Toe wiggles
Curl the toes down, then spread them and pull them up, as far as the plaster allows.
- 10 times
- Every hour while awake
Home / Patient library / Exercise sheets / Sheet 68
After surgery on a broken heel bone or midfoot
Foot & ankle · After surgery on the heel bone or midfoot
Count the weeks from the day of your operation. The date is on your discharge card.
If your doctor wrote a different plan on your prescription, follow that instead of this page.
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Weeks 0–2
Bring the swelling down: keep the foot raised above the level of the hip most of the day, with the pillow under the calf so the heel is not pressed on the bed. Keep the plaster, splint or boot on and the wound dry. Keep the toes, knee and hip moving. If we prescribed blood-thinning injections or tablets, take every dose. If you smoke, stop now: smoking slows the healing of the wound and the bone. If you have diabetes, keep it well controlled.
Weight bearing As written on your prescription — usually no weight at all on the operated foot. Use the walker or crutches every time.
Quad sets
Sit with the leg straight. Press the back of the knee down and tighten the thigh.
- Hold 5 seconds
- 10 times
- 3 times a day
Should feel: The thigh muscle tightening Should not feel: Knee pain
Straight leg raise
Lie down, good knee bent. Keep the operated leg straight and lift it 20 cm.
- 10 times
- 3 times a day
Should feel: The thigh working Should not feel: The knee bending or back pain
Buttock squeeze
Lie on your back with the legs straight. Squeeze the buttocks together, hold, then relax.
- Hold 5 seconds
- 10 times
- 3 times a day
Should feel: The buttocks tightening Should not feel: Back pain
Lying hip slide out
Lie on your back, legs straight, toes pointing up. Slide the leg out to the side and back, keeping the knee straight.
- 10 times
- 3 times a day
Should feel: The side of the hip working Should not feel: The toes rolling outwards
Not yet Standing on the operated foot, letting the leg hang down for long, resting the heel on anything hard, getting the wound wet, or driving.
Move to the next stage only after we have seen you, and the X-ray if one was planned.
Weeks 2–6
Stitches out once the wound has healed; a wound over the heel can take longer than 2 weeks. If we have moved you into a removable boot, take it off to exercise the ankle and to wash, and wear it at all other times; then start moving the ankle and turning the sole in and out, gently and within comfort: this keeps the joint just below the ankle from stiffening. If you are still in a plaster, start these only once we have taken it off. Carry on with the earlier exercises.
Weight bearing As written on your prescription — usually still no weight on the operated foot. Keep using the walker or crutches.
Ankle pumps
Pump the feet up and down to keep the blood moving.
- 20 times
- Every hour while awake
Should feel: The calf working Should not feel: Calf pain or swelling — tell us
Ankle circles
Move the ankle slowly in circles both ways.
- 10 each way
- 3 times a day
Should feel: The ankle loosening Should not feel: Sharp pain
Turning the sole in and out
Sit on a chair with the heel of the operated foot resting lightly on the floor and no weight on the foot. Keeping the knee still, turn the sole of the foot inwards, then outwards, only as far as is comfortable.
- 10 times
- 3 times a day
Should feel: Gentle movement just below the ankle Should not feel: Sharp pain, or pulling at the wound
Not yet Standing or walking on the operated foot, walking without the boot, stretching the calf hard, or driving.
Move to the next stage only after we have seen you, and the X-ray if one was planned.
Weeks 6–12
Weight on the foot starts and increases step by step, as written on your prescription and as the X-ray shows healing — usually first in the boot, then in a shoe. Start the cycling only once we allow weight on the foot. Swelling of the foot by evening is normal and can last for some months; raise the leg when you rest. Carry on with the earlier exercises.
Weight bearing Increasing, as written on your prescription and as the X-ray shows healing. Keep the crutches until you walk without a limp.
Towel calf stretch, sitting
Sit with the leg straight. Loop a towel round the ball of the foot and pull the toes towards you.
- Hold 30 seconds
- 3 times
- 3 times a day
Should feel: A stretch in the calf Should not feel: Sharp pain
Sitting heel and toe raises
Sit with both feet flat on the floor. Lift the heels, lower them, then lift the toes.
- 10 times
- 3 times a day
Should feel: The calf and the front of the shin working Should not feel: Sharp pain
Towel toe curls
Scrunch a towel with the toes.
- 10 times
- Daily
Should feel: The foot muscles working Should not feel: Cramp
Static cycling
Set the seat high, so the knee is almost straight at the bottom. Pedal gently with little resistance.
- 10 minutes
- Daily
Should feel: The knee moving freely Should not feel: Pain in the knee or hip
Not yet More weight than your prescription allows, running, jumping, climbing a ladder, or working at a height.
Move to the next stage only after we have seen you, and the X-ray if one was planned.
Month 3 onwards
Walk without a limp and build calf strength and balance. Go back to work step by step, as the X-ray shows; heavy work, and work on a ladder or at a height, often take several months. Some ache and swelling of the heel or midfoot can last for many months, especially on uneven ground. Carry on with the third-stage exercises.
Weight bearing Full, unless we have told you otherwise.
Calf raises
Rise onto both toes and lower under control.
- 15 times
- Daily
Should feel: The calf working Should not feel: Sharp pain
Single-leg balance
Stand on one leg beside a worktop.
- 30 seconds
- 3 times a day
Should feel: Working to stay steady Should not feel: Losing balance — hold on
Heel-to-toe walking
Walk heel to toe along a line, beside a support.
- 10 steps
- Daily
Should feel: Steadier walking Should not feel: Wobbling — use the wall
Step-up
Hold a rail. Step up onto a low step with the operated leg, then step down with the other leg.
- 10 times
- Daily
Should feel: The thigh working Should not feel: The knee falling inwards
Not yet Jumping, running on uneven ground, or working at a height, until we clear you.
Stop and telephone us if
- The toes become numb, weak, cold, pale or blue — go to the nearest hospital
- Pain that keeps getting worse despite the painkillers, with a tight, swollen foot — go to the nearest hospital
- Heel or midfoot pain suddenly becomes severe — come the same day
- The wound leaks, or its edges open up or turn black — come the same day
- The calf becomes swollen, tight or painful — go to the nearest hospital
- Sudden breathlessness or chest pain — go to the nearest hospital
- You have put more weight on the foot than allowed, or the foot starts to look a different shape
- Redness spreading around the wound, or fever
- The plaster or boot feels too tight, or rubs in one spot
Ready when you are.
Call either clinic during consulting hours, or send a WhatsApp message any time.