Causes of a heel stress fracture
A heel stress fracture is caused by overuse and due to repetitive and excessive forces on the heel bone. The heel bone fails to absorb the forces resulting in bone failure and a small crack or fracture.
Factors that may increase the risk of a heel stress fracture include:
- Heel fat pad atrophy
- An increase in running or training especially on hard surfaces.
- Poor running shoes
- Poor foot biomechanics leading to a decrease in shock absorption at heel strike.
- Diet deficiences or disease causing a decrease in bone strength.
Heel fat pad atrophy is a common factor in heel stress fractures and other causes of plantar heel pain. In heel fat pad atrophy the normally thick fatty pad under the heel bone is reduced and fails to shock absorb the heel. This results in excessive ground forces being transferred to the heel bone leading to an increased risk of a heel stress fracture.
Heel stress fracture diagnosis
A heel stress fracture can often be hard to diagnose clinically as symptoms are often similar to that of a bruised heel. A thorough history taking is essential as often it can flag risk factors associated with heel stress fractures. If our podiatrists suspect a heel stress fracture they will generally refer you for a MRI or bone scan to confirm diagnosis. X-rays are not useful as stress fractures can often be missed in the early stage of injury.
Podiatry treatment for a heel stress fracture
Treatment for a heel stress fracture by our Melbourne podiatrists is aimed at reducing forces on the heel bone to allow for healing. Once the heel bone has healed treatment is then aimed at identifying and eliminating the causative factors to help prevent future stress fractures from occurring.
Common initial podiatry treatment options include:
Secondary podiatry treatment options aimed at heel stress fracture prevention may include: