Breaks or fractures (they are the same thing) of the heel bone can be incredibly painful and 99% of the time are due to a falling or high force trauma.  The heel bone, or calcaneus, is the largest bone in the foot and is designed to take tremendous stresses. Think about how much pressure we place on it just walking, so it takes a lot of force to actually break it. Most of the time the trauma involves a significant force like falling off a ladder, jumping off the back of a truck or the pressure of a brake pedal pushing back on the foot during a car accident.  

When this occurs, the foot becomes very swollen and often has a wider appearance of the heel compared to the uninjured foot. This bone is very vascular so when it breaks, you are going to see a lot of bruising.  The bruising usually surrounds the heel bone, which is a class sign of a calcaneal fracture. It is often too painful to apply pressure to the heel and by the way it feels you probably know something bad happened!

Best thing you can do is get off the foot, put ice on it immediately, and call our office right away. If it is after hours or on the weekend, get yourself to the ER. Small breaks that are not dislocated often heal well with immobilization like a boot or a cast. But significant breaks usually need surgery to put the bone back together and reduce the chances of severe arthritis in the future. 

These things hurt...a lot. But left untreated, can result in severe, debilitating arthritis down the road.