If your calcaneus breaks, either from a traumatic injury or from chronic overuse or repetitive stress, recovery can be a long and difficult process. However, you can maximize your chances of a successful recovery by following your doctor's instructions and following a rehabilitation program with a physical therapist. If you develop long-term problems, such as difficulty walking or chronic pain, discuss your options with your care team.
Part 1 of 3: Get treatment
Step 1. See your doctor if you have symptoms of a broken heel
If you think you might have broken your heel, call your doctor right away or have yourself taken to the emergency room. Look out for symptoms like:
- Pain in and around the heel that could get worse if you move your foot or try to walk.
- A blue and swollen heel
- Difficulty walking or putting weight on your injured foot.
- Go to the emergency room if you experience serious symptoms, such as a clear deformity in your foot or an open wound in the injured area.
Step 2. Agree to examinations and tests that can determine how bad your fracture is
The correct treatment will depend on the type of injury you have. Allow the doctor to examine your heel and describe in as much detail as possible how the injury happened. Tell the doctor if you have any other illnesses (such as diabetes) that could affect the healing process. In addition to a physical exam, imaging tests will likely be done, such as:
- X-rays, which can confirm whether the heel is broken or not and show if the bones have been dislodged.
- A computed tomography scan that can help your doctor get a better idea of the type and severity of your fracture or fractures. He may order a computed tomography scan if the x-rays show that your heel is broken.
Step 3. Talk to your doctor about non-surgical treatment options
If the break isn't too serious and the bones around your heel haven't shifted, your doctor may recommend immobilizing the foot for a few weeks so it can heal. He will put a splint, cast, or brace on your foot to prevent further damage. Follow your doctor's instructions for handling the cast or splint and go to the follow-up exams to make sure your foot is healing properly.
- Your doctor will likely recommend rest, cooling, compressing bandages, and elevations. This includes not putting weight on the foot, placing ice packs on it, and gently compressing the area with a bandage. You should also elevate your foot whenever possible.
- You will likely have to wear the splint or cast for at least 6-8 weeks. Don't put weight on your injured foot until your doctor says it's okay.
- Your doctor may also provide additional home instructions, such as placing your foot higher than your heart and placing ice packs on the injury to reduce the swelling.
- Some heel fractures can be treated well with a method called "closed reduction," where the doctor manipulates your foot to move the displaced bone fragments into their correct position. You would be stunned during this process.
Step 4. Discuss surgery if the break is more serious
You may need surgery if your heel has broken multiple times and the pieces of bone have moved, or if the muscle or soft tissue in your heel has been damaged. If your doctor recommends surgery, ask about the risks and benefits of the process, and discuss what the recovery process will be like.
- If the tissue around the bone is injured or inflamed, your doctor may recommend waiting a few days to have the surgery so the swelling goes down before performing the surgery. In other cases (e.g. if the break is associated with an open wound, it is important to operate immediately.
- Surgery could include placing screws or plates in your heel to keep the bone fragments in place.
- You will have to wear a cast a few weeks after the operation and maybe a special boot for a while after that.
Step 5. Follow your doctor's home care instructions closely
No matter what type of treatment you and your doctor choose, it's important to take proper care of your foot afterwards so that it can heal as well as possible. Schedule regular follow-up exams with your doctor and call them right away if you have any concerns or questions. You may have to:
- Use crutches, a rollator, or other device to take weight off your injured foot as it heals.
- Take over-the-counter pain relievers to help manage pain and inflammation, especially after surgery. Always take these medications as directed by your doctor.
- Take antibiotics as prescribed to prevent infection.
Part 2 of 3: Do rehab after treatment
Step 1. Ask your doctor how long your recovery will take
It can take a long time to recover from a calcaneus fracture. The time of your recovery will depend on a number of things, such as your general health, the severity of the break, and the treatment you received. Talk to your doctor to see if it is safe to begin rehab and how long it will be before you can return to normal activities.
- Depending on the situation, you may be able to start physiotherapy or other rehab activities a week after your treatment.
- If your break was relatively harmless, it will likely be 3-4 months before you can return to normal activities. After a more complicated fracture, it could take 1-2 years.
- Unfortunately, many fractures of the heel bone never heal completely. It could happen that the functionality of your foot and ankle remains permanently restricted. Talk to your doctor or physical therapist about what to expect.
