Only about 2% of all injuries lead to a broken or fractured heel bone. Depending on the impact and damage your foot receives, you may or may not undergo surgery. Minor injury on your heel bone will get non-surgical treatments such as wearing a cast or a splint or applying ice packs to reduce swelling. If your bone is fractured, you’ll have to undergo surgery. Your bone will start to heal within 6-8 weeks, and you will have to do simple motion exercises. After 3-4 months, you may be able to start walking again.
I have witnessed my grandmother break her ankle from sliding off our bathroom tiles. She had to have surgery and stayed at the hospital for 3 weeks. Two months later, when her cast was off, she started therapy to walk again. After a year, she started getting on her feet with occasional support.
However, until now, she couldn’t go outside the house without a walker. It could be because of her old age, and before her injury, she was already limping due to an infection she got on poliovirus.
There’s no magical formula or a spell that would mend your broken heel or ankle immediately. Your bone takes time to heal completely. What you can do is rest, wait, and listen to your doctor.
The heel bone (calcaneus)
Your heel bone or the calcaneus is at the back of your foot just below your ankle joint. It’s the largest bone in your foot that connects other smaller bones to your ankle.
This bone always receives the impact of your body weight to the ground when you’re running or walking. If it is injured or fractured, it may affect the surrounding tissues, joints, or other bones in your foot or ankle.
What causes a broken heel bone?
There are different reasons why you may break your precious heel bone. Oftentimes, young adults experience injury in their calcaneus due to sporting and doing high-impact activities.
Older people also get their heel bone injured due to accidents like slipping off the ground while walking or falling from their step on the stairs.
Below are some of the most common reasons why people get a broken heel bone:
Falling from somewhere high
For example, falling off a roof or from the stairs. You will most likely put all your body weight on your legs or foot as soon as you land on the ground.
The damage depends on the impact your foot receives upon touching the surface.
Motor or car accidents
The impact of vehicular accidents will cause injury in your legs, foot, and other parts of the body, such as your spine and hips.
Exercising is good for your body. However, excessive exercising causes sore muscles and even serious injuries.
For example, when you’re lifting too many heavyweights and lifting them in a bad posture, your legs and feet will give way causing your joints to snap or your ankle to break.
These are inevitable, especially for people active in sports that include lots of footwork like running, jumping, skipping, or even long-distance walking.
In addition, the stress your foot receives may lead to a broken heal.
Two common types of broken heel bone
There are two major types of fractured heel bone which are intra-articular fractures and extra-articular fractures.
- Intraarticular calcaneal fracture – This type of fracture is a bit tricky to heal as it involves damage in the surrounding joints (particularly the subtalar joint) and connective tissue of your bones or cartilage.
- Extra-articular calcaneal fracture – This type of fracture doesn’t involve damage to the joints. It happens when the Achilles heel or a ligament tears apart a piece of your heel bone (an avulsion fracture). This could also be aresult of mild traumatic and crush injuries.
Symptoms of a broken heel bone
- Severe pain in your foot and ankle
- Bruising and swelling
- Deformity in your heel and ankle
- Inability to walk or move your toe
- Intense pain when putting weight on the heel
You must call for emergency help immediately if you had a bad accident and felt like you broke your foot.
If you feel severe pain when you try to move or step on it, wait for someone to assist you. As much as possible, do not step on your feet when you still haven’t seen your doctor yet.
If you find an open fracture or an open wound in your heel, you should seek emergency help immediately. You may apply first aid by covering the wound with a sterilized dressing or clean cloth and apply pressure to stop the bleeding.
Please make sure that you’re not applying pressure on the bone fragment protruding on your skin. You must stay still and don’t move your fractured foot. Let someone else or an ambulance transport you to the nearest hospital.
Once you are in the hospital, your doctor will give you a physical examination and image testing.
These tests will help them make a correct diagnosis and decide what best treatments they will administer to you. You may have to tell them what happened why you got a broken heel bone.
Physical examination lets the doctor see if you can still feel and move your toes from side to side or up and down.
They will check if your skin is damaged and punctured and see if your blood is circulating just fine on the affected area. They will also examine if you injured some other parts of your upper leg.
Imaging tests include an X-ray and a CT scan. An X-ray will produce dense images of your heel bone. Doctors will be able to see if you have broken or fractured it.
