Broken calcaneus (heel bone)

Discussion in 'Health & Fitness' started by chollyred, Feb 23, 2012.

  1. chollyred

    chollyred Rookie

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    Just got home from the podiatrist's office. I was playing old-fart tennis Monday. When chasing down a lob, I hyper-extended my left knee and suddenly had severe pain in my foot. This was the first time I've ever had to retire from a tennis match. I came home a did R.I.C.E. and got very little relief. Tried a heating pad and still no relief. I finally got to the podiatrist today. X-Ray showed the break. He said I was lucky that I didn't rupture the achilles tendon. He put me in heel lifts (pads) and told me to stay off it as much as possible for the next three weeks, then we'll see where we go from there...
     
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  2. chollyred

    chollyred Rookie

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    It's only been a week, so I'm still in the heel lifts and limping and hobbling around like an old man. I go back to the podiatrist on the 15th to see what's next. Unless something improves dramatically between now and then, I'm suspecting my tennis season (starts March 17th) may be in jeopardy. I'm NOT a very patient patient!

    After doing this, I've done a ton of reading on the web. Most heel breaks occur from high falls or car wrecks, but in those cases, the breaks are usually much different from mine. In those cases, most require extensive surgery and usually still end up with post-operative foot issues.

    Mine was like clipping the end off of the heel so I think caused little structural damage. As my podiatrist put it "Hurt like a son-of-a-*****, didn't it?!"
     
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  3. maggmaster

    maggmaster Hall of Fame

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    It is called the Don Juan break. Generally only requires surgery if it is significantly out of place. UNfortunately it increases the odds of arthritis in the joint.
     
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  4. charliefedererer

    charliefedererer Legend

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    The American Association of Orthopedic Surgeons has a good review of "Stress Fractures of the Foot and Ankle"
    - http://orthoinfo.aaos.org/topic.cfm?topic=a00379


    It emphasizes a few points:
    "A stress fracture is an overuse injury. When muscles are overtired, they are no longer able to lessen the shock of repeated impacts. When this happens, the muscles transfer the stress to the bones. This can create small cracks or fractures.

    The most common sites of stress fractures are the second and third metatarsals of the foot. Stress fractures are also common in the heel (calcaneus), the outer bone of the lower leg (fibula), and the navicular, a bone on the top of the midfoot."

    "Conditioning
    Doing too much too soon is a common cause of stress fractures. For example, runners who are confined indoors for the winter may want to pick up where they left off at the end of the previous season. Instead of starting slowly, they try to match their previous mileage. Because of the lower level of conditioning, muscles become fatigued faster. The result could be a stress fracture in the foot or ankle."

    "Anyone with a medical problem or taking medication that decreases bone density is susceptible to stress fractures."

    The following are "Medicines That May Cause Bone Loss". http://www.nof.org/node/232
    Aluminum-containing antacids
    Antiseizure medicines (only some) such as Dilantin® or Phenobarbital
    Gonadotropin releasing hormone (GnRH) such as Lupron® and Zoladex®
    Heparin
    Lithium
    Proton pump inhibitors (PPIs) such as Nexium®, Prevacid® and Prilosec®
    Selective serotonin reuptake inhibitors (SSRIs) such as Lexapro®, Prozac® and Zoloft®
    Steroids (glucocorticoids) such as cortisone and prednisone
    Thiazolidinediones [oral diabetic meds] such as Actos® and Avandia®
    Thyroid hormones in excess


    There are some medical diseases that are associated with decreased bone density, including:

    "Blood and bone marrow disorders
    Chronic obstructive pulmonary disease (COPD)
    Depression
    Diabetes
    Hyperparathyroidism
    Hyperthyroidism
    Inflammatory bowel disease, including Crohn’s disease and ulcerative colitis
    Kidney disease that is chronic and long lasting
    Liver disease that is severe, including biliary cirrhosis
    Malabsorption syndromes, including celiac disease
    Poor diet, including malnutrition
    Prostate cancer"
    - http://www.nof.org/aboutosteoporosis/detectingosteoporosis/diseaseboneloss

    Also, Vitamin D levels have just recently been easy to test with an automated blood level test that is very accurate. Vitamin D is essential for bone health, and it has been a surprise how many have low Vitamin D levels.

    "Older adults
    Older adults are at increased risk of developing vitamin D insufficiency in part because, as they age, skin cannot synthesize vitamin D as efficiently, they are likely to spend more time indoors, and they may have inadequate intakes of the vitamin [1]. As many as half of older adults in the United States with hip fractures could have serum 25(OH)D levels <30 nmol/L (<12 ng/mL) [2]."
    - http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/

    25-hydroxy vitamin D test http://www.nlm.nih.gov/medlineplus/ency/article/003569.htm



    Anyway, the odds are that your calcaneus fracture is sort of a freak accident. But the calcaneus is usually a pretty tough bone, so you may want to mention that this fracture occurred to your internist.
     
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  5. chollyred

    chollyred Rookie

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    Broken Heel (update) & shoe question

    The heel is getting much better, but still a little tender. The podiatrist is keeping me in heel lifts to help reduce pressure/stretching of the achilles tendon and calf muscle. He actually recommended wearing cowboy boots if possible due to the higher heels. He told me NO barefoot for any reason.

    He did say I could go out and play a little tennis. He said the foot will tell me what I can and can't do. So, of course I went to team practice Thursday night. I managed about 7 games before I called it quits, although there were several balls that I let go that I'd normally chase down. I'll probably try again this Thursday and hopefully be able to progress. Right now, I'm doubtful for playing this season.

    Now, the shoes I was wearing when I hurt my foot are K-Swiss GranCourt IIs and have a fairly low heel, quite a bit lower than the New Balance cross trainers I've worn in the past. The New Balances are totally worn out and need to be replaced. Are there any other shoes with a significantly thicker sole at the heel? I'm wondering if these K-Swiss were a contributing factor for my injury. New Balance seems to have changed the sole pattern of most of their shoes to more of a less smooth pattern than comfortable for tennis.
     
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  6. chollyred

    chollyred Rookie

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    Update

    Still having issues with the broken heel. Had a follow up with the foot doc yesterday. He said we're down to two options, a cortizone shot (a one-time option) and surgery. He said there's a piece of free-floating bone that is keeping the achilles tendon extremely inflamed.

    I chose the cortizone yesterday, hoping that it will work. If not, in about 6 weeks or so, they'll go in and remove the piece of bone and probably have to work on the tendon. That'll mean at least 6 weeks in a cast and absolutely no weight bearing. Probably PT after that.

    I'm starting to wonder if I'll ever get to play again. :(
     
    #6
  7. charliefedererer

    charliefedererer Legend

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    Sorry to hear you are still having so much trouble.
     
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