Calcaneus Surgery ORIF Success Stories?

Awesome to hear you're making progress, Trevor. Saw my doc yesterday (5wks post-op) and we did new x-rays, things looking good, doc says WB starts in 3 weeks. He says I'll be able to get on the stationary bike then as well, which should help with rebuilding muscle.  

I've been using a TENS/NMES unit on my calf to try and stave off a little atrophy but I can already tell that calf weakness is going to be an issue.

Regardless, feels good to have a target in sight up ahead.

This thread has been super helpful to me during recovery, so I'll add my experience to the pile. I fell while bouldering too high, missed the pad, and shattered my left calcaneus and fractured my left wrist. Luckily, the wrist didn't need surgery just a cast for 6 weeks. Calcaneus ORIF surgery 2 weeks post-injury to put in a plate, some bone graft, and 14(!) screws. The post-surgery pain was terrible the day after surgery, but by 3 days post-surgery it was manageable with tylenol/ibuprofen.

The first 4 weeks post-surgery were tough since I couldn't use crutches on account of the wrist fracture. I have 2 young kids at home and it was hard not to be able to help much around the house, my wife deserves a medal for doing the vast majority of the parenting and household work that first month. A knee scooter was essential because it allowed me to function semi-normally at work and at home. Graduating to the removeable cast 4 weeks post-surgery made a huge mental difference since I could work on ROM and shower without the cast.

I started partial weight bearing at 6 weeks post-surgery and progressed relatively quickly after that. Full weight bearing in the boot at 8 weeks and done with the boot by 10 weeks post-surgery. I'm now at 14 weeks post-surgery and can walk in shoes without pain. The left foot still has limited range ROM (can't point my toe as much as the other foot), and I'm a ways off from any running or jumping, but I started PT last week and am hopeful that I can regain 90-100% function in my left foot. I put on climbing shoes for the first time since the injury and climbed 5.10 in the gym this week, which felt like a huge milestone. 

Thanks to everyone else sharing their stories, it helped me tremendously through the non-weight bearing weeks. Heal up everyone!

Wow, sounds like a quick recovery so far, that’s great!

I would like to hear longterm updates from everyone. I’ll post something at 1-year (in a few months), hopefully with some good news. I haven’t given up hope but I also can’t see the light at the end of the tunnel, and if people checked back in to say they’re mostly fully recovered, that would really amazing. 

I'm 3.5 years out from my fracture and ORIF. Sanders 3 (5+ large pieces) with a plate, 2 long screws, 6 short. IIRC calcaneocuboid and subtalar joints got crushed a little, but calcaneus took the brunt of the impact. Just had my hardware removed. Surgeon told me before the ORIF to expect to never run a 10k again and that I'd regain ~90-95% function/ROM, though I think he was mainly doing his best not to set me up for disappointment. 

Before the hardware removal, I'd say I was at 99% - running 10k a couple times a week and able to do multiple back to back days of Grade III/IV multipitch with long approaches while leading harder than ever. I'm pretty sure I'll hit 100% full recovery with no arthritis but a slight weird cramp in my big toe and a bunion.

Peter Y, what was the rationale for removing the hardware if you were at 99% function? Long term anti-arthritis benefit?

Just asking because I'll have to make the same decision for myself in the next few years.

Dalton B wrote:

Peter Y, what was the rationale for removing the hardware if you were at 99% function? Long term anti-arthritis benefit?

Just asking because I'll have to make the same decision for myself in the next few years.

My surgeon didn't feel the risks from removal surgery were worth the benefits but respected my decision after we talked a lot about what I'd gain from that last 1% (I'm pursuing a guiding side career). I also have really good insurance and my surgeon's one of the best in the country. Performance/health reasons:

- There was a reduction in my foot's inversion/eversion for jams and subsequently how hard I could torque it into cracks
- In the rare event that a later complication (like infection) develops, I'd like to prevent that while my body's in peak shape to fight a possible current infection from the removal surgery and heal the bone. I say "rare event" because the scientific research (some authored by my surgeon) suggests pretty low lifetime risk of complications with current procedures/materials
- There were 2 long screws drilled through the back of the calcaneus and smacking them against anything, including while sitting, hurt like hell. Paradoxically, a haglund's deformity developed that eased the pain a bit, but heel hooks with direct contact would still hurt
- Back to back long days sometimes led to a feeling of stiffness around the hardware, particularly the plate

Once the nerve block wore off 2 days later, I noticed an immediate improvement in inversion/eversion. My removal was probably worth it, but my experience shouldn't speak for everyone's.