A CT scan will produce in-depth, cross-sectional imaging of your foot. This test will help doctors determine how serious your injury is and what treatments would be best for you.
Treatments and recovery
Your doctor will give you treatments based on how severe your injury is. They will also evaluate your overall health for the healing process.
In this case, you may want to tell your doctors about your medical history (e.g., if you’re diabetic) and what medications you are having.
If you have diabetes, it may affect your recovery. Your doctors will determine what crucial steps they will make to avoid further complications. You may also want to stop smoking (in case you are).
Smoking gradually slows down the healing process of your injury.
If your injury isn’t severe, your doctors will give you treatments and advice on treating your heel bone without undergoing surgical procedures. Take note that this only applies to injury in which bones aren’t severely fractured or displaced.
- Wearing a cast or a splint – It will help protect and support your injured bone and broken joints. You may have to wear a cast for 6-8 weeks without having to put any weight on your foot until it fully heals.
- Ice packs – Elevating your heel bone using a chair and applying ice packs now and then. It will help reduce the swelling of your injury.
- Rest – You may have to keep your weight off on your foot for a couple of weeks or months. Cancel high-impact activities until you have fully recovered and gained your motion again.
- Close reduction – If your injury allows, your doctor may perform this method to fix your dislocated bones without undergoing surgery.
Your doctors may require you to have surgery if your heel bone is badly displaced or there’s damage in the surrounding tissues and joints.
If you happen to have a closed fracture or the bone didn’t cut open on your skin, your doctors may require you to treat the swelling before having the surgery.
However, open fractures need surgery immediately as it is prone to infections. Doctors will clean your open wound and treat the damaged tissues.
In some cases, when you get into an injury, your Achilles tendon may pull off a fragment of your calcaneus. This condition is known as an avulsion fracture which requires emergent surgery to prevent further complications on the tendon.
These two surgical procedures are common for various types of calcaneal fracture:
- Open reduction and internal fixation – Your orthopedic surgeon will open your skin and place the bone back into its normal alignment. Then, he will attach metal rods, screws, plates, or pins to attach the bone.
- Percutaneous screw fixation – Your doctor will only make small incisions on your skin and insert special screws or rods in fixing your bone.
After your surgery, your doctor will let you wear a cast within 4-12 weeks. They may also prescribe you some pain relievers to reduce any post-surgical pains.
Talk to your doctor if you still feel immense pain despite taking medications after a few days.
Recovery of broken heel bone
Once your doctor lets you remove your cast, you will have to wear a special boot and go on physical therapy.
It is necessary to help you gain your motion and balance back again. It is just like learning how to walk again by gradually putting weight on your foot. However, your physical therapist will only let you put on about half of your weight until your bone heals completely.
It will take 3-4 months regardless if you had surgery or not. Depending on your overall health, you may start to walk again during these times.
However, doctors will recommend some assistive devices to you especially, if you still feel pain once you start stepping on your foot.
Learning how to walk again after the accident
As much as possible, don’t move your broken toe or heel until your doctor allows you.
When the time is right, and your doctor sees progress in your treatment, they will let you do simple motion exercises. During the early stage of your recovery, it may be painful to move it around.
However, it is necessary to prevent complete loss of motion. Most of the foot and ankle exercises that your doctor will let you do involves sitting or lying down.
It is to avoid putting weight on your broken heel when it is not yet completely healed.
- Ankle plantarflexion and dorsiflexion – Sit with your affected leg straight while the other leg is bent. Gently point your toe away from you then, back to starting position (ankle flexion). On the other side, slowly pull your toes toward you and then back to starting position (ankle dorsiflexion). Do this 8-12 times on each side. You may also use a resistant band on these exercises.
- Ankle inversion and eversion – Sit or lay down with your legs flat on the floor. Slowly move your toes in an inward and outward motion.
- Ankle alphabets – You may do this while sitting on a chair (or lying down). Your affected foot should be on a pillow. Point your toe and slowly draw the letters of the alphabet.
- Figure 8’s – Just like ankle alphabets, you have to move your toe and slowly draw figure 8s repetitively.
- Heel raises – Do this when your affected foot can bear small parts of your weight. Do not put too much weight when doing the raises. Get a chair for support when doing the exercise.
After you gain your early recovery in your feet and ankles, your doctors may recommend you to undergo physical therapy.
