Rehabilitation after a heel fracture

A calcaneal injury affects the patient’s mobility and affects the health of not only the foot, but the entire leg. Reduced physical activity leads to muscle atrophy and negatively affects blood circulation and metabolism. Therefore, we recommend not limiting yourself to just applying a plaster cast, but be sure to consult a doctor who will draw up a program of rehabilitation measures.

Recovery after a heel fracture allows you to avoid a large number of complications, including hallux valgus, metatarsal bone deformity, degenerative changes in the joint, tendon irritation, periodic pain at the site of injury, the appearance of bone spurs, the development of flat feet, osteoporosis, arthritis, etc.

Features of recovery after a calcaneal fracture

The rehabilitation program can last up to six months, which depends on the severity of the injury, the individual characteristics of the patient (age, weight, physical activity, etc.) and the qualifications of the doctor.

The Blagopoluchiya specialist selects recovery methods individually: we do not use “template” solutions, since each case is unique, and only a personal approach allows us to solve the specific problems of each patient in the shortest possible time.

The rehabilitation program is comprehensive and consists of a number of techniques:

Massage. It can be done even before the doctor removes the plaster cast: the massage therapist develops the areas around the plaster. The main goal of the method is to increase blood circulation. At first, the patient may experience discomfort. This is a normal reaction, but it is better to report it to a specialist.
Physiotherapy. Particular attention is paid to the method if the fracture was displaced. The first simple exercises can be performed after the bone has healed: the patient bends and straightens the toes, rotates, flexes and straightens the foot, pulls the toe toward and away from him, walks on his toes and heels, rolls a ball with his foot, etc. Severe pain after a heel fracture there should not be: if the patient feels discomfort, then you should interrupt the training and report your condition to the doctor.
Physiotherapy. They improve blood circulation, lymph circulation, relieve pain, inflammation, normalize metabolism, launch regeneration processes and promote faster restoration of bone and soft tissue. The doctor may prescribe electro- and phonophoresis, laser treatment, UHF, etc.
Hydrotherapy. Usually the doctor prescribes warming baths, which restore muscle tone and normalize blood circulation.
Proper nutrition. The diet should contain foods high in calcium, silicon and magnesium.
Wearing orthoses and orthopedic shoes. Soft, rigid and semi-rigid orthoses reduce swelling and avoid muscle atrophy. And special insoles allow you to correctly distribute the load on the foot, making it less tired. They wear orthopedic shoes for at least six months, the doctor gives precise recommendations.

The patient is considered healthy if he can stand on the injured leg, walk and move without pain or any restrictions.

Rehabilitation methods

Treatment of any fractures includes measures to restore function after removal of the cast. Prolonged immobilization leads to circulatory problems in the broken organ and loss of muscle elasticity.

The heel bone is the largest part of the foot skeleton. She is under constant pressure from the weight of her entire body. An unsuccessful jump or accident leads to a bone fracture, which is often accompanied by displacement.

Attention

! Severe pain after fractures of this type leads to the fact that patients, especially elderly and overweight ones, remain lame.

Restoration measures are always needed. Their duration and success depend on the age, perseverance of the patient and his desire to regain an easy gait. Incorrectly carried out rehabilitation leads to:

to the formation of flat feet;
to the persistence of lameness;
to the development of joint diseases;
to the formation of bone calluses and growths that interfere with walking and deform the foot.

It is especially important to carry out full rehabilitation after a displaced heel fracture, since immobilization is required for a period of three months. You can only lean on your leg when your doctor allows it. During this time, muscle atrophy develops and blood supply deteriorates.

Restorative procedures include:

Massage.
Specially selected sets of exercises.
Physiotherapeutic procedures.
Compresses and warming ointments.
Diet.
Therapeutic baths.
Wearing specially selected shoes.

Only comprehensive measures will help to completely restore lost motor functions. While wearing the cast, a gentle gait is developed with minimal load on the broken leg, which careful patients often maintain for a long time.

Massage

Massage actions are carried out during immobilization on parts of the leg that are not covered with a plaster cast. This speeds up healing and helps maintain muscle tone. After the leg is released, the massage is performed on the entire limb. When performing actions, you can use warming balms and creams.

