The calcaneus is also known as the heel bone which is present in the back of foot. Overuse or repetitive strain to this bone results in a stress fracture. It is commonly seen in those individuals who are involved in activities which put continuous pressure on the heel bone such as soldiers, who have to march a lot etc. Acute fractures of the calcaneus bone occurs from a sudden impact or force to the heel, e.g. falling from a height and landing on the heel.
Causes of Calcaneal Stress Fracture
- Increased weight bearing e.g. marching and running.
- A recent increase or change in training regime.
- Risk Factors Include: Bad foot posture, weakness of the muscles, poor flexibility, stiffness in the ankle joint, ill-fitting footwear and excessive or inappropriate training especially on hard or rough surfaces.
Signs and Symptoms of Calcaneal Stress Fracture
- Pain in the heel which gradually intensifies.
- Increasing pain upon weight bearing.
- Pain upon pressing the back part of heel from both sides.
- X-ray may not reveal a fracture until the actual healing process of the fracture has started. Stress fracture may not be visible on x-ray at all. MRI or bone scan can be done for further confirmation of diagnosis.
Treatment of Calcaneal Stress Fracture
- Patient should seek consultation from a sports specialist immediately.
- In case of a stress fracture, rest should be taken for 6 to 8 weeks. Complete weight-bearing should be avoided and crutches can be used for support.
- Heel pad can be used for protection of the heel.
- For severe pain, a plaster cast should be applied for 2 - 6 weeks.
- Patient should start a rehab program consisting of stretching and strengthening exercises to increase mobility and flexibility of the muscles of the lower leg.
- Deep tissue massage can be done by a professional.
- Electrotherapy such as ultrasound is also beneficial.
- Athlete should return to the training regime gradually.