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Heel pain and can't walk

by David
(Stockton)

I jumped off a 6ft wall and landed on my heels, straight away I felt a sharp pain in my heel at first I could walk on it but not as much n now 3 days later Its got worse n I try not to walk on it at all and I keep getting a dull pain when not walking on it. If I have to walk I walk on the outside of my front of my foot. I went for a xray the day after I done it and they said they can't find anything wrong with it. I don't know what to do.!!!!??


RESPONSE
Hi David,
Many times an x-ray is not enough in order to make an accurate diagnosis. The fact that it appears to be getting worse is obviously cause for concern.
In many instances an initial x-ray right after trauma may not show small fractures. It can take upwards of ten days to reveal some of these breaks.
You do not mention what type of doctor treated you but my advice would be to seek the services of a foot specialist who is best suited to treat these kinds of situations.
If the foot is terribly painful my first piece of advice would be to get off the foot and go non-weightbearing with the use of crutches. This is recommended for two reasons. One, the foot will not hurt as much and two, you will limit further damage to the heel. If there is a break or even a ligament or tendon tear, continued walking on the heel will cause further damage.
If you were to walk into my office I would probably order an MRI rather than wait another few days to re-xray the foot.
An MRI will not only show a fracture that an x-ray failed to show, but might also reveal any soft tissue damage such as a ligament tear or muscle tear.
Structures such as the achilles tendon, the plantarfascial ligament and most of the muscles on the bottom of the foot all attach into the heel so there is always the possibility you did damage to some of those structures.
The only good news that I come up with based on your story is that even if there is a fracture of the heel bone it is probably a simple fracture rather than some of the more serious fractures known to occur in the heel. The only question I would have, is who read your x-ray? Was it read by a radiologist or foot specialist? Any one else reading the initial x-ray such as your family doctor might not be qualified to look for a break in the heel bone, particularly where it comes in contact with the talus bone which is the bone above the heel bone.
In any event, make sure you are seeing the proper type of doctor in order to receive appropriate treatment. You do not want this to become a chronic issue.

Marc Mitnick DPM
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