Fractured Calcaneus

I fractured mt left calcaneus(heel) Feb. 19, I fell on a stupid warm-up route at shelf and landed on a ledge. I have been out the last two weekends climbing on toprope, it's been interesting climbing with a cast. Strange cast jams, lots of down palming, and reworking generally easy terrain.

My concern, is when I get the cast removed Apr. 10, how great is the risk of rebreaking my heel if I take a fall. I plan to toprope for a while until I regain the strength in my foot. How soon can I run, or perform higher impact exercises?

Your foot will be very weak and emaciated when it comes out. You won't really want to risk any kind of fall for months, sorry. Everything depends on your specific injury and physiology. But the heel/ankle is tough and you may need up to half a year before you feel close to normal.

you probably shouldn't be climbing now, nevermind in 2 weeks.

you should be asking your doctor these questions...

i fractured my calcaneus snowboarding a few years ago, doc said i'd never run again.

he did surgery and gave me a super hot physical therapist. years later i can run and be on my feet for days at a time without pain.

i babied it for many months. it's worth it. not being able to walk would suck.

i would do it the same way if it happened again.

S Denny wrote:you probably shouldn't be climbing now, nevermind in 2 weeks. you should be asking your doctor these questions... i fractured my calcaneus snowboarding a few years ago, doc said i'd never run again. he did surgery and gave me a super hot physical therapist. years later i can run and be on my feet for days at a time without pain. i babied it for many months. it's worth it. not being able to walk would suck. i would do it the same way if it happened again.

I'm no doc, but...

I fractured my calcaneous on April 17th of last year (lead fall to ledge). Mine was a "severely comminuted inter-articular fracture"...bad stuff requiring big surgery with scary looking hardware put in. I received the same prognosis as s.denny from one doc ("You will never run again and probably won't be able to walk on uneven surfaces.") but I finally found a climber-ortho who had a much more positive outlook and performed a very succesful surgery.

I did start climbing (in the gym and only using my healthy foot, meaning one-footed climbing) about eight weeks post surgery. But my injured foot didn't touch the rock until a full 16 weeks post surgery, and then ONLY on top rope. I didn't begin even gentle "high-impact" stuff until six months post surgery. (I would not consider a potential lead fall to be "gentle high impact".)

However, as I understand it, recovery from heel fractures can vary widely depending on the type of fracture. Non-inter-articular fractures are significantly less problematic as they do not affect the sub-taler joint which takes them out of the realm of "ankle fractures". (my laymens understanding)

If your fracture is of a severe inter-articular type, I think you might want to seriously reconsider actively using that foot, even in the cast, at four weeks post injury. You really don't want to mess up your sub-taler joint any more than it already is.

My doc would give a hearty "NO" to high impact activities (lead falls, running, carrying heavy packs) for up to eight months post surgery/injury for an inter-articular fracture.

I had a second surgery three months ago to remove the hardware in there and to repair a tendon. My foot feels really good and my gait is normal (which is excellent news for this type of injury). My surgeon will be giving me the full "thumbs-up" release on April 13...almost exactly one year post injury.

What Evan S. and S.Denny said are both good advice. Get a really good physical therapist and prepare to be shocked at how weak your calf muscles have become and how tight all of the tendons and ligaments in your foot have become. As far as high impact goes...baby it.

Hope this helps

had bilateral calcaneal fractures. decked from 25 feet up. fell in the end of june and I didn't start climbing till the following may. be easy.

Don't jack anything in your ankle, you will really regret it long term.

What they said. I broke my right calcaneus in March 2007. Thing is, bones don't heal as fast when you are 40 as when you are a teenager.

The non-load-bearing phase (cast) lasted about 6 or 7 weeks. Then my doc put me in an air boot for another month or so, and finally an ankle brace. In the brace I could hike and bike and get back into my aerobic routine.

Being off that leg on crutches will atrophy your left leg (that happens as quickly as 10 days), but letting the bone heal is worth it.

I was leading again by July 2007, and climbing mountains in August (carefully, used stiff boots for the approaches). The bone may knit in 6 weeks, but it will probably be more like a year before it is really healed.

rhyang are you calling me old? ;) I think I was very lucky compared to some of you guys. I took an approx. 20ft fall and minimally displaced my left calcaneus, closed extra-articular fracture. The ortho decided the non-surgical treatment would be best. He did give me the yada, yada, yada about walking on uneven surfaces and pain in the foot along with a different fit of my shoe, rant. I know, I read a lot of the standard stuff on line. I know it differs from patient to patient, but Im hopefull and I generally heal well. Im not ready to give up yet!

