Hammertoe Recovery Timeline: What to Expect Week by Week
11th Mar 2025
Hammertoe surgery is performed to straighten the middle joint of the lesser toes, mostly the second, third, and fourth toes of feet. The most common joint involved in forming the deformity is known as the proximal interphalangeal joint or the PIP joint.
The procedure typically involves removing the deformed joint and fusing the ends of the bone to each other, holding it in place with either screws or pins, also known as K wires. The K wires or screws hold the bone in position whilst the bone heals over a six to eight week period and becomes one bone that is straight and well aligned.
The objective of correctional deformity is met once the bone is healed and soft tissues have reduced in swelling and the toe is well aligned.
Hammer Toe Surgery Recovery Week-by-Week
Day of Surgery:
– Recovery starts on the day of the operation.
– Typically performed as a day case under local anaesthetic with or without sedation.
– Physiotherapy session immediately after surgery.
– Fitted with a special postoperative rigid sandal for use during the postoperative period.
First 48-72 Hours:
– Pain relief required.
– Most postoperative swelling occurs.
– Elevate as much as possible.
– Walk no more than 5-10 minutes per hour using the sandals only.
– Keep dressings intact.
Days 3-14:
– Pain usually subsides.
– Maintain dressings and walk in post-op sandal.
– Elevate and mobilise 10-15 minutes per hour as comfortable.
– Painkillers may not be necessary for most people.
Week 2:
– Clinic visit for stitch removal.
– If screws were used, can return to a rigid trainer or UGG boots.
– If K wires are in place, continue using postoperative shoe with minor dressing covering the wires.
– Generally, feet can get wet, but with K wires, keep toe ends dry to prevent infection risk.
– Toes may be splinted to reduce risk of floating toe and maintain alignment.
Weeks 2-4:
– Increase activity levels to 20 minutes per hour, sometimes more a couple of times a day.
– Some swelling persists.
– Begin scar management with deep tissue massage and toe massage to reduce swelling.
Week 4:
– Increased mobility.
– Swelling subsides and toes begin taking shape.
Week 6:
– Clinic visit with possible X-rays.
– X-rays should show good healing and fixation position.
– K wires, if present, removed at this point.
– Screws remain in the toe and do not need removal.
– Begin increasing activity, including high-impact activities.
– Can start Pilates, static bike, weights.
Weeks 8-12:
– May begin running around 8 weeks post-op.
– Most swelling continues to subside.
Week 12:
– Toes should be mostly well-healed.
– Healing should have mostly stopped.
Some people may experience swelling for up to 6 months, and occasionally up to 12 months, but these cases are rare.
FAQs
How painful is hammertoe surgery recovery?
The current techniques involving local anaesthetic to manage postoperative pain allow postoperative recovery to be predictable. I would anticipate that pain relief will be required for two to three days to ensure that any postoperative pain is well managed. Many patients do not require more than paracetamol or ibuprofen and occasionally add codeine for a few days. There may be some discomfort after the first couple of days that may last up to one to two weeks, but mostly, the pain is well managed after the first few days throughout the whole process, and any significant pain will only need managing for the first couple of days.
When can I start walking after hammertoe surgery?
You will be walking straight away in the postop sandal, but no more than ten minutes an hour for the first week. You may be pushing it to two hours fifteen minutes in an hour in week two, and then gradually increase the activity levels over a four to six week period to full weight bearing and sports. Sports can be resumed after six to eight weeks, which involve high impact. Gentle weight bearing sports such as static weights and static bike can be resumed at three to four weeks post op activity.
Will I need physiotherapy?
Most of the time, you will not need physiotherapy after hammertoe surgery. Some home exercises such as deep tissue massage with scar and exercises to strengthen the tendons around the toes will be required. We sometimes advise to strap the toes for five to six weeks postoperatively to ensure excellent correction and alignment.
Can hammertoes return after surgery?
Only if there is nonunion of the bones, which is about two percent of cases that you can get recurrent hammertoe. With arthroplasty procedures where the bone joint is removed, the increased risk is approximately five percent, but mostly hammertoe surgery is permanent.
Find Out More
If you have any other questions or would like to reserve an appointment at our practice, don’t hesitate to get in touch with our team: