Heel Injuries

Heel injuries occur for various reasons, as they can affect any of its components. However, the most common ones involve the bones, tendons, and skin.

The most notable heel injuries can vary in severity:

• Calcaneus fracture: This refers to fractures of the back bone of the foot, usually caused by a strong impact, such as a fall from a height, or by engaging in high-impact sports like volleyball or basketball. While not very common, they can lead to severe complications if not diagnosed and treated promptly.
• Achilles tendinitis: This is inflammation of the Achilles tendon due to overuse or trauma. It is common among runners, especially those with improper foot placement, or athletes participating in explosive sports that require frequent changes of pace, such as soccer or tennis.
• Achilles tendon rupture: This occurs when the tendon tears or completely ruptures due to excessive stretching. It primarily affects individuals who engage in sports regularly.
• Retrocalcaneal bursitis: This condition involves inflammation of the heel bursa, a synovial sac that protects the bones, muscles, and tendons by cushioning impacts and reducing friction. It is typically caused by excessive use of the joint, making it common among athletes who run or jump frequently.
• Heel spur: These are calcium deposits that develop on the heel, usually as a result of chronic plantar fasciitis.
• Plantar fasciitis: This is inflammation of the fascia membrane (fibrous tissue connecting the toes to the heel), causing pain mainly along the inner sole and heel.
• Heel wounds: These involve cracks that cause the skin on the heels to split. Although mild, if left untreated, they can lead to more severe problems, such as infections. They are often caused by a lack of foot hydration or wearing inappropriate footwear.

Although heel injuries can be very uncomfortable, they rarely lead to complications. Nevertheless, it is advisable to consult a specialist at the first sign of discomfort to diagnose and treat the issue as soon as possible.

Symptoms

Since heel injuries vary, their symptoms also differ. The most significant ones include:

• Calcaneus fracture:
• Pain, especially when bearing weight on the heel.
• Swelling in the ankle and sometimes the entire foot.
• Bruising.
• Deformity.
• Achilles tendinitis:
• Pain above the ankle that starts after exercise.
• Stiffness.
• Achilles tendon rupture:
• Intense pain.
• Swelling in the heel area.
• Inability to bend the foot, stand on tiptoe, or walk.
• Retrocalcaneal bursitis:
• Heel pain.
• Swelling.
• Redness.
• Sensitivity to touch.
• Stiffness.
• Difficulty walking.
• Heel wounds:
• Dry skin.
• Cracks of varying depth.

Causes

On the one hand, calcaneus fractures, Achilles tendinitis, and retrocalcaneal bursitis are caused by trauma or excessive use of the foot and its joint, often due to occupational reasons or the practice of certain sports.

On the other hand, cracks on the heels usually appear when proper foot care and hygiene are neglected.

Risk Factors

The main factors that increase the risk of heel injuries include:

• Age: Over time, bones weaken, and tendons become more rigid.
• Physical foot deformities: Such as flat feet (low arch) or high arches (excessively pronounced arch).
• Obesity: Excessive weight puts additional strain on the heel.
• Regular physical exercise: Engaging in sports frequently.
• Professional athletes.

Complications

Heel injuries can be disabling as they often prevent proper weight-bearing on the foot. If not treated correctly, they can lead to various complications:

• Calcaneus fracture: Compartment syndrome due to increased pressure in the soft tissues of the ankle, posing a greater risk of muscle contractures, chronic pain, or toe stiffness.
• Achilles tendinitis: Achilles tendon rupture, leading to the inability to bend the foot, stand on tiptoe, or walk.
• Achilles tendon rupture: Muscle mass loss or movement limitations.
• Retrocalcaneal bursitis: Restricted foot movement or infection in the synovial sac.
• Heel wounds: Deep cracks that can result in infection.

Prevention

Maintaining good foot health and training properly are essential to preventing heel injuries. Some key aspects include:

• Strengthening the calf and ankle muscles.
• Warming up before intense exercise.
• Stretching after sports activities.
• Wearing appropriate footwear: comfortable, cushioned to reduce pressure, and providing proper support.
• Keeping heels clean and moisturized throughout the year.

Which Doctor Treats Heel Injuries?

Heel injuries are treated by specialists in traumatology and orthopedics or by sports medicine doctors.