Calcaneus Fractures: A Complete Guide

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Your feet bear a lot of weight over the course of your life, but it’s still easy to forget how strong these parts of our body are.

Most of the time, we’re more inclined to notice our feet when we’ve hurt ourselves and they can no longer bear our weight as easily. Such is the case with the calcaneus fracture.

heel bone

“What is calcaneus?” you may ask, “And what does a calcaneus fracture do that’s so attention-grabbing?”

This guide to calcaneus fractures will give you more information about the calcaneus, its purpose, and the signs you need to look out for if you suspect you’ve injured this foot bone.

Identifying the Calcaneus

Your foot isn’t just made up of one uniform bone. As a matter of fact, there are various tendons connecting twenty-six separate bones throughout the entirety of your foot.

These twenty-six bones are divided between hindfoot, midfoot, and forefoot bones. Your toes take up all but seven of these bones, leaving the calcaneus to dominate the back of your heel.

That means, of course, that the calcaneus bone is more commonly known as your heel bone.

According to the authorities at OrthoInfo, it is one of the largest bones in your feet, and it creates the foundation on which you rest the bulk of your weight as you walk.

The calcaneus is a bit of an odd bone, because it’s not structured in the same way other bones in your body are. Different bones, like your tibia (or shinbone), have a thick exterior that protects the marrow inside.

The official website of the American College of Foot and Ankle Surgeons compares your calcaneus to a hardboiled egg, because the exterior of the bone is actually quite thin, whereas the center is softer than most others. This softness makes it easier for the heel bone to bear your weight.

Understanding Calcaneus Stress Fractures

Heel injuries like a calcaneus stress fracture occur when that thin, eggshell-like exterior of the calcaneus is damaged.

When force is applied to the calcaneus that the bone is unable to bear, the bone is known to crack into a number of pieces, not usually breaking but instead developing fissures all along its structure.

heel bone

When this happens, the soft center of the bone is exposed and has to bear your weight all on its own.

Prolonged exposure to that weight can cause the interior of the calcaneus to become unnaturally wide or to shorten, which, in turn, makes it more difficult for you to walk. That’s not to mention the pain that arises when this softer material is exposed to any amount of weight.

A calcaneus fracture can develop on its own after a traumatic event, but these fractures have also been known to develop alongside sprained ankles or other injuries to the foot.

Frequency of Calcaneus Fractures

Calcaneus fractures are not especially common injuries for the average person to suffer from, due to the trauma that the heel bone must undergo in order to fracture.

However, according to a study performed by Stephanie Mayer and her peers, because these fractures can appear after a person sprains their ankle or injures another part of their foot, calcaneus fractures are more often seen in athletes than other populations.

Causes of Calcaneal Fractures

That connection to athletics may give you some idea as to what causes your average calcaneal fracture.

According to Chilan Leite and peers, these sorts of fractures are more likely to appear during events that may otherwise be physically traumatic. This means that you may find yourself at risk for a calcaneal fracture after taking a fall from a high place or getting into a car crash.

If you do spend a lot of time playing some kind of sport, you may find yourself with a calcaneal fracture after tripping over your own feet or getting tackled to the ground.

Leite et. al elaborates on these causes of calcaneal fractures, emphasizing that most appear when you fall from a great height, twist your ankle, or have your heel crushed due to some sort of trauma.

If none of these events have occurred by the time you start to notice bruising on your heel, then there may be another cause for the discomfort you’re experiencing.

Fractured Heel Symptoms

If you think you’ve developed a calcaneal stress fracture, keep an eye out for some of the following symptoms:

heel injuries

  • Sudden pain in your heel.
  • Difficulty walking or bearing weight on a particular foot.
  • Swelling or bruising in your heel and ankle.
  • Pain in your foot that develops slowly over several days.

A bruised heel is one of the surefire signs that something’s not right with your calcaneus, as that bruising indicates internal bleeding.

The gradual development of pain in your foot over the course of several days, though, can be a far more severe symptom.

Your foot will try to compensate for the fracturing of the calcaneus at first, but aggravating the fractures by continuing to expose that fragile interior to pressure will make the pain significantly worse over time.

By the time it becomes too difficult for you to walk, you may have agitated your injury to the point where home remedies for the fractures are no longer enough. You’ll have to seek medical attention.

Fracture Severity

The severity of your fracture will depend on a number of symptoms, but you won’t be able to know how bad the fracture is until you seek medical attention.

There are still different degrees of fracturing, though, that you should be aware of, especially if you’re just assessing your heel for any potential damage.

Number of Fractures

If you’ve experienced a tremendous amount of trauma and, in turn, injured your heel, then any fractures in the bone may have the opportunity to spider or fracture further.

The number of fractures you have in your calcaneus will impact how severe your injury is. The more fractures you have, the more diligent treatment you may require.

what is calcaneus

Fracture Disruption

The trauma you experienced can also leave the portions of your fractured calcaneus pressed up against one another, like puzzle pieces fitted correctly – or at uncomfortable and disjointed angles.

