Heel Pain and Stress Fractures of the Calcaneus

One of the most common causes of heel pain is plantar fasciitis, where the band on the bottom of the foot becomes inflamed. This typically causes pain in the area after rest, and the pain will get better after taking some steps. However, there are other causes of heel pain. One of the other causes of heel pain is a stress fracture of the heel bone or calcaneus. This happened to a friend of mine while she was training for the Chicago marathon last summer, and with improved weather conditions in the next few months, it is something to consider as people increase their outdoor activities. The calcaneus or heel bone is a large and complicated bone just under the ankle. It is very strong but also undergoes a lot of stress and pressure with running, jumping, and even walking. On occasion, this bone can develop a stress fracture (a hairline type of fracture or break), which will cause nagging pain that does not improve. There may be pain to touch, swelling, and difficulty with walking and exercise. This injury can be caused by improper training or improper shoegear, weak bone density, continued microtrauma (marching, running, jumping), obesity, trauma, and biomechanical issues. Conventional x-rays may be taken to look at the bone structure of the calcaneus, but often, more advanced radiological studies like CT or MRI studies may be needed to identify the fracture. Stress fractures frequently cannot be identified in the bones of the foot for at least 21 days on conventional x-rays, and sometimes, they are never visible on x-rays because the break is so thin. Treatments include the following: rest, immobilization, elevation, and avoiding the activity that may have caused the injury. After healing, physical therapy, new shoegear, and orthotic devices may be needed to transition the patient back to normal life and exercising. If you have heel pain, call Dr. Bender at Advanced Physical Medicine, 6931 W. North Ave., Oak Park, IL 60302. 708-763-0580. advancedphysicalmedicine.org and oakparkpodiatry.com