A heel fracture is the break or crack of the calcaneus bone, causing symptoms such as intense pain, swelling or bruises there, as well as the inability to place the foot on the ground and place body weight on the heel.
This type of fracture can be caused by impacts such as falls, accidents or jumping on hard surfaces, causing the calcaneus bone to become shortened, flattened or widened. Additionally, overuse or repetitive strain, such as running, can cause a stress fracture of the heel.
A heel fracture is serious, it usually leaves sequelae and takes a long time to recover and the person may have to spend 8 to 12 weeks without being able to place their foot on the ground. During this period, the doctor may recommend treatment with cast immobilization, followed by the use of a splint which can be removed for physiotherapy.
Heel fracture symptoms
The main symptoms of a heel fracture are:
- Severe pain and swelling in the heel;
- Purple spots or bruises on the heel, which may extend to the arch of the foot or ankle;
- Inability to place body weight on the heel;
- Difficulty placing your foot on the floor.
These symptoms generally appear and are more intense after trauma to the foot or ankle, such as accidents, falls or jumping on hard surfaces.
In the case of a stress fracture in the heel, the symptoms are usually milder, and pain or discomfort may appear in the heel, which worsens throughout the day. See other symptoms of stress fracture.
How to confirm the diagnosis
The diagnosis of a heel fracture is made by the orthopedist by evaluating the symptoms, as well as when they started, health history, history of falls, accidents or sports, in addition to a physical examination of the affected foot.
If you have symptoms of a heel fracture and want an orthopedist to evaluate you, make an appointment in the nearest region:
To confirm the diagnosis, the doctor must order imaging tests, such as X-rays or computed tomography, for example, as they allow you to assess the angle of the fracture and whether the small joints of the foot, ligaments and tendons have also been affected.
Possible causes
The main causes of heel fracture are:
- Injuries or sprains to the foot or ankle;
- Falls from height;
- Car accidents;
- Jumps on hard surfaces;
- Trauma by blunt or penetrating objects.
Furthermore, a calcaneal fracture can also arise due to excessive or repetitive use of the feet, usually during sports such as running, for example.
How the treatment is carried out
Heel fracture treatment must be carried out under the guidance of an orthopedist, with the aim of consolidating the fracture and restoring its anatomy and function.
Therefore, the main treatments for heel fractures are:
1. Immobilization
Heel fracture treatment begins with immobilization with a plaster cast for approximately 15 to 20 days, in order to prevent the joint from moving or placing weight on the heel, allowing it to heal.
After removing the plaster, the doctor should recommend the use of a splint or boot that can be removed for physical therapy.
To make it easier for the person to move beyond the boot with a cast, the doctor may recommend that they use crutches, but without ever placing their foot on the ground, and therefore the ideal is to move as little as possible, remaining more seated or lying down.
2. Elevate your foot
Elevating the foot helps relieve swelling because it promotes blood circulation and the lymphatic system, so that blood circulates normally throughout the body again.
Therefore, it is recommended to elevate the affected foot above heart height when lying or sitting, placing cushions or a pillow under the ankle.
3. Use of medicines
To relieve pain and swelling in the heel, the doctor may recommend the use of analgesic or anti-inflammatory medications, such as paracetamol or ibuprofen, for example.
4. Physiotherapy
Physiotherapy can be started as soon as possible, even before the fracture solidifies and aims to help consolidate the fracture, eliminate the hematoma and de-swell the foot.
To do this, the physiotherapist can use different techniques such as magnetron or cryotherapy, as well as stretching exercises for the leg muscles and techniques to move the fingers and ankle, always respecting the pain limit and range of movements.
In addition, elastic bands of different intensities can be used to position the toe of the foot up, down and move the foot side to side.
5. Surgery
Surgery for heel fracture is performed by an orthopedist and is generally indicated in cases of dislocation of the calcaneus bone, presence of bone fragments or compression of the lateral tendons due to enlargement of the bone, for example.
This surgery does not need to be performed as soon as the fracture is identified, but can wait until the region is less swollen. However, in cases of an open fracture, surgery is performed immediately.
The surgery is time-consuming and the use of plates or screws, or even a bone graft, may be recommended to fix the calcaneus bone. In some cases, external fixation devices can be placed.
How long does it take to recover
Recovery from a fractured heel can take a little time, and normally it can take 3 to 4 months to put your foot on the ground again.
However, this time varies according to the severity of the fracture, and in the most serious cases, the total recovery time can take from 12 to 24 months.
When to return to work
Normally, the person can return to work 6 months after the heel fracture and during this period they can take leave from work so that they can undergo the necessary treatment.
Possible complications and sequelae
The main complications of heel fracture are:
- Osteomyelitis;
- Arthrosis;
- Pain in the heel and ankle joint;
- Stiffness and difficulty moving the ankle in all directions;
- Widening of the heel, which can make it difficult to wear closed shoes;
- Pain in the sole of the foot, with or without a burning or tingling sensation.
It is not always possible to identify when these complications may occur, but it is possible to avoid them by following all the instructions from the orthopedist and physiotherapist.
