Physiotherapy for Calcaneal Stress Fracture

A calcaneal stress fracture refers to a fracture to the calcaneus, also known as the heel bone due to direct trauma. There are several muscles attached to the calcaneus, so when the muscles contract, they cause the bone to get pulled. Excessive forces due to repetitive weight bearing activities that exert pressure beyond what the bone can withstand can cause a fracture of the calcaneus bone. This will initially result in a stress reaction of the bone; however, repeated damage may progress to a more severe fracture.

Calcaneal stress fractures normally occur with time as people continue weight bearing activity such as running or marching, causing the condition to worsen and progress to  further complications.

Signs and symptoms

Patients with calcaneal stress fractures usually experience pain in the inner or outer region of the heel bone. Pain may increase with weight bearing activities such as running, jumping, marching or landing. In severe cases, the person may not be able to walk due to aggravating symptoms. Additional symptoms may include pain when you touch the affected region or night aches.


Treatment for stress fractures primarily involves rest from physical activities and weight bearing activities. Patients are instructed not to do aggravating activities as they may cause more harm than good. You may also be instructed to use a cane, crutches, walker or a protective boot to support you while you walk and rest your foot at the same time. Your doctor may immobilize your joint using a cast and rest from weight bearing activities may last up to 6 weeks or more, after which the doctor will remove the cast and you will be asked to wear a protective boot for a few more weeks. After this, follows the commencement of your rehabilitation exercise program were you will gradually increase weight bearing activity with mild exercises making sure symptoms do not increase. This should be continued for a period of several weeks or months under your physiotherapist’s supervision, depending on the severity of the damage.

Before resuming everyday physical activities, make sure you perform alternative exercises with minimal weight bearing forces on the injured bone in order to maintain fitness and preventing your foot structures from becoming stagnant. Mild exercises may include cycling on a stationary bike and swimming – make sure you do this under your physiotherapist’s supervision. Exercises must be perform to restore strength, flexibility and balance in order to allow your foot, ankle and heel to function properly once you are able to restart weight bearing physical activities.  Your physiotherapist will advise you on which exercises will suit you best depending on the severity of your condition.

Physical therapy for calcaneal stress fracture

Physiotherapy is essential for patients with calcaneal stress fracture in order to promote healing and reduce the patient’s chances of getting injured again. Treatment measures may include:

  • Soft tissue massage
  • Immobilization of the joint
  • Electrotherapy for ultrasound for pain
  • Taping
  • Usage of walkers, crutches or a cane to rest the foot
  • Hydrotherapy
  • Biomechanical correction
  • Flexibility, strengthening and balancing exercises
  • Gradually returning to advanced activity

Exercises for calcaneal stress fracture

Your health care provider may prescribe special strengthening and flexibility exercises to treat stress fractures. Consult your doctor about what exercise will suit you best. Exercises should generally be performed thrice a day, making sure that you do not worsen symptoms of the condition.

  • Foot ankle exercise: Up and down

Move your foot and ankle in an upward and downward motion as much as possible while you are seated. Make sure that this exercise does not cause any pain and you can only feel a subtle to moderate calf stretch. Repeat 10-20 times provided that symptoms do not worsen.

  • Foot and ankle exercise: In and out

Move your foot and ankle in an inward and outward motion while you are seated. Make sure that this exercise does not cause any pain and you can only feel a subtle to moderate calf stretch. Repeat 10-20 times provided that symptoms do not worsen.

For world class foot care and treatment on calcaneal stress fracture,  talk to any of our Perth physiotherapist for help.  Call Happy Physio today at 9272 7359!