Step 2. Start moving your foot and ankle as soon as your doctor says it is safe to do so
Starting early in the healing process, moving your foot and ankle, can help you recover faster and prevent loss of mobility. Ask your doctor when and how often to do simple foot and ankle exercises. You will have to wait until your pain allows movement and wounds from surgery have healed. Early foot exercises could include:
- Ankle flexion. Sit or lie down with your foot outstretched. Point your toes away from you, then pull them back towards you.
- Alphabet. Point the toes of the injured foot away from you and pretend you are writing the alphabet with your toes.
- Eighth. Tip your toes and move your foot to describe a lying 8.
- Turn inwards and outwards. Place your foot flat on the ground and roll it from side to side so that the sole alternates in and out.
Step 3. Work on your strength and flexibility with a physiotherapist
Ask your doctor for a referral to a physical therapist who is experienced in treating foot injuries. Physiotherapy is necessary to help you recover from the injury and keep your heel healthy in the future. Physical therapy exercises can help you restore the strength and flexibility of your foot and ankle, which is an important part of the healing process. In addition to the exercises, your therapy program could include:
- Massages to promote healing and prevent stiffness in the injured area.
- Regular checks of your strength and flexibility during the healing process.
- Low-impact physical activity (such as swimming) to keep you in shape while your foot heals.
- Gait training when you start walking again.
- Help in handling assistants (such as crutches or a walker) and orthotic aids (such as braces or special shoe insoles).
Step 4. Follow your doctor's instructions when walking with your injured foot
Once you start walking again, you need to be very careful not to worsen your injury or damage any objects surgically placed in your foot. Work closely with your doctor and physical therapist to determine when you can put weight back on your foot and what types of strenuous activities are safe.
- Your doctor or therapist will give you instructions on how to use aids such as crutches, a walker or special shoe so that you can reduce the stress on your foot.
- As soon as you are ready to walk alone again, gradually increase the weight you are putting on your foot. For example, you could increase the load by about 10 kg every 2-3 days until you can load your foot with all your weight again.
Step 5. Take good care of your general health while your injury heals
During the healing process, it is important to ensure that you eat healthy, get enough sleep, and exercise as recommended by your doctor and physical therapist.
- If you have another illness, like diabetes, it could interfere with your healing process. So work with your doctor to make sure this condition is properly treated during and after the recovery process.
- If you smoke, ask your doctor to help you quit. Smoking can slow your healing process.
Part 3 of 3: Coping with Chronic Symptoms
Step 1. Talk to your doctor about orthotics if you have trouble walking
Even with excellent medical care and consistent physical therapy, a broken ankle can sometimes cause your foot to permanently lose functionality. This can make it difficult for you to walk, especially on odd surfaces or steep slopes. Talk to your doctor or physical therapist about orthotic aids to improve your gait and make your foot feel better.
- Simple modifications to your shoes can be sufficient in many cases. For example, you may need to wear heel pads, ridges, or heel cups in your shoes in your shoes.
- Your doctor or physical therapist may also recommend custom shoes or braces for your foot.
Step 2. Work with your health care professional to manage chronic pain
In some cases, even after the fracture has completely healed, you will feel pain or discomfort in the foot. Tell your doctor if you still have pain after treatment and rehab. She may do tests and exams to find out what is causing the pain and treat it, or help you deal with it.
- Common causes of chronic pain after a fractured calcaneus include damage to the soft tissue surrounding the bone and poor healing of the bone (i.e. when the fragments are still not properly joined together after treatment).
- Depending on what is causing your pain, your doctor may recommend treatments such as an orthotic device (such as a shoe insert or an ankle brace), physical therapy, medication, or surgery.
Step 3. Inquire about your treatment options if you have nerve pain after surgery
There is a risk that the nerves in your foot may have been damaged. If you have nerve pain after the surgery from the damage from the injury, talk to your doctor about treatment options. A few common treatments used for nerve pain are:
- Injections of steroids to reduce inflammation around the nerves.
- A nerve block, which involves injecting anesthetic into the nerve to relieve pain.
- Medications such as amitriptyline, gabapentin, or carbamazepine relieve nerve pain.
- Physiotherapy speeds healing.
Step 4. Talk to your doctor if you need more surgery
You may need additional surgery if your bone isn't healing properly or develops another complication, arthritis in the heel. Work closely with your doctor to oversee your healing process and discuss whether further surgeries might be helpful for you.