Calcaneus Stress Fractures Sports Injuries | Calcaneus Stress Fractures Injury Treatment from Sports Medicine Specialist Dr. David Geier

Stress fractures are common overuse injuries, and fractures of the calcaneus, or heel bone, are especially common in running athletes. Typically the runner will complain of pain that initially starts after a certain amount of running but gets better with rest. As the problem gets worse, he or she will have pain earlier in the run, and the pain will take longer to go away after the run. As it progresses to a stress reaction, or later a stress fracture, the pain will not go away with rest, and often the pain is present during activities of daily living, such as walking.

$Calcaneus stress fracture$

Pain from a calcaneus stress fracture is typically felt deep in the bone of the heel (white arrow), as opposed to the sole of the foot, as in plantar fasciitis (yellow arrow).

A physician who examines a runner with a calcaneus stress fracture can usually reproduce pain along the heel. Unlike the pain with plantar fasciitis, which is typically on the sole of the foot at the heel, the pain with a calcaneus stress fracture is more spread out all along the heel. Typically the physician can squeeze the sides of the heel together and recreate the pain. Often x-rays will be enough to demonstrate a calcaneus stress fracture. If the physician is fairly certain that this is a stress fracture but the x-rays are negative, he or she might choose to order a bone scan or MRI.

Treatment is almost always nonsurgical. Rest from running, wearing a walking boot or protective shoe, and often decreasing the patient’s weight-bearing status is usually sufficient to get the fracture to heal. The athlete is usually held out of running until the fracture heals. Then running is slowly reintroduced into the athlete’s training. While the fracture is healing, non-weight-bearing, non-impact activities such as swimming and stationary bike riding can be performed. There are usually no long-term consequences of this injury. It is important for someone who suffers a calcaneus stress fracture to consider a bone density study to evaluate for osteoporosis. Referral to a sports nutritionist to ensure that the athlete’s diet is providing sufficient calories, vitamins, and minerals is important as well.

Concern for a calcaneus stress fracture in a runner?