Heel Stress Fracture

The calcaneus is most often fractured during a:

• Fall from a height 
  • Twisting injury to the ankle
  • Motor vehicle collision

  The severity of a fracture can vary. For example, a simple twist of the ankle may result in a single crack in the bone. 

  Stress fractures of the calcaneus are most common in these sports:

  • Long-distance running
    • Soccer
    • Basketball
    • Track & field sports
    • Dance

Patients with calcaneus fractures usually experience:

• Pain
• Bruising
• Swelling over the heel
• Heel deformity
• Inability to put weight on the heel or walk
• Difficulty in walking , limping

• Most stress fractures of the calcaneus will heal with non-surgical measures.
• Taking a break from sports that place repeated stress on the heel, such as running, is essential to starting the healing process.
  • Additional conservative treatments may include:
  • Applying ice to reduce swelling
    • Using crutches to keep weight off the heel
    • Wearing a boot walker or cast to provide support and protection to the heel
    • Physical therapy after the bone has healed

  It is helpful to wear well cushioned shoes or add gel pads to your shoes to lessen impact during weight bearing once walking is allowed

Initially involves RICE protocol.

GOALS

• Reduce pain
• Maintain mobility
• Maintain cardiovascular fitness
• Muscle strength
• Accelerate healing

REHABILITATION

• Reduce oedema and pain .
• Low impact cross fit training
• Swimming
• Deep water running and cycling
• Balance exercise
• Taping
• Hydrotherapy

After 9-12 weeks

1. Full-weight bearing ambulation
2. Joint mobilization to all hypomobile joints
3. Soft tissue mobilization to hypomobile tissues

Progressive resisted strengthening

• Use of pulleys
• Weighted exercise
• Toe-walking ambulation
• Ascending/descending stairs,
• Skipping
• Plyometric exercise
• Pool exercises
• Climbing activities
• Work hardening program or activities to allow return to work between 13- 52 weeks.

The calcaneus is more commonly known as the heel bone. A stress fracture of the calcaneus is a small break in the heel bone. Located at the back of the foot, the calcaneus is essential for walking and provides support and stability to the foot

While uncommon, calcaneus fractures can be severe and require medical treatment.

Treatment often involves surgery to reconstruct the normal anatomy of the heel and restore mobility so that patients can return to normal activity. But even with appropriate treatment, some fractures may result in long-term complications, such as pain, swelling, loss of motion, and arthritis.