Stress Fracture of the Calcaneus

Stress Fracture of the Calcaneus – This pain gets worse the more you walk on it and is due to overworking your heel bone. Find out how to fix it FAST!


Causes of A Stress Fracture of the Calcaneus

Stress fractures occur as a cycle or repetitive loading and unloading of the bone and are not the result of a weak bone or any other systemic illness like osteoporosis! People who develop stress fractures can be described as weekend warriors or people who start to take on too much of an activity too quickly after not preparing themselves properly.

This would include people who went from not walking to walking many miles per day, or someone who just started training very hard for a marathon after not really running before. If the patient has diabetes or decreased nerve function this raises the possibility of a neuropathic fracture which is a fracture due to a lack of feeling and sensation in that area of the heel.


Calcaneal Stress Fracture Diagnosis:

  • Diagnosis of a stress fracture of the heel bone is based upon listening to the prior history, which usually includes increased activity.
  • The most common site of stress fracture is just inferior and posterior to the posterior sub-talar joint facet of the calcaneus.
  • The stress fracture can be confirmed by compressing the heel and causing pain especially on the outside of the heel.
  • Swelling, warmth and tenderness should be present in that area.
  • Studies have shown that compression pain of the heel with surrounding swelling, warmth and tenderness of the heel bone are very accurate in suggesting a stress fracture in the calcaneus.


Calcaneal Stress Fracture Imaging:

  • X-ray is good to detect a stress fracture, but it is difficult to locate one in the first 10-14 days of the stress fracture occurrence.
  • The most sensitive initial scan is a technetium bone scan or MRI, the only problem with these is that they are a little bit more difficult and expensive to administer.
  • An X-ray is usually a good enough diagnosis tool if it is combined with the compression test and signs of inflammation in the heel bone.
  • After 2-3 weeks the X-ray will show a thickened white line in the area of the stress fracture as it begins to remodel itself.

Calcaneal Stress Fracture Prevention and Treatment:

The stress fracture will eventually heal on its own if you keep weight off it, but you can do these things to make it heal faster and prevent one from even coming back.

  • Immobilization in a CAM walker.
  • Anti-inflammatory medication.
  • Cryotherapy.
  • Transition into a stiff soled shoe.
  • Lose weight.
  • Biomechanical evaluation.
  • OTC orthotics.
  • Stretching exercises.


Healing Time of a Stress Fracture of the Calcaneus

Healing time of two months or so until the pain has gone away; the stress fracture of the calcaneus almost always heals in the correct position.