Q Recently I broke both my heels (bilateral calcaneal). One is a clean break and one is smashed. I will start swimming and cycling to regain my fitness – but can I run again?
A You need a multi-disciplinary approach to get you back on track. Start by seeing a consultant who specialises in the foot and ankle. They will give you a thorough orthopaedic review, especially if you have any stiffness or pain in the ankle area, to rule out any arthritic changes the break may have caused.
Also, have your heel pad analysed by a podiatrist as this structure may also have been damaged, making it less likely to be able to properly absorb shock at heel strike. Following a biomechanical evaluation and gait analysis, shoes and orthotic devices could be prescribed, which can reduce pain.
Once the heel can take impact, and any underlying concerns have been ruled out, you need to have a muscle balance assessment with video analysis to look at your pelvic stability with an experienced musculoskeletal physiotherapist.
It is more than likely that the injury has resulted in an altered movement pattern with significant muscle wastage – issues that will all need to be addressed. Core-stability training can be started to return the soft tissues in your legs to their original strengths.
Remember that rehabilitation will be a gradual process and will make you go back to basics with both training and fitness.
—Wayne Edwards, Musculoskeletal Podiatrist, Health & Fitness Solutions