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Another not-so uncommon cause of heel pain is stress fractures.

Another cause of heel pain, that is not plantar fasciitis, is a stress fracture.  These injuries are sometimes described as "the pain that stops you in your tracks."  These injuries can be very dangerous if not treated quickly.  It is important to understand what a stress fracture is, what they are caused by, and why it is so important that they are diagnosed and treated quickly.

A stress fracture is defined as a fracture caused by repetitive mechanical stress.  This is different than a typical fracture because a typical fracture is caused by a sudden mechanical stress beyond what the bone can absorb.  Stress fractures are also different from a typical fracture in that they do not crack a bone in half or into pieces. Rather, they are a collection of tiny cracks within the bone.  That being said, stress fractures that are left untreated can lead to a full fracture of a bone.  A good way to think of a stress fracture is to imagine a bone as a hard-boiled egg.  If you take a knife and cut through the shell and through the egg itself, this would be a complete fracture.  If you tap a hard-boiled egg on the counter, creating tiny cracks in the shell, while the inside of the egg remains intact - this would be a stress fracture. 

Stress fractures can occur in a variety of people.  People with osteoporosis are at a heightened risk due to the weakness within their bones.  In these individuals, a stress fracture can occur from walking more than usual or walking without shoes.  In many instances, a person with osteoporosis may not even recall any change in activity that could have caused the stress fracture.  Athletes are also very common victims to stress fractures.  Athletes can suffer a stress fracture due to a change in training, increase in mileage, change in running surface, or transition to a new style of shoes. 

A typical fracture takes 6-8 weeks to heal in an average adult.  This timeframe can be similar with stress fractures, or can be decreased if treated early and aggressively.  If the bone is not given enough time and rest to heal itself, additional stress can cause the stress fracture to break fully through the bone.  If this occurs, especially in the heel bone, it leads to detrimental arthritis that usually requires surgery somewhere in the future.

The best chance of not missing a stress fracture and having continued pain and worsening problems is to be aware of the signs of a stress fracture and to address the issue sooner rather than later.  Stress fractures of the calcaneus (heel bone) causes pain in the heel.  The intensity of the pain and how it impacts your activity is also important to note.  In many cases, a stress fracture will cause enough pain that a person literally feels like they cannot walk or run any farther.  The person will also notice some swelling in the foot and, if ignored, the pain will go from being present only with walking/running to being painful even at rest. 

Be in tune with your body and listen if your heel is telling you to stop.  In the best case scenario, stress fractures can calm down and heal in 3-4 weeks rather than 6-8.  Make an appointment with your podiatrist if you start having heel pain!