Thanks for the replies, it's good to hear some first hand stories. It gives me a broader pool of info to look at, but I will discuss activities with the doc when I go back in. Sitting at home is getting very boring and Im just anxious to get this cast off and at least be able to walk.

BTW: Did any of you guys, esp. Scott E, have very large fracture blisters? I had two large ones on the inside of my ankle due to the extreme swelling. Im curios how they healed in the long run...

A lot of good answers here already and sounds like similar replies.

I broke my calc on Feb 25th, non displaced fracture that did not require surgery. I also broke my right Talus too (again non dispalced no surgery) but I'm putting weight on that foot already. My fall was alot more severe, I fell about 40 feet plus rope stretch (est 65 feet total) and smacked a ledge after the stretch on a run out route.

I've gotten two opinions, one from a sport ortho and one from the trauma ortho that saw me in the ER. Both think that by 3 months out I should be weight bearing, 6 months out I should be walking and able to consider top roping if my ankle can handle the approaches. The sports ortho climbs and boulders and thinks that I should wait a year before bouldering and leading he would just put in the no fall camp for a year. His closet remark was that he knew I would ignore that so to just stick to overhanging routes with falls into air. The trauma ortho of course said that some people never run again, etc etc and that I should never climb again but I expected this answer.

Since then my left foot is still immobilized in a splint (too much swelling to actually cast and we wanted to avoid the swelling blisters you mentioned) and my right is weight bearing in a walking boot on crutches and gets better every day.

Damn, Vince! Sorry you busted up your heel there. Hope it heals up well.

Thanks Tim, I should be back at it after a while. It's only a flesh wound!

In answer to your question about fracture blisters, I did not have any. My ankle did swell immensely (it was HUGE, and still has some swelling), but I was in a splint for the two weeks pre-surgery (surgery was specifically put off so that some swelling would subside), and then I was again in a splint post surgery until the walking boot. Maybe I didn't get the blisters because the splints did come off regularly?? I don't know, but the docs were surprised at the lack of them. So I have no info for you there.

BTW I'm 48 and have no intention of letting that injury, and the predictable "You won't run again." comment disuade me from pushing hard.

Be smart but do not go gently into the night.

It is far better to take the time to heal following an injury. The risk of re-injury is real, and the more often you re-injure the same area, the longer it will take to recover.

In my case, I seriously injured my back while switching an engine while in my twenties. I re-injured myself multiple times over the next several years because I was impatient to be active again. Eventually I realized that healing takes time, that physical therapy is my friend, and that I can easily convince myself that I am better long before I have actually healed.

Your bones will "feel" better long before they have completely reknit. Talk to your doctor and your physical therapist. Ask lots of questions. In the long run, it is far better to heal now. You will climb longer and stronger if you let your body repair itself.

Shattered my heel in February 2008, surgery, 4 months non weight bearing, May - walking again hurt like hell, led 5.12 in September, it quit hurting by the end of October & I could run a short distance in November. By February I could actually start running again for real. The whole deal takes about a year. The good thing is steep climbing is a lot more on your arms, so avoid slabs!

X2 on everyone else!!!

March '09 left me with 3 months on couch, the 14 screws in my right heel.

Now I'm back to winter summits and 5.12+ screws and all.
Just take the hit and give it time.

Patience should be a "4 letter word"
But It's all you got right now.

Use this time to work your arms and tendon strength.

Funny how it is, that you've got patience when you can't do anything else...

Hi All. I broke my calcaneous falling off my horse during a jumper course. I did not require surgery and have been 2 months non-weight bearing. Last night was my first night to "start" walking. I tried to walk for abou 1o minutes with a cane and it was really painful. Did others experience that? Am I doing something wrong? I have called my doctor who is less than helpful. Would love to hear other's experiences when they started walking again.

Heather, what you're experiencing sounds very familiar. I had a shattered calcaneous & remember writing the date on my calendar when I would finally "walk" again. Well that day came & amounted to a few steps with intense pain & back to the crutches. Plantar Fasciitis occurs frequently when the foot isn't loaded for several weeks/months. Lots of pain meds & using a frozen water bottle for foot massage helped get through that phase for me. Hang in there!!

Thank you Tzilla Rapdrilla. Did your doctor still recommend walking on it? I am at 2 months exactly and I have noticed that many were told to wait until 12 weeks. I want to be active again (and get back riding), but I also don't want to injure my heel further. I am assuming that I should be taking some steps every day, but not all day (use scooter or something). Is that what you did? Thanks again!

Definitely start off slow at first. I was very much pain limited for the first week, but I could see how overdoing it could irritate something too. I think it was 3 or 4 weeks before I put the crutches down for good. I was 4 months non-weight bearing beforehand though, so you may get your activity level up faster than I did. I was running within a year of the injury though.