Exercises and advice after foot reconstruction surgery

This resource has been designed to help you remember the exercises and advice your therapist went through with you whilst in hospital.

The exercises should be done slowly and smoothly. Your child may have some pain and discomfort doing these exercises after your surgery. If pain is limiting doing the exercises, then timing them around pain relief or muscle relaxant medication may be helpful. However, if pain becomes worse please seek advice from a healthcare professional and stop the exercises.

After muscle lengthening surgery it is important for the muscles to heal in their new lengthened position. In order for the surgery to be successful it is important to follow the daily exercise program as instructed by your child’s therapist.

Exercises

Knee bends

Start lying your child on their back or sitting.

Support your child’s leg under their heel and at their knee. Help them to bend their knee by moving the heel towards the bottom.

Return to the starting position. Repeat 10 times.

Hip abduction

Start by lying your child on their back.

Make sure your child’s hips are level. Support their leg with a hand under their heel and knee.

Gently and slowly take one leg out to the side with the knee and toes pointing up and the knee straight. Continue to take the leg out to the side until resistance is felt then hold this position for 15 to 20 seconds. Keep their other leg anchored to stop any movement in it.

Repeat 10 times on each operated leg.

More challenging exercises for children who have greater control of their movements

Static quads (knee squashes)

Strengthening the thigh muscles

Start lying on your back.

Push your knee down firmly against the bed. Keep your leg straight with your knee and toes pointing upwards.

Hold for 5 seconds. Repeat 10 times.

Static glutes (bottom squeezes)

Start lying on your back or sitting

Squeeze your bottom cheeks together.

Hold for 5 seconds and relax. Repeat 10 times.

How many times should we do these exercises?

Exercises should be do a minimum of 3 to 4 times a day and they should be staggered throughout the day. Any positive positions your child’s therapist has advised should be adopted whenever your child is resting.

What else can improve the outcome of my child’s surgery?

Positioning

It is important to let the bones and muscles heal in their new positions. During this time they must be positioned well and move or be assisted to move regularly to stop muscles getting tight.

Your child should be supported to rest with their knees and toes pointing upwards and their feet elevated above the level of their hips. It is normal for there to be swelling after this operation and therefore keeping the feet elevated will help with this. Do not put pillows under your child’s knees or use the bed function to allow them to bend their knees as this does not promote a good position for healing and can be detrimental in managing swelling.

Sleeping and sitting

If your child has a sleep system their local therapist should adapt it to accommodate their legs in the necessary position. If they do not have a sleep system the therapists will show you how to support your child’s legs with pillows, towels and other items you might have at home.

It is helpful for your child to have elevating leg rests for their wheelchair to support them to elevate their legs and help reduce swelling.

Standing and walking

Your child must not put any weight through their leg for around 8 weeks. Once their consultant has confirmed they can weight bear they may begin to stand and walk but are encouraged to gradually build up their activity. Once their wounds have healed your child can return to, or start hydrotherapy as long as they do not weight bear within the initial period.

Managing pain

Your child will probably have increased pain or discomfort. Having appropriate pain and muscle relaxant medication can help manage this. It is important to make sure there is no pressure damage whilst using gaiters by regularly checking the skin for redness or evidence of rubbing. Any red marks should disappear after 30 minutes of the gaiters being removed. If marks do not disappear and pain continues discuss this with your child’s therapist.

What happens next?

We will contact your child’s local therapist to pass on any important information and ask them to see you at home or in school. Your therapist will review your child’s muscles length, exercises and positioning. It is important that you see your therapist once you leave the hospital so they can continue to help guide your child’s exercises and rehabilitation.

We will contact your child’s local therapist to pass on any important information and ask them to see you at home or in school. Your therapist will review your child’s muscles length, exercises and positioning. It is important that you see your therapist once you leave the hospital so they can continue to help with your child’s exercises and rehabilitation. Your therapist can guide your child’s rehabilitation however it is your responsibility to ensure your child completes the necessary exercises. You should speak with your child’s therapist and school to make a plan for returning to school.