Justification for hardware removal is partly dependent on your age. My surgeon told me it was a simple procedure, and for him it was, but I still had to deal with a big incision that didn't heal as fast as the first one. I'm 72, with 50+ years of climbing under my belt, and I have old climber's foot, so I got marginal returns from the procedure. In retrospect, maybe it wasn't worth it to get my hardware removed.  But if i were under 50 years old It seems obvious, get it removed as soon as you can. Best of luck!!

Silas Miller wrote:

Wow, sounds like a quick recovery so far, that’s great!

I would like to hear longterm updates from everyone. I’ll post something at 1-year (in a few months), hopefully with some good news. I haven’t given up hope but I also can’t see the light at the end of the tunnel, and if people checked back in to say they’re mostly fully recovered, that would really amazing. 

Keep doing everything you can.  I was able to ride a bike before I could walk, and spent a lot of time in the pool re-learning how to walk, a fit looking climber in there with the 80 year olds, walking in the pool, determined to walk again.  Maybe you could do some PT exercises in the pool to take some weight off, if you still have pain doing certain exercises..  I also had a lot of pain near the incision, I used a lacrosse ball to roll out the scar tissue and massage it, which caused a bit of pain, but eventually helped.  Also, after the wound healed, and before I could really walk again, I used one of these therapeutic ultrasound devices for 10 minutes a day (something like: US 1000 3rd Edition Portable Ultrasound Therapy Device ).  I'm not sure it helped, but it seemed to heat things up, and help break down scar tissue around the incision.

I hope you get back to doing everything you want, and appreciate the awesome things you can do right now while you recover, like mountain biking.

I'm now 100 days in from injury, been WB about 3 weeks. Slow going with some significant pain at cuboid / peroneal tendon attachment area, possibly catching on a screw. Heading back into to doc to get some imaging done and see. Anyone else experienced any issues with hardware interfering with peroneal tendon movement?

I'm six years out from surgery and still have my hardware. It really doesn't bother me that much at all and I have almost full range of motion. It gets sore after a big day and it's trickier to stand one-legged on the foot with the damage but it really doesn't limit me at all for outdoor stuff. I bagged a talus-y 12000 foot peak last week and I thought I was going to be hating it after the descent but it didn't bother me. I've mostly been biking since the injury and I really think it's helped me a ton. I started riding my bike as soon as I could take the boot off.

Hi Everyone 😊July 16 I broke my right calcaneous while paragliding.
I sustained ‘comminuted moderately displaced and distracted calcaneous fracture with intracranial-articulated extension.’ My surgeon was really mostly focused on the angle of Bohler. Mine got flatten by the impact to 13 degrees. I was told they only operate, if it is less than 10. I was put in a cast for 4 weeks then in an air boot. After 7 weeks I was allowed to PWB, I started weight bearing 9 days ago since the I can only walk on two crutches in air boot. It seems like I haven’t made any progress. Every time I tried one crutch or none pain is too much to bear. Physio exercises are ok.
 During my last appointment my surgeon told me, I can increase my weight bearing during the next two weeks until I ditch my crutches and a boot. I don’t see it happening in such a short timeline. I am fit, 43 (so not quite a spring chicken) but I love running and climbing.

I wonder how quickly people progressed to no crutches once they have been allowed to do PWB-WB. How much pain have you had?

I am just wondering, if maybe I need surgery, why there is still so much pain.

I am seeing my PT soon but anxious to understand this more!

Wishing everyone here a full recovery, full come back to what we love to do.  

If you are 2 months out from your accident, you would have to find a super specialist, not just a regular ortho surgeon. Be prepared to travel to see someone who might be able to do something. I was lucky after my accident I was taken to the Trauma Center in Las Vegas, where the Resident who attended to me happened to be a climber. He referred me to a really good surgeon who was also a climber and knew how I wanted to use my foot. I had ORIF and they used a retractor to restore height plus alot of grafting of the joint surface with autogenous bone and calcium phosphate. Heavy duty stuff. BTW I'm two years out and there is still some pain so I guess it comes with the territory. Best of luck with your healing process. 

