I was wondering if you guys could shed some light on an area of postoperative care that is not very clear to me. So after surgery at the first metatarsal phalangeal joint, its accepted that the joint gets stiff, and therapy is imperative to help prevent this. But my question is how much of this stiffness is related to the local trauma vs. a breakdown in the connection between the brain/CNS and the firing muscle. Specifically, the muscles that are primarily responsible for moving the great toe are located in the leg, far away from the location of the surgical trauma. And during my bunion and hallux limitus surgeries, I don't violate the extensor and flexor tendons. So if the tendons are intact, and the connection between the brain and the firing muscle are intact, why is it so difficult for patients to regain active range of motion, even if they have done a decent job at restoring passive range of motion with therapy? Thanks for any replies!