Calcaneal fracture rehabilitation guide

Odds are you had never heard of a calcaneal fracture until you got one. They’re really rare, representing less than 2% of fractures. 

Here, we’ll briefly recap the essential info about calcaneal fractures then give you a guide to rehabilitation so you know what to expect. 

What is a calcaneal fracture?

A calcaneal fracture is a fracture in your heel bone that most commonly happens to people aged 20-39. The calcaneus is a knobbly looking bone at the back of your foot that supports your body’s weight and makes normal walking possible.

When a calcaneal fracture happens, the bone widens and shortens, causing symptoms such as pain, swelling and bruising. 

You will probably also find it hard to put weight on your heel or walk properly. If your fracture is small, your Achilles tendon may be strong enough to support your weight so you can walk with a limp. If your fracture is more serious and has deformed your heel bone, then you’re likely to experience a lot of instability and find it hard to walk. 

How do calcaneal fractures happen?

Calcaneal fractures usually happen from a high-energy event like:

  • A car crash when you’ve slammed the brakes on forcefully with your foot
  • Twisting your ankle
  • Landing from a height – they were known as ‘lovers’ fractures’ as they often happened when a Casanova-type had to leap off a balcony to avoid being discovered doing the naughty with someone else’s partner. 

Treatment for calcaneal fractures

There’s no single treatment that’s suitable for all calcaneal fractures. Your doctor will consider various aspects of your fracture such as its severity, associated soft tissue damage, your lifestyle and your overall health before recommending either a surgical or non-surgical treatment plan. 

Surgery aims to restore the normal shape of your heel bone. Non-surgical treatment is another option, which will involve wearing a cast for 6-8 weeks while the bone heals. There are pros and cons to each approach. Surgery involves risks of infection or nerve damage, but non-surgical treatment may lead to long-term complications like arthritis or a limp. 

Whichever treatment option you choose, you will need rehab afterwards.

Your calcaneal fracture rehab guide

Calcaneal fractures are rare, but they can be debilitating. Recovery can be much slower than you’d like. You may find it hard to walk on uneven ground, find that footwear irritates the area or that there’s ongoing pain and limited mobility. 

Rehabilitation aims to:

  • Improve mobility in your ankle
  • Help you bear weight on that side again. 

Improving ankle mobility

Even before you can stand, we start working on improving your range of motion, practising small movements with the joints in your foot and ankle.

Normal walking involves many coordinated and repeated movements. It takes strength, flexibility and stamina. All of that has to be rebuilt after a calcaneal fracture. 

Doing your exercises may feel uncomfortable or painful at first, but your physio will encourage you to keep going so that you make progress. 

Return to weight bearing

As your fracture heals and your recovery progresses, we gradually encourage you to put weight on your foot again. It’s important not to do that too soon. 

When your doctor is happy for you to start standing and walking, you’ll probably need to use crutches or a walking boot to help support your weight. 

Your physiotherapist may recommend: 

  • Weighted exercises
  • Toe walking
  • Going up and down stairs
  • Plyometric exercises (aerobic exercises designed to increase your speed, endurance and strength). 

As the healing process continues, we’ll start encouraging you to walk, helping you relearn a healthy gait pattern and maintain your balance. 

How can Sycamore Health help?

Calcaneal fractures are rare. That means you can’t assume every physio has experience in treating them. 

We do. We know that it’s hard when every movement hurts and you can’t do the things you enjoy. We can help you through each stage of your recovery from a calcaneal fracture, aiding your progress and encouraging you to keep going towards the finish line with a carefully crafted rehabilitation plan.

Book an appointment today.


All information is general in nature. Patients should consider their own personal circumstances and seek a second opinion.

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