At home, hydromassage is useful, alternating warm and cool water with strong pressure from the shower.

Diet

A diet high in calcium, vitamins and microelements helps restore bone tissue, strengthens the immune system and improves body tone. Must eat:

cottage cheese;
fish;
fruits and vegetables;
nuts;
honey;
cheese.

A balanced diet is a necessary condition for a speedy recovery. Proper nutrition will help bones heal faster and speed up metabolic processes.

Physiotherapy

Rehabilitation after removal of the cast using hardware procedures helps restore the muscles atrophied after a heel fracture. The following hardware methods have been successfully used:

electrophoresis with drugs;
laser exposure;
magnetic therapy;
electrotherapy;
mud therapy;
phonophoresis.

The procedures help improve local blood flow, get rid of salt deposits, and reduce inflammation.

Baths

Warm baths (38°-40°), as well as physiotherapy, accelerate metabolism in the tissues of the limb. For them they use:

sea salt;
chamomile;
sage;
calendula;
balm “Golden Star”.

Thermal effects help in the restoration of cartilage tissue and relieve pain.

What are the purposes of recovery procedures?

The specialist faces many tasks:

Return muscles, ligaments and tendons to their former elasticity and normalize their tone.
Restore motor functions of the leg, avoid muscle atrophy.
Activate blood supply and lymph flow in the area not only of the heel, but also of the entire leg.
Reduce tissue swelling, avoid inflammation and other complications after a fracture.
Accelerate healing processes.
Relieve pain syndrome.

Complex therapy, tailored individually for a particular patient, helps to accomplish these tasks. Doctors at Blagopoluchiya pay attention not only to the procedures themselves. They help patients place their feet correctly to avoid additional stress on the heel.

Symptoms and causes of heel fractures

The main cause of fractures of one of the strongest bones in our body is a jump from a height onto straight legs. In other cases, the cause of such injury, as a rule, is road traffic accidents or blows to the heel area. It is worth noting that due to the fact that the heel bone is unusually strong, its fracture is most often accompanied by fractures of other bones of the body: the ankle, thoracic and/or lumbar vertebrae.

Separately, we can distinguish the so-called stress fractures of the calcaneus. They can be found among soldiers who have recently enlisted in the army, as well as among non-professional athletes.

Accompanied by fractures of the calcaneus:

pain in the heel area;
inability to step on the heel;
heel deformation, swelling;
hemorrhage in the heel area may also indicate a possible bone fracture;
the ability to move the ankle joint is limited.

Contraindications for fracture

Some patients believe that restorative procedures are necessary primarily while wearing a cast. But rehabilitation after a heel fracture after the cast is removed is no less important. During this period, you should also follow the doctor’s recommendations, do not overload the joint, and wear special orthopedic shoes selected by a specialist. Self-medication or ignoring therapy can lead to re-injury, pain, bone displacement, etc.

You can do exercise therapy after a fracture only with the permission of a doctor: even seemingly small loads can lead to serious consequences. The doctor selects the type of exercise, monitors the technique, the patient’s condition, determines the number of repetitions and range of movements.

When drawing up a rehabilitation program, the doctor carefully examines the patient to ensure that there are no contraindications to any of the recommended treatment methods. As a rule, a number of techniques are contraindicated for oncological, psychological, infectious, skin diseases, chronic diseases in the acute stage, etc.

Anatomy of the foot

Let's start by deciphering some terms.

Tarsals are small bones located between the tibia and metatarsus.

Metatarsus - bones of the foot between the tarsus and phalanges.

So, the foot consists of the bones of the tarsus, metatarsus and phalanges of the toes. There are only 27 bones. The rear supporting point of the foot is located in the tarsus, one of the largest and strongest bones in our body - the heel bone. It is attached to the tendons and muscles of the foot. The joint work of tendons, muscles and the bone itself ensures the normal position of the latter and its correct movements when necessary.

In cases of bone fractures, in addition to its anatomical structure, the balance of forces that act on it also changes. As a result, long-term and possibly lifelong functional impairment occurs.

Calcaneal fracture: rehabilitation in

We pay close attention to each patient: our center has created all the conditions for a comfortable stay for sedentary patients. All our premises have anti-slip, threshold-free coating, wide doorways, there are ramps and handrails, we provide crutches, wheelchairs, and select orthoses and insoles.

