There's an old saying that goes, "The bigger you are, the harder you fall." You can take that one step further and say, "The farther you fall, the harder you land." And human bodies, being somewhat less dense and firm than concrete, don't do so well in those impacts.

For example, if you fall off a one-story building, you'll impact at between 16 and 17 mph. "Not all that bad you say?" Well, would you like to run into a brick wall at that speed? Brick walls and concrete driveways don't "give" much in impacts with humans, unless you're referring to giving injuries. And falling and injuring your feet in the process can take the "spring" out of your step for up to six months, according to Dr. David W. Alford, a specialist in orthopedic surgery with Southern Bone and Joint in Dothan, Ala.

Alford's been performing foot and ankle surgeries since 1998. These days he typically sees three or four new patients each month who have fallen off roofs or ladders and broken their ankle or their calcaneus (heel bone). He explained those injuries "can be quite debilitating," adding, "Depending on the height of the fall -- if it is over 10 feet -- these can be classified as high-energy injuries with the bones being broken into many pieces."

Because your feet support your body's weight, such injures severely limit your mobility. Simply getting up and going to the bathroom can require you to use a wheelchair, walker or crutches and be painful enough you'll wait until you really need to go.

Alford explained that when you take a normal step you transfer your body's weight from your calcaneus through the subtaler joint at your ankle and up your leg. And that subtaler joint, he said, is essential to walking.

"This joint handles the side-to-side motion that is necessary when both in normal gait and having the foot accommodate uneven surfaces," he said. "If the calcaneus is broken and arthritis develops in that joint, this can cause significant pain or discomfort."

Because the accident causes a lot of swelling, surgery is sometimes postponed for up to three weeks to allow the swelling to go down. Since the calcaneus has little soft tissue around it to help absorb impacts, it is typically mashed flat, Alford said. Therefore, he has three goals when he operates -- to restore the height and width of the calcaneus and repair the subtaler joint. Repairing that joint typically includes using metal hardware such as plates and screws and can make for very interesting post-surgery X-rays.

From there on it's a long, slow healing process that involves wearing a non-weight bearing cast for up to six weeks. After that point if X-rays show the surgery has properly healed, you'll get a cushion for the inside of your shoe and, possibly, receive physical therapy. However, you're not out of the woods yet. According to Alford, it takes up to five months for the surgery to completely heal and during that time you'll have plenty of pain to keep you company. Some days -- especially in the beginning -- just walking to the kitchen will be challenging enough.

That's where the rub comes in if you're an Airman. While you're recovering you'll be very limited in performing your duties -- especially if you spend much time on your feet. And while the mission won't change, your not being there can affect unit readiness.

Finally, the unfortunate truth is that while surgery will help, your foot will never be as good as it was before. Because these accidents are life-changing events, Alford warned, "It warrants care and caution any time using a ladder. It is most often a very preventable injury."

-- Bob Van Elsberg