A friend of my family has a son that runs track at Seabreeze High School. He continued to have problems with pain in his heel for months and months. Finally that friend gave me a call, and his son came in and was treated for heel pain with insoles and medication. When the patient came back two weeks later, the pain had not improved at all. I then ordered an MRI, which showed a stress fracture of the heel. The patient was then placed in an immobilization boot, and his pain was gone within four weeks. 

Heel pain is not always caused by a ligament or an inflammatory process, and is sometimes caused by a crack or break in the bone. Heel stress fractures are caused by shock and overuse. Runners who have been resting for months may shock their foot muscles by trying to match their earlier mileage without proper warm up. Runners practicing for longer than the required number of hours may also develop fractures of the heel. Inadequate or improper equipment like ill-fitting sports shoes may also cause heel stress fractures. Changes in the running surface, such as running on in indoor track to a harsher outdoor track can contribute to the development of stress fractures.

Conditions like flat-footedness, osteoporosis, and bunions can also radically alter the way the foot works, making it more prone to stress fractures.


Because X-rays are not very effective in detecting stress fractures, most doctors recommend patients to undergo a more thorough radiographic test. MRI or bone scan are much more precise than X-rays and can spot fractures of the heel at their early stages.


Heel stress fractures, with immobilization, heal on its own. Most patients are required to shift to a stiffer soled shoe or braced shoes for two to four weeks, depending on the severity of the heel fracture. Athletes, especially runners who need to maintain high levels of physical activity are usually advised to temporarily switch to another sport until their fractures heal. Swimming, for example, is an excellent alternative and does not put stress on the affected area. Don't continue to struggle with heel pain, as there may be more to the pain than just a ligament.

The physicians at Atlantic Foot and Ankle Associates want you to continue doing what you love… pain free!  We have four offices conveniently located in Palm Coast, Daytona Beach, Port Orange, and Orange City, so come in and visit us so we can get you healthy and back on your feet again!

By Dennis McBroom, DPM, FACFAS

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