Exercise and Activity Recommendations for Pedal Foot Fat Grafting

Rest, elevation at or above the level of the heart to assist with swelling reduction.

• Non weight bearing range of motion exercises, all to be completed 3 times per day
  • Ankle circles 30 repetitions
  • Tracing ABC’s with the foot
  • Seated calf stretch with knee straight, hold 30 seconds, 3 repetitions (strap placed off of location of procedure)
  • Seated calf stretch with knee bent, hold 30 seconds, 3 repetitions
  • Plantar fascia stretch pulling great toe back, hold 30 seconds, 3 repetitions
  • Lifting the arch, try to lift the arch up while keeping toes and heel in contact with the floor, hold 3 seconds, repeat 20 times
• Non weight bearing strengthening exercises
  • 4 directional band resistance, pushing toes down, pulling toes up (need assistance for someone to hold), inward and outward individually, 30 repetitions each direction
• Walking 10 minutes per hour for the first four weeks
• All upper body exercises while sitting are permitted

• May begin swimming as long as wearing shoes

REQUIREMENTS TO PROGRESS

• Exercises completed above with minimal to no increase in pain level
• Ankle range of motion full and near pain free

• Stationary bike, attention to location of foot pressure on pedal, placed off of location of procedure. Recommend starting at 10 minutes or less increasing in 5-10 minute increments per week if no increase in pain level.
• Walking about may increase 15 minutes per hour ??
• Strengthening progression may include:
  • Double leg bridge: Begin laying on back, knees bent and feet flat on floor. Lift hips up 10 repetitions, repeat 2-3 sets
  • Laying on side, lift leg upward 45° 10 repetitions, repeat 2-3 sets
  • Hands and knees, lift leg back into hip extension 10 repetitions, 2-3 sets
  • Modified prone plank on knees 10 second hold, 10 repetitions
  • Modified side plank on knee 10 second hold, 10 repetitions

REQUIREMENTS TO PROGRESS

• Tolerate stationary bike for 20 minutes with light resistance
• Tolerate walking about 15 minutes per hour with minimal pain or difficulty ??
• Subjective pain rating at rest recommended less than or equal to 2-3/10 prior to progression ??

*May start activity, but must sit down when uncomfortable

• May begin elliptical, recommend starting at 5 minutes, no resistance, no incline, increasing 5 minutes over one week. Increasing time only if no increase in pain level or return to baseline pain within 24 hours. Add light resistance or preset program once able to complete 10 minutes total time.
• May begin Tai Chi, yoga and low impact aerobics at home, with shoes, extra floor pads
• May begin walking for exercise 5-10 minutes continuous pace, no incline. May increase time 5 minutes over one week. Increase only if no increase in pain level or return to baseline pain level within 24 hours.
• Strengthening progression may include
  • Seated hip abduction, adduction, seated hamstring curl, seated knee extension

REQUIREMENTS TO PROGRESS

• Tolerate 15 minutes continuous pace on elliptical with minimal to no pain (self-rated 2-3/10 pain scale)
• Tolerate 15 minutes walking with minimal to no pain and no compensatory gait patterns exhibited

• May begin standing squats, lunges starting with no resistance 20-30 repetitions
• May begin group aerobic classes

• May begin walk/jog progression for return to running
  • Recommend 3:1 ratio, walking 3 minutes, jogging 1 minute or less as symptoms allow, total 8-10 minutes for first week of walk/jog
  • Recommend increasing 1 to 2 minutes jogging per week if no increase in pain level or soreness
• May continue previous exercises for lower body flexibility and strengthening.