Welcome to icliniq
Here is my reply to your questions
1. My Physiotherapist said me to use bicycle rather than motorcycle or car. He told me that it will make my thigh stronger. I am surprised because my heel are fractured and not thighs then why is so important to do exercise to strength thigh muscles. What is the connection between heel and thigh ?
Quadriceps weakness is common after injury and this weakening affects gait and causes more strain at knees. The only relation of the muscle with the heel is that during walking contraction of quadriceps straighten the knee before heel strike phase of the gait cycle. It's strengthening is part of any lower limb rehabilitative protocol.
2. You said that “Swelling is not the cause of pain but my PT said that when swelling will go, pain will also decreased.
Post injury swelling is usually unrelated to pain. As in my previous post I ahave asked for xrays, this swelling could be due to synovitis of the ankle joint. Synovitis in post ttraumatic scenario arises from osteoarthritis which causes pain.
3. Should I try to do small jumps and run fast ? Should I start walking on uneven surfaces i.e. fields, stairs etc
If you are able to do these activies to some extent you can try to perform them. As per your previous clinical examination finding there was loss of subtalar movements so walking on uneven surfaces can be painful.
4.When I raise the heels keeping the knee straight, it raises only 2-3 inches (extreme painful). I feel as if my bones are locked. My PT told me that pain I feel is cure for me. Dr. Patel (Ahmedabad) also told me to walk on toes keeping the knee straight even if tears come out of eyes.
Pain on joint movements can be due to altered joint space or stiffness of the soft tisssues around it. To determine the cause, different views of ankle and heel are required.
5. What should I do “Standing on toes” or “Walking on toes” or both?
Start with Standing on toes and when you start feeling conmfortable slowly progress to walking on toes. Currently you have extreme pain while standing on toes so I think asking you to walk over toes is too much to ask for.
6. Do I really not need medicines as Dr. Patel did not write any medicine ?
Pain killers can be taken for extreme pain or un bearable pain but not on regualr basis. If there is need for regular medicaion, kindly consult your treating physcian.
7. I feel stiffness in both legs (Ankle area). What should I do for that ?
A Xray is required for determinning whether the stiffness is due to bony factor or joint is normal and stiffness is realted to soft tissue factor around it.
soft tissue related stiffness can be corrected by physoitherapy but bony stiffness can not be corrected by it and the individual cause for it has to addressed.
8. When I asked my PT how much time should I give to exercises, he told me as much as time you give to exercise, faster will be recovery. Because I do this exercise whenever I get time including morning and evening. For example in the night at 11 pm is I am not sleeping I do the exercises. Is it true that overdoing exercises will not make any harm.
It is unkiely for such exercises to harm you, however you should listen to your body and the intensity of exercises should be according to it.
9. In diagnosis of Dr. Patel, my both heels are broaden. Does it cause walking, running, yoga etc ?
Boadening of heel is due to calcaneal fracture leading to loss of calcaneal height and alters the biemechanoics of foot, puts more strain on ankle and foot leading to pain over foot/ankle.
10. Lastly most important, will my condition improve or it will remain for lifetime
this question can only be answrerd after physical examination and investigation to know if there is more scope for increased moveemnt or not.
I hope your queries are answered, if there is anything else, feel free to discuss.
Investigations to be done:
Xray ankle- Anteroposterior, lateral and mortise view
Xray heel- axial view