One or more of the joints of the midfoot can be fused to relieve pain and disability due to joint damage, probably as a consequence of age-related changes known as osteoarthritis.

Some individuals undergo a midfoot joint fusion due to fractures or rheumatological diseases such as rheumatoid arthritis which may have deteriorated the joint over time.

Phase one - The first phase of your recovery will be focused on managing your pain, reducing lower leg, ankle and foot swelling and early general mobilisation to reduce any chances of DVT or infection.

Your lower leg will be placed in a backslab plaster and you will be provided with a walking frame or elbow crutches and be instructed to take no weight through your operated leg for at least two weeks after your surgery.

Your physiotherapist will educate you on how best to adapt movements and activities given these limitations, and provide some alternatives so you can return to independence as quickly as possible. It is advisable to elevate your lower leg regularly to help reduce swelling.

With help from your physiotherapist, you will be taught and supervised how to safely ascend and descend stairs prior to being discharged from hospital.

Depending on the exact joint or joints fused, your surgeon will clear you for full weight to be taken through your operated leg at the earliest six weeks post-surgery.

Until this time, your physiotherapist will prescribe you some appropriate non-weight bearing exercises designed to specifically target certain muscle groups: ankle/foot plantarflexion muscles (which help to propel you forwards and upwards when walking), ankle/foot dorsiflexor muscles (which pull your feet and toes up) and ankle/foot invertor and evertor muscles (which stabilize your ankle from side to side).

Phase two - Your active rehabilitation will commence once weight-bearing restrictions have been lifted. Your physiotherapist will supervise you taking appropriate weight through your operated foot as you get used to walking without movements of the midfoot.

Your surgeon may recommend that you wear a specialist walking boot for the initial weeks when taking full weight through your operated leg. As you become able to walk with a more normal gait pattern, you will be encouraged to wean off the walking frame or elbow crutches to using sticks.

Our physiotherapists will also design a rehabilitation regime to help you to continue to regain strength in your operated ankle/foot. At this stage, many of the exercises may still be non-weight bearing but gradually, gentle weight-bearing exercises may also be started.

Phase three - The third phase of your recovery will begin when you have recovered enough strength and balance in your operated leg to commence more vigorous weight bearing exercises. As such, the exercises our physiotherapists prescribe during this phase will typically take in to consideration your normal activity levels, sports and hobbies and will aim to increase functional strength.

Examples of exercises that might be prescribed are wall slides/squats and step-ups or heel raises to increase your strength and balance when walking and climbing stairs.

Circle’s Game Ready Ice Machine, electric muscle stimulator, AlterG anti-gravity treadmill and Hydro Physio aqua-jogger may help rehabilitation following a midfoot joint fusion

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Circle Health, 32 Welbeck St, Marylebone, London W1G 8EU