Only modern equipment is used, and the center’s doctors regularly improve their skills in order to return patients to health and well-being in the shortest possible time.

Treatment

Heel fractures can be non-displaced or displaced. Non-displaced fractures heal faster; a plaster cast is placed for one month. The displacement may not be corrected if it does not exceed six millimeters; if the gap between the fragments is larger, then reposition (alignment) of the fragments is done by hand. If it is impossible to straighten it by hand, an operation is performed, fastening the two parts with a plate. If there are a lot of fragments, as a rule, an operation is performed; sometimes the Achilles tendon tears off a piece of the heel bone; this is the most severe case, in which a titanium plate and plaster are placed for several months.

Doctors often insist on surgery, although even with displacements, manual reduction can be done in 70% of cases, it’s just that there are surgeons in provincial clinics, but there are no specialists in straightening fractures. A displaced fracture also has one negative drawback - ruptures of muscles and tissues are possible, which can then heal unevenly, which leads to a long period of “walking” of the leg.

For heel fractures, a circular cast is sometimes applied. But, as a rule, with a calcaneal fracture, the tumor on the leg can be large and, if it is constrained by a rigid bandage, there may be a disruption in the nutrition of the surrounding tissues and even gangrene. Therefore, in case of a calcaneal fracture, a splint is placed, which is wrapped with a bandage and does not restrict movement; it can be removed if you need to undergo a physical procedure or wash your leg.

Modern medicine also offers plastic casts that you can swim in, as well as removable orthoses, the peculiarity of which is that in such orthoses you can walk already in the second week after the fracture. True, these modern orthopedic items are quite expensive, especially orthopedic orthoses. But the orthosis is quite comfortable, since you can even walk on the street in it, so the period of sick leave is reduced, which is good for those for whom it is important to go to work or engage in any activity.

In plaster

After you have placed a plaster cast (or a plaster splint), you can begin simple leg exercises.

It is better not to move at all for up to a week, since the Achilles tendon has a lot of force and can displace the bones.
For up to two weeks, you can move your toes a little, trying to maintain motor functions. You can’t step on your foot, but blood circulation needs to be brought back to normal.
From two to four weeks, the bone is well fixed and you can make flexion and circular movements of the foot, bend and straighten the knee.
After four weeks, if there are no problems, you are allowed to step on your leg, but only in a cast. During this period, you can gradually walk with crutches, restoring motor functions.
Physical procedures are prescribed - magnetic therapy and electrophoresis with a calcium solution, then massage, which, in principle, can then be replaced by intense walking.

Probability of complications after osteosynthesis

Surgery leads to injury to soft tissues and skin, so complications are possible. The following complications may develop after surgery:

The wound is healing slowly. This is common in calcaneal fractures because the skin and muscles in the foot have a poor blood supply. Such complications occur more often in smokers and people with diabetes.
Wound infection. Possibly due to the structural features of the muscle tissue of the foot. Often the reason is slow healing of the wound.
During surgery, damage to the sural nerve may occur. Sometimes this occurs as a result of pressure placed on it by the scar tissue that forms. Symptom of damage: the sensitivity of the leg is impaired and pain occurs at the site where it passes.
Arthrosis of the subtalar joint often develops and stiff mobility of the foot is noticed. This complication occurs due to injury.
Sometimes patients experience pain or discomfort where the plate or pins are placed. In this case, after the bones have fused, they can be removed.

These were the main complications that can arise during recovery from heel surgery. With the supervision of the attending physician and timely initiation of treatment, the risk of their development is minimal.

Indications for heel osteosynthesis

Medicine recommends osteosynthesis of the heel in case of displacement of bone fragments and other cases. These may be open fractures, when urgent surgical intervention is required to disinfect the wound and remove particles of soil, dust, etc. that have gotten into it. It is possible that scraps of tissue from the insole, pieces of sole, and stones may get into the wound. All this debris must be removed.

In case of an avulsion fracture, surgery is required as soon as possible. This injury is rare. This happens due to the traction of the Achilles tendon. It is attached to the heel bone and sometimes comes off along with a piece of bone. Only the earliest possible surgical intervention can reduce the risk of skin damage in this area of the limb.