Foot and Ankle Surgery: Step-by-Step Guide

You need foot and ankle surgery when pain, instability, or deformity affects your ability to move around and conservative treatment options stop working. Learn everything about surgery from understanding how your foot and ankle system works to preparing for surgery and recovery with this step-by-step guide.

How Do Foot and Ankle Systems Work?

The foot and ankle complex work together to form one of the body’s most sophisticated load-bearing systems. With each step you take, 26 bones and numerous joints collectively known as the foot and ankle experience force.

Between them, dozens of muscles, tendons, and ligaments work to stabilize your foot while allowing it to flex and adapt to your surroundings.

Consider how your ankle works to stabilize you while you are walking or while you run or jump. It acts like a hinge to control your movement and adapts to uneven surfaces.

When a joint is injured, arthritic, unstable, or structurally abnormal, other tissues compensate for the abnormal motion or alignment.

That’s why so many patients with foot pain experience knee, hip, or lower back pain. If left untreated, it eventually affects your entire body.

Any weakness or limitation, such as lack of ankle dorsiflexion forces other tissues to overwork and become injured over time.

When is surgery needed?

Conservative treatment options should always be tried first. Surgery is typically your last option after months or even years of physical therapy, bracing, medications, activity modifications, and orthotics.

It’s only when your pain becomes debilitating and prevents you from doing the things you love that you should strongly consider surgery.

If you have a noticeable foot deformity that continues to get worse, experiences instability with giving way, or has not responded to nonsurgical treatment, the chances are you need surgery.

Most patients that need foot and ankle surgery know something isn’t right because they have a limp. The limp doesn’t go away with rest or other home remedies, which should be a clear indication to get it checked out.

This limping motion is your foot trying to protect itself from feeling pain. Over time, that compensation causes other parts of your body to start hurting.

Surgeons utilize advanced imaging, like X-rays and MRIs, to determine the source of pain.

But surgery isn’t always based off of these imaging reports.

Foot and ankle surgery focuses on correcting the root cause of pain and mobility limitations, not hiding the symptoms.

Common Foot and Ankle Procedures

Foot and ankle surgeries vary based on exactly what is wrong, but most procedures fall under one of five categories:

1. Soft Tissue Repair

This includes tears in tendons and ligaments around the ankle. Achilles tendon repair is one example.

2. Bone Realignment (osteotomy)

Cutting and reshaping bones to realign the joint and restore normal alignment. Often used for bunions or collapsed arches.

3. Joint Fusion (arthrodesis)

This procedure stops motion at an arthritic joint to relieve pain. Bones are fused together so the joint no longer moves.

4. Joint Replacement (arthroplasty)

These procedures preserve motion by replacing damaged surfaces. Ankle replacements are much less common than knee and hip replacements.

5. Fracture Fixation (ORIF)

Fixing broken bones with metal hardware like plates and screws falls into this category.

What Happens During Foot and Ankle Surgery?

Foot and ankle surgery goes through several stages regardless of the procedure being performed.

Patients are placed under either regional, spinal, or general anesthesia depending on their comfort level.

An incision is then made over the affected area, usually following a straight line drawn with your surgeon before the procedure.

From there, your surgeon works to repair, remove, realign, or replace anything that needs to be corrected.

Every procedure is meticulously planned ahead of time. Surgeons use advanced imaging like MRIs and CT scans along with their knowledge of anatomy to create a surgical plan.

Muscles, tendons, nerves, blood vessels, and bones are all precisely positioned in the foot and ankle. Small errors can cause damage to nearby structures.

The incision is then closed in layers and covered with a sterile dressing.

Preparing For Foot and Ankle Surgery

Foot and ankle surgery isn’t a walk in the park. Properly preparing for the procedure can mean success or failure.

Here’s what you need to do prepare for your upcoming foot and ankle surgery:

• Ask questions: Learn everything you can about your surgical procedure and what to expect afterwards

• Medications: You will likely need to stop certain medications before surgery, like blood thinners

• Transportation: Arrange for someone to drive you to and from the hospital

• Prep your home: You won’t be able to drive for at least a week—sometimes longer. Make sure you have everything you need within easy reach and clear walkways for when you come home

• Recovery area: Create a comfy spot to relax and keep your foot elevated

Few people take the time to prepare their home or create a comfortable space to recover. Don’t be that person.

Resting with your foot elevated is one of the best ways to minimize swelling after surgery.

Knowledge is power too. Learn what to expect during your recovery so you know it’s normal and aren’t terrified by every twinge of pain.

Recovery & Rehabilitation After Foot and Ankle Surgery

Someone once told me that recovery is not passive. You have to work for it.

This rings true with foot and ankle surgery. Your recovery will be broken up into different phases depending on what procedure you underwent.

0-2 Weeks | Weeks 2-6 | 6+ Weeks

Your main goal during the first several weeks is protecting the foot and allowing it to heal.

You’ll be non-weight bearing or partial-weight bearing for a while.

During this time, you’ll slowly begin to move your foot. Immobilization will start to come off, but you’ll still have some limitations. Swelling should start to subside.

Physical therapy will likely start or intensify during this phase. You’ll work on regaining mobility, strength, balance, and proprioception.

Normal function returns anywhere from 3-6 months depending on your procedure.

Physical Therapy Exercises

After surgery, patients often undergo physical therapy to help them recover strength, balance, mobility, and function.

Your physical therapist will also help you correct any faulty movement patterns that may have contributed to your injury.

It’s extremely important to do your therapy exercises as directed.

Neglecting physical therapy is a surefire way to lose mobility and remain stiff.

Returning to Normal Activity

If you’re like me, you’re eager to get back to normal as soon as possible. Surgery isn’t meant to keep you down, though. You’ll be surprised how fast you recover.

Walking should be possible without assistance fairly quickly after surgery. Other parts of your life, like driving, work, and sports, will take longer.

Your doctor will clear you for each stage of recovery.

Don’t rush back into things or defy their orders. Doing so can result in setbacks and even injury.

Eventually, you’ll find yourself walking normally again. Your limp should go away as your foot and ankle regain function.

Frequently Asked Questions

Q: How do I know if I need foot surgery?

A: Foot surgery is only considered if your pain is debilitating and you’re no longer responding to conservative treatment options. A limp that won’t go away can also be an indicator that surgery is needed.

Q: Is foot surgery very painful?

A: Pain is normal following foot surgery. However, it can be managed with medication. You’ll feel the most pain within the first few days.

Q: What is the biggest mistake people make after foot surgery?

A: Not allowing enough time for recovery. People often think they’re healed when they’re not. Foot surgeries require weeks, sometimes months, of recovery.

Restore Hope Through Mobility

If you’ve suffered a serious foot injury or deformity and need surgery, there’s still hope for recovery.

Mobility aims to help athletes just like you recover from injury and regain your life through proven rehabilitation and training techniques.