Heel pain is common, but sometimes discomfort signals a more serious injury, such as a fracture. Understanding the distinctions between a broken heel and a less severe sprain or bruise is important for seeking appropriate care. A heel bone fracture requires prompt medical attention for proper healing and to prevent long-term complications.
Key Indicators of a Broken Heel
A broken heel, or calcaneus fracture, typically results from significant force, such as a fall from a height or a car accident. This injury often presents with immediate, intense pain, making it impossible to bear weight on the injured foot.
Visible signs include substantial swelling around the heel and ankle, which can appear rapidly. Extensive bruising, sometimes extending to the sole of the foot or up the ankle, is also common. In more severe cases, the heel may appear widened, shortened, or deformed. Tenderness to touch, particularly when squeezing the sides of the heel, can further suggest a fracture.
Differentiating a Fracture from Other Heel Pain
Distinguishing a heel fracture from other common causes of heel pain, such as a severe bruise, sprain, or plantar fasciitis, involves observing the nature of the pain and accompanying symptoms. A severe heel bruise shares symptoms with a fracture, including pain, swelling, and bruising. However, bruise pain is typically less intense, and while walking might be difficult, it is often not entirely impossible, unlike with a fracture.
Heel sprains involve damage to the ligaments supporting the heel, rather than the bone itself. While a sprain can cause pain and swelling, the immediate, severe pain and inability to bear weight seen in a fracture are generally not as pronounced. Plantar fasciitis, a common cause of heel pain, involves inflammation of the plantar fascia tissue on the bottom of the foot. This condition typically causes a stabbing pain worst with first steps in the morning or after rest, often improving with movement. In contrast, fracture pain is usually sudden, consistently severe, and does not improve with initial movement.
Stress fractures of the heel bone are tiny cracks that develop over time due to repetitive stress. The pain from a stress fracture usually has a more gradual onset and worsens with continued physical activity, easing with rest. This differs from an acute heel fracture, which typically results from a single, high-impact event and causes immediate, intense, and debilitating pain.
Next Steps and Medical Consultation
If a heel fracture is suspected, immediate action is important to manage the injury and prepare for medical assessment. Applying the R.I.C.E. protocol—Rest, Ice, Compression, and Elevation—can help reduce swelling and pain. Resting the foot, applying ice packs for 15-20 minutes every one to two hours, compression with a bandage, and elevating the foot above heart level all contribute to reducing swelling.
Seeking professional medical attention promptly is necessary for an accurate diagnosis and appropriate treatment. A healthcare provider performs a physical examination to assess the injury, including checking for tenderness and range of motion. Imaging tests, such as X-rays, are commonly used to determine if the calcaneus is broken. A computed tomography (CT) scan may also be ordered for more detailed images of the bone and to assess fracture severity, which guides treatment decisions.