Expert: Scott F. Gillman, DC, DACBSP - 3/6/2009

Question
I broke both my heels in a fall from a latter in Sept 08.  I had surgery to repair the bones with plates and screws.  I took a very long time for the wounds to heal and I did have a set back with a staff infection in December.  Currently the right foot is almost back to normal.  It could use some better range of motion but the use of the foot is bearable.  The left foot continues to be stiff and painful to walk on.  Range of motion is very limited.  If the foot is down for a period of time it tends to swell.  My ortho says this pass in time.  I am simply tired of the pain and taking pain medication to get by.

Answer
Harold,

Unfortunately, your condition is not easy to deal with.  Post surgical pain and the emerging condition called "complex regional pain syndrome" or CRPS is a challege for both doctor and patient.  I would recommend finding a chiropractor with a lot of experience in treating the lower extremity.  Credentialed sports chiropractors tend to have more expertise in this area.  Go to www.acbsp.com and see if there is a diplomate-level practitioner (at best) in your area.  Joint manipulation to any articulation that is not stabilized with hardware will surely improve range of motion.   Focussed soft tissue therapy would also be helpful.   This would include Graston Technique (see www.grastontechnique.com) to the foot and Active Release to the leg/calf muscles.   Kinesiotape is a "proprioceptive taping" procedure that also can improve movement, aid with swelling, and sometimes reduce pain.   Some folks have had courses in how to use it and some not.  There is a Kinesiotape credentialling course out there and I, too, am waiting to get "certified" despite my several workshops using the tape.  They, too, have a web site that describes it.   I also would recommend low level laser therapy.  It cannot hurt, only help.  Again, there are many references on low level laser that you can search on line.  Some acupuncture could be helpful in reducing pain.   If you can find a chiropractor trained to do all the above, then you're in business.  You should know after a hand-full of treatment sessions if your condition is heading in the right direction.  

'Best of luck with this.

Dr. G