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Calcaneal Fracture Treatment – Exercises, FAQs, Case

Table of Content:

CALCANEAL FRACTURE RECOVERY FAQs:

Can you walk on a fractured calcaneus?

It’s not recommended unless it’s a very small or hair line fracture of the calcaneus. If it is a fair sized calcaneus fracture or if the bones have shifted then you will be on crutches for 4-6 weeks or may require surgery to align the bones.

Is a calcaneus fracture serious?

Yes, calcaneus fractures are serious. Even small calcaneus fractures can turn into a big problem if you do not give them time to heal. Something that could have healed up nicely with crutches or a boot might require surgery if not treated properly.

Can a heel fracture heal on its own?

Yes a heel fracture can heal on its own, if you take the weight off the heel by using crutches or using a cast/boot the bone will heal if it is aligned correctly. If the fracture caused the bones to shift then you may need surgery to make sure the bones are aligned when it heals. Otherwise, you could have serious complications with pain when walking.

How do you know if your heel is fractured?

If there’s swelling, bruising and you can’t put weight on the heel to walk 10 ft then it is most likely fractured.

Does a broken heel need a cast?

No, some broken heels will not require a cast as long as you can keep your weight off of it. Bigger heel breaks will require a cast or boot to make sure the bones don’t shift from your weight being on the broken heel. How can the bones shift? You accidentally put your weight on it or swelling sets in around the bones slowing down the healing.

CALCANEAL FRACTURE RECOVERY CASE STUDY: 

Injury Background:

A calcaneal (heel) fracture is a break of the heel bone of your foot. These breaks commonly happen from falls from a high height or from a motor vehicle accident. Signs of a fracture include immediate bruising, pain and inability to put pressure on your foot. The calcaneus is the most commonly broken bone in the foot.

As long the bones stay aligned then casting for 2-6 weeks can heal the injury. If the bones are not aligned then pins during surgery may be used to line up the bones so they heal in proper alignment.

If surgery is required then the patient is usually non-weight bearing for a few weeks followed by a few more weeks in a walking boot. Physical therapy is usually started between the 2-4 week post-operation mark.

Physical Therapy Protocol for Non-Surgical Recovery:

Stage 1:

In this stage you will be in a walking boot or a cast.

This stage will last 4-6 weeks until the heel bone is well on it’s way to healing. You can perform laying down leg exercises or sitting leg exercises to keep your leg muscles from wasting.

You can also ride a bike or rowing machine for cardio because you will not put full weight on the cast.

Stage 2 :

You will come out of the cast. Most of your calf and lower leg muscles will have shrunk. Learning to walk again after a broken heel will be difficult for a few days. Your calf will also burn if you walk for long stretches because it is out of shape and doesn’t have enough blood supply for the muscle. As you walk, you will build muscle and blood supply to the muscle. Your weight and gravity will slowly strengthen the bone in the healed calcaneus fracture.

You can start doing body weight exercises like squats, heels raises at this point to gain the strength back. Ankle ROM exercises are also necessary to get full range of motion and mobility back in the ankle.

With walking, focus on losing the limp and putting the weight through the heel and rolling off on your toes for normal walking mechanics.

Stage 3:

Third Stage consists of regaining strength and toughness in the foot. We will start single leg exercises (see video below). We will start doing 50% speed jogging, agility drills, hopping and jumping type activities.

Return to sport training begins after 12 weeks and once approved by the surgeon after he/she reviews your x-rays to see how the bone has healed.

Physical Therapy Protocol for ORIF (Surgery) Recovery:

Stage 1:

This stage of PT is usually from weeks 2-6. We want to work on ROM, strength and flexibility, all in non-weight bearing. So all exercises should be in sitting or laying down.

Stage 2:

Second stage of PT involves starting to put weight through the foot, we start gently and eventually work up to putting full weight through the foot by the end of this stage. Walking training also starts in this stage.

Focus on losing the limp and putting the weight through the heel and rolling off on your toes like normal walking.

Stage 3:

Third Stage consists of regaining strength and toughness in the foot. We will start single leg exercises (see video below). We will start doing 50% speed jogging, agility drills, hopping and jumping type activities.

Return to sport training begins after 12 weeks and once approved by the surgeon after he/she reviews your x-rays to see how the bone has healed.

Real Patient Recovery Example:

Here is a calcaneus (heel) fracture patient who required internal fixation (surgery to place pins to hold bones in place so they heal properly). This patient fell from a ladder and required surgery. She is in the third stage of her rehab and is doing advanced balance, strengthening and conditioning exercises.

Exercises:
  • Single leg balance on Airex with T-Band reach outs – Working on balance and intrinsic foot muscle/core strength in this exercise. The lower leg and foot muscles should burn from the effort needed to maintain balance.
  • Slider Reach Downs – Great exercise for balance, mobility and control. She is reaching down to touch her ankle while the other foot slides back like a lunge.
  • Lunge KB Cross-Overs – She’s loaded up the ankle in a mini lunge position and is doing cross overs with a a kettle bell. Good way to work on ankle mobility, leg strengthening and ankle loading.

Checkout our Instagram profile @motionptr for a break down of injuries and their rehab.

Summary
Article Name
Calcaneal (Heel) Fracture Recovery - Case Study, Exercises, FAQs
Description
Overview of calcaneal fracture recovery with physical therapy exercises for the 3 different stages of healing, real patient case study and answers to FAQs
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Publisher Name
Motion Physical Therapy & Rehab
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