Post-Surgery Walking Issues: Limb Length Discrepancy and Swelling

After surgery, I am walking with a limp without the crutches?

Hello Doctor, on July 13th of this year, I underwent surgery to remove the accessory navicular bone from my left foot and to correct the outward angulation of my entire left foot.
Bone grafting was also performed.
During my follow-up appointment on September 2nd, the doctor removed my cast and advised me to start walking, even suggesting that I could stop using crutches.
Since then, I have started to practice walking slowly, and once I got used to my foot touching the ground, I tried to walk without crutches.
However, I find that I am limping.
Previously, I experienced pain in the sole of my foot when it touched the ground, but now the muscle feels like it has recovered, and I no longer have the previous pain.
Instead, I feel like I have a leg length discrepancy, with my pelvis tilting downwards to the right.
My right knee is very painful, and strangely, even though I had surgery on my left foot, it seems like my left foot is longer, causing me to limp when walking without crutches.
Is there really a risk of having "leg length discrepancy," or could it be due to improper walking posture? The doctor did not specifically recommend rehabilitation; should I schedule rehabilitation myself? Additionally, it has been nearly two weeks since my cast was removed, and my swelling has not subsided.
Are there any methods to improve this? The swelling has persisted for a long time… Thank you for your response, Doctor!

Xiao Zhen, 10~19 year old female. Ask Date: 2015/09/15

Dr. Shi Guozheng reply Orthopedics

Leg length discrepancy is related to pelvic tilt; for example, if the left side is tilted downward, it may feel like the left lower limb is slightly longer.
After surgery, there may be swelling in the leg for a period of time, and elevating the leg or lower limb can help improve circulation.
Currently, rehabilitation may not be necessary.

Reply Date: 2015/09/15

More Info

After undergoing surgery to remove the accessory navicular bone and correct the alignment of your left foot, it is understandable to experience some challenges with walking and potential discrepancies in limb length. The issues you are facing, such as a limp, knee pain in the right leg, and persistent swelling, can be attributed to several factors related to your surgery and recovery process.

Firstly, it is not uncommon for patients to experience a temporary limb length discrepancy following foot or ankle surgery. This can occur due to swelling, muscle weakness, or changes in gait mechanics as you adapt to the post-surgical state. The perception of having one leg longer than the other may stem from compensatory mechanisms your body employs to alleviate discomfort or instability. When one limb is surgically altered, the body often compensates by shifting weight or changing posture, which can lead to misalignment and discomfort in other areas, such as the knee.

The knee pain you are experiencing in your right leg could be a result of altered biomechanics. When you walk with a limp or an altered gait, it places additional stress on the opposite knee, leading to pain and discomfort. This is a common issue after foot surgeries, as the body tries to adjust to the new mechanics of movement. It is essential to focus on proper gait training to help alleviate this issue. A physical therapist can provide you with exercises and techniques to improve your walking pattern and strengthen the muscles around your knees and ankles.

Regarding the persistent swelling, it is crucial to manage this effectively to promote healing and comfort. Swelling can be a normal part of the recovery process, but if it persists for an extended period, it may indicate that the body is struggling to return to its baseline state. Here are some strategies to help reduce swelling:
1. Elevation: Keep your foot elevated above the level of your heart whenever possible. This can help reduce fluid accumulation in the area.

2. Compression: Consider using compression garments or wraps to help manage swelling. These can provide support and reduce fluid buildup.

3. Movement: Gentle range-of-motion exercises can promote circulation and help reduce swelling. Be sure to follow any guidelines provided by your healthcare provider or physical therapist.

4. Ice Therapy: Applying ice to the swollen area can help reduce inflammation and provide pain relief. Be sure to wrap ice in a cloth to avoid direct contact with the skin.

5. Hydration: Staying well-hydrated can help your body manage fluid levels more effectively.

6. Consultation with a Physical Therapist: Since your doctor did not specifically refer you to rehabilitation, it may be beneficial to seek out a physical therapist on your own. They can assess your condition, provide tailored exercises, and help you regain strength and mobility in a safe manner.

In summary, the issues you are experiencing post-surgery, including the perception of limb length discrepancy, knee pain, and swelling, are common and can be addressed through proper rehabilitation and self-care strategies. It is advisable to consult with a physical therapist who can guide you through the recovery process and help you regain normal function. If the swelling persists or worsens, or if you experience significant pain, it is important to follow up with your surgeon for further evaluation.

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