Calcaneal Stress Fracture

What is a calcaneal stress fracture?

A calcaneal stress fracture is one or more small breaks in your heel bone (calcaneus). These fractures often occur because of repetitive, long-term stress on the bone, such as from jogging.

Calcaneal stress fractures can cause intense pain and make walking more difficult. It’s important to see your healthcare provider right away if you have a calcaneal stress fracture or think you could have one. Treatment can help you avoid further damaging the broken bone.

What is the difference between a calcaneal stress fracture and a calcaneal fracture?

Stress fractures are tiny cracks in your bone. But your heel bone may also break because of an impact injury, such as a car accident.

Calcaneal fractures include stress fractures, but they may also be other types of bone fractures. For example, a fragment of bone may stick out of your skin (compound fracture).

Who might get a calcaneal stress fracture?

Calcaneal fractures are most common in men or people assigned male at birth who are ages 30 to 50. You’re more likely to get a calcaneal stress fracture if you participate in activities or sports that involve repetitive movement, including:

• Basketball.
• Dancing.
• Long-distance running.
• Soccer.
• Track and field sports.

Other factors that increase your risk of calcaneal stress fractures include:

• Having an eating disorder.
• Using tobacco or overusing alcohol.
• Working a job that involves heavy physical labor.

How common are calcaneal stress fractures?

Calcaneal stress fractures are rare. All foot fractures account for only around 2% of fractures. Only half of those affect the calcaneus.

What are the symptoms of a calcaneal stress fracture?

The most common symptom of a calcaneal stress fracture is intense heel pain. You may also have trouble putting weight on your heel. The pain may:

• Affect only one spot of your heel.
• Increase when you try to stretch your foot.
• Worsen the longer you stand.

Other calcaneal stress fracture symptoms include a heel that is:

• Bruised.
• Flushed or red.
• Swollen.
• Tender or warm to the touch.

What causes a calcaneal stress fracture?

Calcaneal stress fractures occur when your body doesn’t have enough healing time between activities. You may get these injuries if you run often or suddenly increase your activity levels.

How is a calcaneal stress fracture diagnosed?

To diagnose a calcaneal stress fracture, your healthcare provider physically examines your foot and ankle. They may ask you to wiggle your toes or check if you can feel sensations on the bottom of your foot.

You’ll likely also have imaging tests such as:

• X-rays are the most common imaging tool to diagnose fractures. They use low, safe doses of radiation to get clear images of your bones.
• CT scans or MRIs are common follow-up tests after X-rays. They provide more detailed images of your feet to help your healthcare provider determine the extent of the injury.

How is a calcaneal stress fracture treated?

To treat a calcaneal stress fracture, you limit or avoid putting weight on your foot for four to eight weeks. Your provider may also prescribe a boot, cast or splint to keep your foot in one position while the fracture heals. If needed, your provider may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) or pain medication.

Most people heal from a calcaneal stress fracture with noninvasive treatment. You rarely need surgery for a calcaneal stress fracture.

How soon after calcaneal stress fracture treatment can I return to usual activities?

After eight weeks, you may start walking and resuming other usual activities. Depending on how severe the fracture is, healing may take longer. Most people can resume their typical activities within 12 weeks.

How can I prevent a calcaneal stress fracture?

To lower your risk of a calcaneal stress fracture:

• Avoid alcohol and tobacco.
• Consume enough calcium and vitamin D to strengthen your bones, as directed by your healthcare provider.
• Correct any improper foot mechanics with physical therapy if your healthcare provider recommends.
• Wear padded heel inserts for extra cushion.

What can I expect if I have a calcaneal stress fracture?

Most people heal from a calcaneal stress fracture within a few months. During healing, you’ll likely wear a cast or splint and avoid putting weight on your heel. After treatment, you may need physical therapy to improve your strength and prevent further injury.

It’s important to get treatment if you think you could have a calcaneal stress fracture. Without treatment, stress fractures may worsen and lead to more significant bone fractures. Larger fractures often involve more healing time and may even require surgery to treat.

What questions should I ask my doctor?

If you suspect you have a calcaneal stress fracture or have been diagnosed with one, you may want to ask your healthcare provider:

• What is the most likely cause of a calcaneal stress fracture?
• Are there nonsurgical treatments for calcaneal stress fractures?
• What are my options for pain management while healing from a calcaneal stress fracture?
• What can I do to prevent another stress fracture?
• Am I a candidate for physical therapy to reduce my risk of fractures?

What is the difference between plantar fasciitis vs. calcaneal stress fracture?

Plantar fasciitis and calcaneal stress fractures both cause heel pain. Plantar fasciitis is inflammation or damage in the thick band of tissue (plantar fascia) in the arch of your foot. A calcaneal stress fracture is one or more cracks in your heel bone.

A note from Cleveland Clinic

A calcaneal stress fracture is one or more tiny breaks in your heel bone. People often get stress fractures when they overexercise or increase their activity levels too quickly. Timely treatment can help you avoid further damage to your heel bone. Usually, treatment involves wearing a cast or splint and avoiding putting weight on your heel for up to eight weeks. Most people heal from a calcaneal stress fracture in about three months.