Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Fracture, Calcaneus


Related Terms

  • Calcaneal Fracture
  • Calcaneus Fracture
  • Extra-Articular Calcaneus Fracture
  • Heel Fracture
  • Intra-Articular Calcaneus Fracture
  • Os Calcis

Specialists

  • Occupational Therapist
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Physical Therapist
  • Sports Medicine Physician

Comorbid Conditions

Factors Influencing Duration

The type of fracture, involvement and amount of joint surface disruption, treatment, and amount of weight bearing required for job activities may all affect disability. Duration of disability depends on job requirements and whether job duties can be performed while seated. Heavy work is not usually compatible with intra-articular fracture of the calcaneal body. Duration of disability can be affected by age, diabetes, vascular disease and associated nerve injury. Other factors include non-union and post-traumatic arthritis.

Medical Codes

ICD-9-CM:
825.0 - Closed Fracture of Calcaneus (Heel Bone)
825.1 - Open Fracture of Calcaneus (Heel Bone)

Rehabilitation

The duration of treatment for a fracture of the calcaneus is related to the associated soft tissue involvement and type of fracture. The main focus of rehabilitation should emphasize restoring full range of motion, strength, proprioception, and endurance while maintaining independence in all activities of daily living (Bucholz). Resumption of pre-injury status is the goal with consideration of any residual deficit. Protocols for rehabilitation must be based upon stability of the fracture and fracture management (operative, nonoperative).

The goal of rehabilitation with a calcaneus fracture is to return the patient to full function with a painless mobile ankle, when possible. Swelling (edema) is a common problem and may be controlled using modalities such as cold packs and compressive wrapping. Control of edema is especially important prior to any surgical procedures, and may take up to 2 to 3 weeks to achieve. The individual should be encouraged to continue functional activities to prevent complications of inactivity and bed rest. Gait training using appropriate assistive devices is indicated based on ability and weight-bearing status. If casted, the individual may benefit from range of motion exercises of the adjacent joints, unless this is contraindicated based on fracture stability (Easley). After cast removal, the individual begins range of motion, proprioceptive, and strengthening exercises, which should be progressed until full function is evident.

If operatively managed, the protocol for rehabilitation will be dictated by the treating physician. In some cases a subtalar fusion may be performed, which can lead to an earlier return to work.

Bone healing may occur within 10 to 12 weeks; however, weight bearing is usually not permitted until there is bone union. Return to demanding job duties may take up to 4 to 6 months and may not occur in some cases. The bone strength and the ability of the bone to sustain a heavy load may take up to several years (Chapman). Once healing has occurred, the individual may resume full activities of daily living. It is important to instruct the individual not to overload the fracture site until the bone has regained its full strength. The resumption of heavy work and sports should be guided by the treating physician.

FREQUENCY OF REHABILITATION VISITS
Nonsurgical
SpecialistFracture, Calcaneus
Physical TherapistUp to 20 visits in 12 weeks
Surgical
SpecialistFracture, Calcaneus
Physical TherapistUp to 20 visits in 12 weeks
Note on Nonsurgical Guidelines: Rehabilitation may not begin until tissue healing, about 6 to 8 weeks after the fracture.
The table above represents a range of the usual acceptable number of visits for uncomplicated cases. It provides a framework based on the duration of tissue healing time and standard clinical practice.

Source: Medical Disability Advisor






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