Depending on your state, you may adjust your meetings the way you want and do the rest of the training on your own. You will start by putting a small amount of weight on your affected foot and increase it over time.
Your therapist will focus on taking care of your foot to prevent future complications when you start walking again.
Below are some of the things you have to do when undergoing physical therapy:
- Gentle massaging on the injured foot.
- Simple ankle and foot stretching.
- Regular follow-up check-ups with your doctor for your healing process.
- Low-impact exercises that don’t involve putting too much weight on your foot.
- Gait training for preparation to start walking independently.
- Walking with assistive devices (such as walkers or crutches) and using orthotic devices (braces or special shoe inserts).
You may still feel intense to minor pain when doing these exercises for the first time. However, it will go away as your bone continues to heal over time.
Your doctor will evaluate the results in your follow-up check-ups through series of imaging tests. They will give you updates if you’re okay to start doing single-leg exercises and focus on regaining your strength on your injured foot.
You take time to do these exercises as recommended to get back to your full range of motion.
It may be challenging and frustrating at first, but everybody else has gone through that too. It could take you several months and could get up to a year or two for you to walk normally again.
The purpose of your surgery is to move your bone back to its normal alignment.
However, you may experience complications such as wound infections, malunion or nonunion of bones, subtalar arthritis, and nerve damage. Your doctors will recommend you take medications to reduce pain and/or require you for further surgery.
Non-surgical treatments may also cause stiffness in your joints, arthritis, and lingering pain when walking.
These complications will improve as time passes, given that you’re in good health. However, depending on the factors affecting your recovery, you may have to deal with these for a long time.
Some people don’t fully recover and don’t get their normal motion before injuring their heel bone. When they start walking again, they may limp or have difficulties walking normally.
If you’re active and engages in many kinds of physical activities, you may notice changes in the size of your foot or the way you walk.
If you find everything hard, you must reach out for professional help and get emotional support. Many people are on the verge of losing it during their rehabilitation, but they kept ongoing.
In the end, they were back to where they were before. It may take a long and bumpy road but give yourself time and don’t give up.
Will I be able to walk on heels again after a broken ankle/foot?
It would take several months for you to start walking normally again after an injury in your foot. Being able to walk on heels after a broken ankle would take a lot of trial and error. It could get you years of training for your injured foot to endure the pressure and weight of your body while wearing those heeled shoes.
If you have done your rehab and you’re already walking just fine, do not immediately wear those 5-inch shoes of yours. It’s different when you walk on flat slippers than with heels. The tendency is, the tension may cause another damage from your previous injury.
You want to find a pair that would not shock your feet. Say start with 1-inch pairs of heels, then increase the height to 2-inches, then 3-inches, and so on. However, you must know how high you can manage without enduring any lingering pain on your toes.
When you have those perfect pairs, test them around the house or your neighborhood. Just do short distances first and make sure you’re not walking on a rough and rocky path. If you feel like you’re getting it, you could go shopping wearing those heels.
What can I expect during my broken ankle recovery?
You may have to wear a cast until your bone heals within 6-8 weeks. You’re not allowed to put weight on your broken ankle and only do simple exercises while lying or sitting down. Your doctor will request you to do physical therapy and rehabilitation as soon as your bone recovers. It is necessary to get one post-injury to help you learn how to walk again.
If you have no problems with your overall health, you may expect a fast and smooth recovery. However, watch out for occurring symptoms like fever, intense swelling, severe pain, and/or stiffness of your injured ankle as these may be signs of complication. You may also develop long-term effects like arthritis, limping when you walk, and deformity in your injured foot.
If you’re recovering from an injury, do not push yourself too hard to get up from that bed. It will get better in time so, don’t rush because the last thing you want is to break your broken ankle again. Please listen to the advice of your doctor. You also have the right to discuss your recovery timeframe with them.
It would take you approximately 3-4 months before you can start to learn how to walk again. Your doctor may recommend you start physical therapy in the early stage of your recovery within 6-8 weeks after your injury or when your cast is off. It is necessary to let your foot remember motion to minimize the risk of complete loss of its mobility.
You may start by flexing your foot back and forth or drawing letters and numbers while lying or sitting down. When your bone allows, you may start to put weight on it to test its endurance and strength.
Take note that it would take you several months to start getting on your feet again. Your doctor will monitor your recovery and progress from your injury. If any sign of complications occurs, discuss it with your doctor.