Ankle Fractures: Why Is My Heel Still Hurting After Surgery? - Orthopedics

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After undergoing surgery for an ankle fracture, it is not uncommon to experience persistent pain, especially in the heel area, even two months post-operation. There are several factors that could contribute to your ongoing discomfort, and understanding these can help you manage your recovery more effectively.

1. Healing Process: After an ankle fracture, the healing process can take time. While the bone may be healing, the surrounding soft tissues, including ligaments, tendons, and muscles, may still be inflamed or damaged. This can lead to pain in the heel and surrounding areas. It's important to note that even if the bone appears to be healing well on an X-ray, the soft tissues may require additional time to recover.

2. Post-Surgical Pain: Surgical procedures often involve manipulation of the surrounding tissues, which can lead to inflammation and pain post-operation. This is a normal part of the healing process, but it can sometimes be mistaken for complications. The pain may also be exacerbated by the use of immobilization devices, such as casts or splints, which can lead to stiffness and discomfort in the heel.

3. Weight Bearing and Rehabilitation: If you are still experiencing pain while attempting to walk, it may be due to insufficient rehabilitation or premature weight-bearing activities. It's crucial to follow your surgeon's recommendations regarding when to start putting weight on your ankle. Gradual progression in weight-bearing activities, combined with physical therapy, can help alleviate pain and improve function.

4. Potential Complications: While it’s less common, complications such as nonunion (where the bone fails to heal properly) or malunion (where the bone heals incorrectly) can occur. If the pain persists or worsens, it may be worth discussing with your doctor whether further imaging, such as an X-ray or MRI, is necessary to rule out these issues.

5. Nerve or Soft Tissue Issues: Sometimes, pain in the heel can be related to nerve irritation or damage during the injury or surgery. Conditions like tarsal tunnel syndrome, where the tibial nerve is compressed, can lead to pain in the heel and foot. Additionally, soft tissue injuries, such as tendonitis or bursitis, can also cause persistent pain.

6. Physical Therapy: Engaging in a structured physical therapy program can be beneficial. A physical therapist can provide exercises to improve strength, flexibility, and range of motion, which can help reduce pain and improve function. They can also offer modalities such as ultrasound or electrical stimulation to help manage pain.

7. Pain Management: In the meantime, managing pain with over-the-counter medications, ice application, and elevation can help alleviate discomfort. If the pain is severe, your healthcare provider may prescribe stronger pain relief options.

In conclusion, while it is common to experience pain after an ankle fracture surgery, it is essential to monitor the situation closely. If the pain persists or worsens, or if you have concerns about your recovery, it is crucial to follow up with your orthopedic surgeon or healthcare provider. They can provide a thorough evaluation and determine the best course of action to ensure a successful recovery. Remember, healing takes time, and patience is key in the recovery process.