The fat pad squeeze test is a diagnostic tool your doctor may use to rule out stress fractures and bursitis before ordering imaging scans, or making a diagnosis of plantar fasciitis.

Keep reading to learn what you should expect from a calcaneus squeeze test, when your doctor may use this test, and whether you can do this test at home.

What to Expect From a Calcaneus Squeeze Test

A calcaneus squeeze test is a very simple diagnostic tool, that can be performed in just a few seconds in your doctor’s office.

During the fat pad squeeze test, you will lie down on your stomach, with your knees flexed so that the doctor can easily examine your heels.

Your doctor will then squeeze the fat pad of your heel, using three different motions to compress the back, sides, and middle of the heel. Depending on the location and severity of pain during the squeeze test, your doctor can rule out stress fractures and bursitis of the heel, or confirm a diagnosis of plantar fasciitis.

What Your Doctor Can Learn from a Fat Pad Squeeze Test

A fat pad squeeze test can be helpful in two different ways: The test can help confirm your doctor’s diagnosis of plantar fasciitis, bursitis of the heel, or stress fracture in the heel depending on where you feel pain during the test. Or the test can help rule out one or more of these diagnoses. Sometimes initial symptoms of heel pain can present similarly, and the heel squeeze test can hone in on a more precise locus of pain and help your doctor decide whether further imagining is needed.

Plantar Fasciitis or Heel Fracture: Tenderness or discomfort when the doctor presses down on the middle of your heel indicates potential plantar fasciitis. More intense pain indicates a possible heel fracture.

Retrocalcaneal Bursitis: Pain when the doctor presses down on the back of the heel indicates likely inflamed bursa at the back of the heel, or retrocalcaneal bursitis.

Heel Fracture: Sharp pain that results from squeezing the sides of the heel is a warning sign of a heel fracture.

When Your Doctor Might Use the Heel Pain Squeeze Test

Your doctor may decide to perform a heel pain squeeze test any time you are experiencing severe heel pain that makes it difficult to walk or go about your daily activities. Fat pad squeeze tests can be especially helpful in confirming or ruling out stress fractures, in cases where a case of plantar fasciitis does not seem to be improving with conservative care.

If you have any of the following symptoms, that seem to indicate a possible stress fracture or retrocalcaneal bursitis, your doctor may want to do a fat pad squeeze test:

  • Pain that gets worse the longer you are on your feet
  • Pain that is extremely sensitive to the touch, on the back, sides, or middle of the heel
  • Pain that improves somewhat with a long period of rest
  • Pain that gets worse when you stand on tiptoe or flex your feet downward (this can indicate bursitis)

Can You Do the Fat Pad Squeeze Test At Home?

While the fat pad squeeze test might sound simple, you shouldn’t try it yourself at home. For one thing, it will be difficult (without extensive knowledge of the ligaments, bones, and tendons in the foot) to know precisely where to squeeze during each movement.

And just as importantly, without training to help you know how hard to squeeze, it’s possible that you may inflict further damage or pain on an already tender area! If your heel is extremely tender to the touch, can’t support any weight, and gets worse (instead of improving slightly) with stretching and movement throughout the day, it’s time to schedule a doctor’s appointment. You may have a stress fracture or bursitis, instead of plantar fasciitis.

Do I Need to Get a Heel Pain Test?

If your symptoms are consistent with mild to moderate plantar fasciitis, you likely don’t need a heel pain test. The overwhelming percentage (90%) of plantar fasciitis cases can be resolved simply with conservative care, at home within about 3-6 months. Get plenty of rest, ice your feet to manage pain and inflammation, stretch your feet to help improve mobility and strength in the plantar fascia, and wear orthotic inserts to realign and support the damaged fascia.

If, however, your symptoms are severe or inconsistent with mild to moderate plantar fasciitis (for example, extreme tenderness to the touch), you should make an appointment with your doctor, who may decide to perform a heel pain test.