Virginia Conway had two operations on both feet to treat arthritic big toe joints and bunions. The 55-year-old dog training instructor who lives in London describes her experience of hallux rigidus and surgery by Mr Martin Klinke and subsequent recovery.
Describe your foot problem
For many years, I have had slightly bumpy big toes. My big toe joint is out of line with the rest of the foot. At first, it wasn’t particularly a problem, but over time, it became increasingly difficult getting into shoes. Putting on a pair of hiking boots or dress boots could take more than five minutes. Also, the flexibility in my feet was going, particularly in my left foot. I remember complaining to my sister about how difficult and painful it was getting up and down stairs. But my sister is eleven years older than me. That was when I realised – this is silly; I must get something done about my feet.
Describe your procedure
Before I saw Mr Klinke, two other foot specialists had recommended fusing the big toe joint. I didn’t like that idea at all. I wanted to be able to jump or reach up and use my whole foot in that motion. My hobbies include ice skating, rollerblading and Tai Chi – losing flexibility in my big toe would have really had an impact on me. Mr Klinke took a different approach – he explained it would be possible to remove the arthritic changes within the joint and realign the joint so that it articulates much better. I wasn’t sure whether to have both feet operated on at the same time, or whether to have one foot done first. I decided on the latter and had my first operation on my left foot in 2005. Five years later, I had surgery on my right foot.
How did you feel straight after surgery?
I remember feeling a little discomfort immediately after surgery, but nothing compared to the pain I was in before surgery. The day after my operation, the physiotherapist took me to the staircase to help me get used to going up and down stairs. I was using crutches and wearing a post-surgical shoe, which has an open front and is wide enough to wear when your foot is heavily bandaged.
The first two weeks
Before surgery, I did a lot of exercises to improve my upper body strength, knowing I would need to use crutches. It really helped – you still can’t carry a cup of tea and use two crutches but I found I could manage very well. When I had my second operation, I was able to do some weight bearing, which made it easier overall.
Two to four weeks after surgery
At two weeks post-op, I started working with a physiotherapist and also with my personal trainer, who is used to rehabilitation exercises. Between them, they helped me to do various exercises which didn’t put pressure on my left foot, such as sit-ups on a exercise ball, using a wobble cushion and one-legged strengthening exercises.
Four to eight weeks after surgery
At six weeks, I was able to go ice skating, which was a real milestone for me. My left foot was still a little puffy, so I wore a hockey boot rather than a figure skating boot, but I felt very much at home and confident again on the ice. Just being able to flex my foot sufficiently in order to get into the skating boot was something I couldn’t do before surgery. My foot felt slightly sore afterwards, but by that stage, I had learnt how useful a pack of frozen peas can be to bring down swelling.
Two to six months after surgery
My criteria for getting back to normal was being able to run for the bus. I always felt once I could do that, I would consider myself 100 per cent recovered. Just before the three month post-op stage, I remember instinctively speeding up and running for the bus. It was only once I’d hopped on that I thought ‘Look what I just did’. I had complete confidence in my foot, normal flexibility and no pain. I have the complete, normal flexibility in my left big toe which is a real testimony to Mr Klinke’s skills. I put off having my other foot done for five years because my right foot was not as bad and through maintaining foot exercises, I was able to manage well until 2010. When it was clear that I needed another operation, I didn’t have a moment of doubt. I felt so confident about surgery that I agreed to judge a dog show in the States six weeks after surgery. I didn’t admit my plans to Mr Klinke at the time, but my confidence proved to be well founded – I was able to travel to the States and judge the show, which involved being on my feet two days and walking 3 miles each day. Both operations have been a complete success. I can stand on tip toes to reach something above my head, use my big toe to help me jump, point and straighten my toes. My friends in my Tai Chi class can’t believe how flexible my feet are.
What would your advice be to someone with a similar problem?
Strengthening my upper body in preparation for using crutches was really helpful. Working with a physiotherapist and personal trainer was also very beneficial. Your rehabilitation is vital. I know of a woman who had a similar operation but had a less successful rehabilitation and now has huge problems with balance and has consequently become very sedentary. I also think it was the right decision to have one foot operated on first of all, with a period of time in between. It would have been a much tougher period of recovery if both feet had been done together. I am also so pleased to have found Mr Klinke and been offered an alternative to having the big toe joint permanently fused.