6 month update here.

walking is okay, but after a couple of miles it does start to bother me. still feels stiff in front and still have minimal inversion, balance is off but improving with a trainer. I stopped going to PT because the guy I was seeing doesn't really understand what I am doing with my foot while climbing - I do appreciate that he got me walking again, but now at my insurance max it's not worth it to me anymore. might seek out a climber PT at some point, but just doing exercises at home for now...if you're just starting PT make sure your recovery goals align.

anyhow been climbing in the gym ~2x a week, back to both bouldering and easy no-fall leading. I put a lot of pressure on my foot stemming a month or so ago and developed sesamoiditis at the base of the big toe which absolutely sucks. it took me back to having some pain with walking so my ortho has me wearing dancers pads to alleviate it. other than that things are going well; have been very careful to downclimb when bouldering, though I have taken a few jumps and no major issues so far as I can tell.

in regards to the hardware removal discussion - I only have screws (no plate) but there's one directly where I place my heel and it is incredibly uncomfortable/painful when I try to crank on it so I am considering getting it removed sooner rather than later (I love heel hooks!).

@J Mala I mentioned this in previous posts but going from PWB to FWB was super painful for the first week or two, I could only do like 20-40% weight on my injured foot (using both crutches), but then after 3-4 weeks it just started improving super rapidly. my doc thought I would be FWB in a week, so yeah don't sweat it it just takes time.

thanks as always for your support and advice everyone

When I fell, I sustained a calcaneus fracture, which essentially meant I shattered my heel. The heel healed in two months, basically its a chunk of bone that they pieced together like a jigsaw puzzle. But, my foot sustained a lot of other injuries. My ankle was fractured, my talus was impacted into the calc, i had sprains of the forefoot, my hammer toes were aggravated, all the tendons and ligaments were stressed, etc. Some of these things could not be treated. I've come to realize the foot is a complex thing, and very important to climbing, walking, life. So I am grateful for what I can do with it, and don't worry about what I can't do anymore. 

@Trevor Kraus, thank you for your support. Your replay helped a lot. Hopefully I see some improvement soon enough 

hey folks 1 year update

doing well! ankle a little stiff in the morning and ROM still limited. sometimes feels a bit wonky with a lot of activity, but totally manageable.

14 days on the slopes even with the low snow this year and went on a number of winter climbing trips. (I do not recommend jumping back into climbing by leading "easy" trad in jtree, haha). keeping the approaches short so far, but hopefully getting ready to do some backpacking by the time summer and fall come around.

happy to add another good recovery story to the thread, best to anyone else still healing

Brian Lee Victory wrote: Hello, has anyone undergone Calcaneal Surgery that required the insertion of hardware, and if so did you fully recover? What I mean is, were you able to continue climbing and hiking with full range of motion and minimal pain after the surgery? I had taken a ground fall and shattered my calcaneus, including fracturing my subtalar joint. I'm sitting here several weeks after the surgery and just looking for hope in the form of optimistic stories of others who have had the same experiences. Thank you, Brian

A friend of mine went through ORIF after a bad calcaneus fracture from a fall while hiking. The first few months were rough, mostly non weight bearing and slow rehab, but over time things improved more than expected. Around the one year mark he was back to long hikes and light scrambling with only occasional stiffness after big days. The biggest factors seemed to be patience with rehab and slowly rebuilding strength and ankle mobility instead of rushing it. It can take a long time, but good recoveries definitely do happen.

1.5 year UPDATE

My previous post was at around 6 months post-op when progress was slow and frustrating. I did Include a ton of useful techniques that I still stand by. Castor oil massage, acupuncture, don't over do it on the PT, light weight shoes, vitamins, collagen. 

Here are some things I have done since that I wish I had done sooner:

-Stop drinking (limit to 2/week. It causes inflammation and poor healing)

-I see a myofacial specialist that practices Structural Integration. Absolutely amazing, can't recommend enough for rebalancing the body.

-More aggressive ROM from day 1. I thought I was on it, but quite a bit of fibrosis built up and is limiting ROM and blood flow. 