If your calcaneus’s pieces have been displaced, OrthoInfo says that there may be large gaps between the bones and, thereby, greater exposure of the soft interior.

Cartilage Injuries

That exposure may lead to more severe injuries within the cartilage of the fractured bone itself, as well as injuries to the joints surrounding your calcaneus.

If your injury is not localized to your calcaneus, you may have more than just a bruised heel to worry about in the long run.

Here’s a video explaining more on calcaneus fractures.

When to See Your Doctor

That said, you don’t need to rush to the doctor’s office at the first sign of pain in your heel.

Look back to the list of symptoms that suggest the onset of a calcaneus fracture. After this, take into account any that you’ve noticed over the past several days, as well as an event that may have caused the fracture in the first place.

If you have reasonable cause and physical symptoms of a fracture, then go to the doctor’s office and request an x-ray to determine whether or not treatment is needed.

Examination Expectations

When you get into the doctor’s office, your doctor will have to take several steps to evaluate the severity of the injury that’s bruised your heel.

Before you have an x-ray taken or have to endure a CT scan, though, your doctor will test your ability to move your toes and feel pressure on the bottom of your foot.

The pulse your doctor takes from your foot will also help them understand what kind of injury you may have developed.

Calcaneal Stress Fracture Treatment

It’s crucial that you leave your doctor’s appointment with a treatment plan that’s appropriate to the severity of your injury.

There are a number of home remedies that you can try, so long as the fracture isn’t too severe.

If things have gone askew in your foot, it’s possible that surgery will be needed to fill the gaps between the fractures in your heel bone.

Home Remedies

If your fracture isn’t too severe, then OrthoInfo says that you’ll be able to use a RICE treatment, or Rest, Ice, Compression, and Elevation.

bruised heels

Start off by ensuring you get enough Rest. This means sleeping so that your body can begin to recover, as well as keeping weight off your foot over the course of the day.

Don’t let your frustration about the injury drive you to act like everything’s normal. If you do, you’ll likely worsen the damage.

Ice will also help you deal with any swelling that arises in your heel or ankle. Be sure not to over-expose your skin to any ice, or else you may have to deal with freezer burn.

Make use of a covered ice pack and take breaks between treatments. This will make the results most effective.

Compression will require you to keep pressure on your foot as often as possible. You can achieve this by wearing a weighted sock or by securing your heel and ankle in a foot wrap. This will ensure that the fractured pieces of your calcaneus don’t shift when you do move, allowing you to heal all the more quickly.

Finally, Elevation means keeping your foot positioned above your waist for a good amount of time while recovering.

When you’re lying on the couch, prop your injured foot up with a pillow or rest it on a nearby chair. Elevating your feet ensures that your blood continues to circulate properly throughout the whole of your body. This makes the healing process all the easier when you’ve sustained an injury.

Surgical Treatment

FootCareMD and the American Orthopaedic Foot & Ankle Association note that, should your injury be severe enough, your doctor will likely recommend surgery to bind your calcaneus back together.

This surgery may have to wait until the swelling around your heel and ankle has decreased, but each individual surgery will vary on the severity and expansiveness of the fracture.

This source does make a point in saying, however, that waiting to have surgery to restore a calcaneus is one way to prevent complications in the long run.

Surgery to heal a fractured heel is most often considered necessary. A doctor may feel that it is essential to clean the wound that’s developed and to remove any tissue that may have been damaged on initial impact or in the days that have passed since that initial trauma.

If you have surgery to fix a calcaneus fracture, then you may come away from the doctor with a percutaneous screw fixation, or screws inserted into your bone in order to hold the pieces together.

calcaneus bone

Alternatively, the surgeons you work with may be able to fit the pieces of your calcaneus back together without screws, instead relying on wires or metal plates to protect the soft interior of the bone from uncomfortable exposure.

Physical Therapy

No matter what, you’ll likely undergo physical therapy to recover from a calcaneus fracture. Again, the therapy you’re prescribed will vary based on the severity of your fracture.

Altogether, physical therapy will help you regain the original range of motion in your foot and ankle, while also strengthening the joints and muscles that help you walk on a daily basis.

These exercises may cause you pain at first, but if you don’t perform them on a regular basis, it’s possible that you’ll forever alter the way you walk and do more harm to your foot than good.

Calcaneus fractures, then, while not especially common, can still be injuries that lead to significant consequences, should the initial fracture be allowed to become more severe.

This video explains more about how to treat a calcaneus stress factor.

If you notice bruising in your ankle or have difficulty walking after a car accident or a fall from a high place, arrange an appointment with your doctor and do what you can to stay off of your feet. Your calcaneus will thank you in the long run.

Do you have experience dealing with a calcaneus fracture?