Symptoms | Fatigue fracture of the heel

Symptoms

Like almost all sports injuries, fatigue fracture can manifest itself in many different ways. For the attending physician, the decisive factor is the overview of all the patient’s symptoms and the course of the injury, which is determined in the course of the so-called anamnesis. Often the first sign is a rather unspecific, uncomfortable feeling in the heel area, which occurs during prolonged and/or heavy strain and disappears again when the patient is at rest.

In the course of time, this unpleasant feeling quickly turns into pain if the patient does not adjust his training schedule. Initially, the pain also occurs only under stress and improves completely at rest. If the pain also occurs at rest, the fatigue break has usually already occurred at this stage.

If the person continues to train (now mostly under pain) or even intentionally numbs the pain, the last step to permanent pain is only small. Nevertheless, the heel is seldom reddened or overheated in all phases, but often very painful under pressure. In individual cases, however, completely different symptoms or a different course of the disease may occur. In any case, it is advisable to consult a doctor quickly in the case of a large training load and load-dependent pain in order to prevent any further deterioration of the symptoms in good time.

Diagnosis

Compared to the relatively clear diagnosis of a “normal” fracture, the diagnosis of a fatigue fracture of the heel is rather complicated. The diagnosis of a “normal” fracture can easily be confirmed by classic symptoms such as severe pain, visible malpositioning, a major accident shortly before and additionally a simple x-ray. However, if a fatigue fracture is present, the difficulties often begin before the first contact with the doctor.

Initial slight pain does not immediately limit the patient, so it often takes a long time before he even consults a doctor. In the case of a fatigue fracture, it is initially not clear whether the symptoms can also be a direct consequence of training or possibly also muscular or ligamentous injuries. An X-ray of the foot can show a fatigue fracture in the heel area. Often, however, even an experienced radiologist will not see anything pathological at first. The same applies to computer tomography images.A large number of fatigue fractures are only diagnosed after a long time and several visits to the doctor using magnetic resonance imaging (MRI).