Stress fractures in the heel bone, also known as calcaneal stress fractures, are hairline cracks or tiny breaks in the calcaneus, which is the largest bone in the foot. These fractures usually occur as a result of repetitive stress or overuse, rather than a sudden traumatic event. They are a common injury among athletes and individuals who engage in activities that involve repetitive impact on the feet, such as running or jumping. Stress fractures occur when the muscles and bones in the foot become fatigued from repetitive stress and are unable to absorb the impact effectively. Factors that can contribute to the development of stress fractures in the heel bone include sudden increases in physical activity, inadequate footwear, changes in training surface, improper running or jumping techniques, and underlying conditions that weaken the bones (e.g., osteoporosis).
The most common symptom of a stress fracture in the heel bone is heel pain, which tends to worsen with weight-bearing activities and improves with rest. The pain is often described as a dull ache or throbbing sensation. Swelling and tenderness may also be present around the affected area. A proper diagnosis of a stress fracture involves a thorough physical examination, medical history review, and imaging tests. X-rays may not always detect stress fractures in their early stages, so additional imaging studies like magnetic resonance imaging (MRI) or bone scans may be necessary to confirm the diagnosis. A calcaneal squeeze test can be a helpful clinical assessment.
Treatment for stress fractures in the heel bone typically involves rest and protection of the foot to allow the fracture to heal. This may involve limiting weight-bearing activities and using crutches or a walking boot. Ice therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), and physical therapy may also be recommended to reduce pain and promote healing. In some cases, a cast or immobilization may be necessary. Recovery time for calcaneal stress fractures can vary depending on the severity of the injury and individual factors. It may take several weeks to a few months for the fracture to fully heal. It is important to follow a gradual return-to-activity program under the guidance of a healthcare professional to prevent re-injury. Adequate rest, wearing proper footwear, maintaining proper conditioning and technique, and gradually increasing the intensity and duration of activities can help prevent stress fractures.