-Red light therapy device. (totally thought it was a gimmick, but it reduced my scar in two weeks by 50% and reduces pain every day)

-Creatine. Amazing improvements in strength and cognition. 

-PRP injections. Super safe and helps restart the healing process. I ddi some around the incision and would like to do some in the subtalar joint.

-Don't let the foot get cold. After winter set in I realized that if it got cold skiing or working, it would be inflamed and painful for two days. I got heated socks/footbeds. 

-Keto diet if you're up for it. Carbs cause inflammation, and a keto diet helps in healing. 

After all that, and 18 months, and countless specialists, my ankle still hurts all the time. I am able to walk in shoes all day and work, but I can't run, can only climb for an hour, can only ski a bit. Basically the problem is that the subtalar joint took a beating and it gets inflamed with any serious use. All the surgeons have told me this would happen and that eventually it will need a fusion, but I really want to avoid that. I'll try anything. The latest CT scan showed some thinning of the subtler joint cartilage in spots. Specialists keep telling me the surgeon did a fine job, it's just that the talus is do hard/dense that the subtalar joint gets crushed and never really recovers. 

I do feel great in general though. Every day I'm able to walk around and live life is a good day. Not that I think it's necessary, but a traumatic event really puts things in perspective. So in general life is good, I'm fitter than ever, I can still practice the sports I love so dearly, I just can't perform at my peak. Instead of pushing the limits solo because no one could keep up, I now have a family pace that has enabled me to spend more time with the kids, which is great. 

hi all! a little upset i just found this thread! a little back story, about 2.5 ish years ago -i shattered my heel bone riding BMX, had ORIF surgery about 3 weeks post accident.

the surgery and pain after were brutal for me, but after the arc of starting to weight it 8-12 weeks after if i remember correctly then a decent amount of PT i was able to at least start walking again with no boot or crutches maybe 4-5 monthsish post surgery.

due to a bad head space at the time from a combination of a long term relationship ending right before my surgery and falling into the hole of believing the normal speel the surgeon gives you when they tell you what you will and won't be able to do, I spent the following year not exactly taking care of myself and or my foot...bought a motorcycle, was drinking a lot, started smoking...I was really a poster child for how not to handle the situation.

I am also a machinist, so I spend a lot of my workday on my feet so I was struggling with, now in retrospect, waiting too long to find the appropriate footwear and finding ways to be better to my foot. so I spent the subsequent year with a lot of foot pain pretty regularly, it was manageable but i would wake up regularly in the mornings with a bit of a limp and while somedays it wasn't to bad, most days it was pretty sore.

a little more backstory is before my attempt to feel like i was 16 again by getting back into BMX, i climbed for 4 ish years...mainly bouldering...now i spent the last couple years since the injury with just kind of this notion in my head that climbing again was just off limits, too much chance for shock loading it, my foot wasn't going to be strong enough, its already sore a lot so what's climbing going to do to it...yada yada yada. 

over the past couple years one of my best friends who also happened to be my main climbing partner, has several times tried to get me to give it a shot, so about 2.5 months ago i decided to see how it went. i went back to the gym with the mindset, hey...ill give this a shot, ill just down climb everything to avoid landing on it and see how it goes.

well now 2.5 months later I'm almost back to where I was before I stopped climbing and I'm not doing anything different, there's definitely risk but im jumping down from boulders, trying as hard as i was before and putting alot of strain on that foot.

the best part is my foot feels better after these couple months of climbing then it has since the injury which blew me away.

theres still a little bit of pain here and there and some soreness but since i started climbing its way better than it ever was.

for work i found a company called orthofeet...my problem is i need a safety toe and it was hard finding work shoes that didn't make my foot sore...orthofeet make an orthopedic safety shoe and it has helped alot!

for outdoors i wanted to find a lightweight, very soft, cushioned trail runner to try and absorb some of the shock of hiking...i went with new balance heiros, and they have been awesome...havent done a big hikes in them yet...but im thinking about trying a NH 4k this year so well see how that goes

Recovery from a calcaneal fracture is a marathon. Once you get cleared for PT, that's where the real progress happens. A lot of climbers find that while the ankle might feel a bit different or stiffer than before, they can still smear and edge once the strength returns. The subtalar joint involvement makes it tricky, but don't lose hope this early in the game.