12. Continue to put more weight through the front of the feet (simulating normal walking) while wearing the post-operative shoe.
Start seeing a physiotherapist.

Phase 03 · Months 3 – 6

Review with surgeon, have another x-ray, then continue.
Wearing a regular sports shoe — start with short walks and gradually increase. Ensure a wide-sole, wide-body shoe.
May need to consult an orthotist for customised inserts.
Gradually increase activity. Expect some pain and stiffness that will decrease over time and increases with activity. Most of the recovery will be in the first six months after surgery.

Last reviewed: 2025-10-15.