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What is a stress fracture of the calcaneus?
A calcaneal stress fracture is an incomplete fracture or crack in the heel bone. Physiotherapy is an important treatment for a stress fracture of the calcaneus.
How does a stress fracture of the calcaneus happen?
Stress fractures of the calcaneus result from an imbalance between bone formation and bone resorption (removal). When the calcaneus is loaded or stressed, such as during weight-bearing exercise, it responds by increasing its bone turnover. This is necessary for it to live up to your demands on it.
Above: Soft tissue massage and mobilisations of the bones and connective tissues in the foot by an experienced therapistIf stress is put on the calcaneus, areas of the bone can become damaged. These damaged areas of bone are then resorbed (removed) and replaced with new bone. If the new bone formation is slower than the resorption (removal) of the old bone, weak points occur at areas of stress within the calcaneus. An area of weakness in the bone can develop into a stress fracture if the weak area of the calcaneus is repeatedly stressed.
A recent change in training can often be a factor in the development of a stress fracture. This could involve a change in frequency, duration, intensity, training surfaces or footwear.
What are the symptoms of a stress fracture of the calcaneus?
A stress fracture of the calcaneus normally causes heel pain of gradual onset. Activities such as walking and running exacerbate the pain. Squeezing the back of the heel on both sides will cause severe pain. Other symptoms can include:
What should I do if I have a stress fracture of the calcaneus?
If you suspect that you have a stress fracture or have injured your heel, you should arrange a physiotherapy appointment as soon as possible.
What shouldn’t I do if I have a stress fracture of the calcaneus?
If you suspect that you have a stress fracture of your calcaneus you should not continue to exercise through the pain. Putting weight through the heel may make the bone increasingly weak, and therefore, cause a larger fracture.
Above: Mobilisations and stretches of the foot and ankle by specialised therapistPhysiotherapy treatment following a stress fracture of the calcaneus.
Physiotherapy is important in the treatment of a stress fracture of the calcaneus. Initially, your physiotherapist can provide you with a diagnosis. This may require the referral for imaging techniques such as a MRI scan. From this your physiotherapist can develop an appropriate treatment plan. This may initially involve a period of rest and the use of crutches and icing to help with your pain. A programme will be developed to allow you to maintain your cardiovascular fitness and muscle strength without delaying healing. This may involve low impact ‘cross training’, swimming, deep water running and cycling. Other treatment can include: Your physiotherapist may also be able to determine why you developed a stress fracture of the calcaneus in the first place and address this during your recovery to prevent a recurrence when you return to full activity.
Could there be any long-term effects from a stress fracture of the calcaneus?
Stress fractures are areas of weakness in the bone. Provided that the fracture is managed correctly and activity is not commenced until the fracture has completely healed, there should not be any long-term effects.
To arrange a physiotherapy assessment call Physio.co.uk on 0330 088 7800 or book online.
