Ace Physiotherapy and Sports in Singapore
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ACE PHYSIO SPORTS
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Stress Fracture of the Calcaneus
What is a stress fracture of the calcaneus?
A calcaneal stress fracture is a small crack or incomplete fracture in the heel bone (calcaneus). Physiotherapy plays an important role in the treatment and recovery of this type of stress fracture.
How does a stress fracture of the calcaneus happen?
Stress fractures of the calcaneus occur when there is an imbalance between bone formation and bone resorption. During weight-bearing activities, such as running or jumping, the heel bone responds to the increased demands by increasing bone turnover. This process is necessary to adapt to the stress being placed on it.
When repeated stress is placed on the calcaneus, small areas of bone can become damaged. These areas are then resorbed and replaced with new bone. However, if new bone forms more slowly than the old bone is removed, weak spots begin to form in the stressed areas of the calcaneus. If these weak areas continue to be overloaded, they can eventually develop into a stress fracture.
A recent change in training habits is often a contributing factor in the development of a stress fracture. This may include an increase in training frequency, duration, or intensity, as well as changes in training surface or footwear.
What are the symptoms of a stress fracture of the calcaneus?
A calcaneal stress fracture usually causes heel pain that develops gradually over time. Activities such as walking or running tend to make the pain worse. Pressing or squeezing the back of the heel from both sides often produces significant pain. Other symptoms may include:
- Swelling around the heel or ankle
- Tenderness to touch, especially at the sides or bottom of the heel
- Pain when standing for long periods
- Discomfort that improves with rest and worsens with activity
- Difficulty pushing off the foot while walking or running
- Pain that persists even when wearing cushioned or supportive footwear
What should I do if I have a stress fracture of the calcaneus?
If you suspect that you have a stress fracture or a heel injury, you should book a physiotherapy appointment as soon as possible.
What shouldn’t I do if I have a stress fracture of the calcaneus?
If you suspect a stress fracture of the calcaneus, you should not continue exercising through the pain. Continuing to put weight through the heel can further weaken the bone and potentially lead to a larger fracture.
Physiotherapy treatment following a stress fracture of the calcaneus.
Physiotherapy plays a key role in treating a stress fracture of the calcaneus. Your physiotherapist will first make a diagnosis, which may involve referral for imaging such as an MRI scan. Based on this, an appropriate treatment plan will be developed. In the early stages, this may include a period of rest, use of crutches, and icing to help manage pain. A tailored programme will also be created to help you maintain cardiovascular fitness and muscle strength without delaying healing — using low-impact activities such as swimming, deep-water running, cycling, or other forms of cross-training. Other treatment may include:
- Gradual weight-bearing progression as the bone begins to heal
- Foot and ankle strengthening exercises to restore muscle support and stability
- Stretching exercises for the calf muscles and plantar fascia to reduce stress on the heel
- Manual therapy or joint mobilisation to improve ankle movement if stiffness develops
- Taping or support bracing to protect the heel and offload pressure during walking
- Orthotic advice or cushioning insoles to reduce impact forces on the heel
- Education on footwear and training modifications to prevent re-injury during return to activity
Your physiotherapist can also help determine the underlying cause of your calcaneal stress fracture and address these factors during your rehabilitation, helping to prevent the injury from recurring when you return to full activity.
Could there be any long-term effects from a stress fracture of the calcaneus?
Stress fractures represent areas of weakness in the bone. As long as the injury is managed correctly and activity is only resumed once the fracture has fully healed, there should be no long-term complications.
To arrange an appointment, please call +65 81535374 or visit acephysiosports.com.
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