A bruised heel, medically known as a calcaneal contusion, is a common injury affecting the heel bone (calcaneus) and surrounding soft tissues. The calcaneus is the largest bone in the foot and is cushioned by an elastic fat pad designed to absorb the immense forces generated during walking, running, and jumping. When a person lands forcefully or repeatedly impacts a hard surface, this protective fat pad can be compressed and damaged, leading to bruising of the soft tissue or the bone underneath. Since the heel must bear the body’s entire weight with every step, this injury is particularly painful and often slow to resolve.
The Typical Healing Timeline
The recovery time for a bruised heel varies significantly depending on the injury’s severity and whether the damage is confined to the fat pad or extends to the bone. A mild contusion, affecting only soft tissue, typically resolves within one to three weeks. This shorter timeframe applies when the pain is manageable and does not prevent limited weight-bearing activity after the first few days of rest.
If the impact caused a deep bone bruise, the healing period extends considerably, often requiring four to six weeks for noticeable recovery. Moderate to severe bone bruises may take six to eight weeks of conservative treatment, and in rare instances, complete resolution can take up to six months. Factors such as age, overall health, and compliance with activity modification directly influence how quickly the injury heals.
Persistent weight-bearing activity, such as running or long periods of standing, is the primary factor that slows recovery. Protecting the heel from impact is crucial, as pushing through the pain can lead to chronic inflammation or a more serious stress injury.
Immediate Steps for Relief and Recovery
Managing the initial pain and inflammation of a bruised heel centers on protecting the injury and reducing swelling. The R.I.C.E. protocol—Rest, Ice, Compression, and Elevation—provides a framework for immediate self-care. Rest involves limiting weight-bearing activities, potentially using crutches or a cane during the initial days to remove pressure from the heel.
Ice should be applied to the heel for 15 to 20 minutes every two to four hours to reduce localized pain and control swelling. Compression with an elastic bandage helps minimize swelling, but it must be wrapped snugly without cutting off circulation to the toes. Elevating the foot above the level of the heart uses gravity to encourage fluid drainage and reduce swelling.
Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can manage pain and inflammation during the acute phase of the injury. Beyond the initial days, supportive footwear is necessary for preventing re-injury and promoting healing. Shoes should offer generous cushioning and arch support.
Specialized heel cups or shock-absorbing orthotics are effective in redistributing pressure away from the heel. A slight heel elevation can also reduce the stress placed on the heel tissues during walking.
Recognizing When Professional Care is Necessary
While many bruised heels improve with self-care, certain symptoms indicate a more serious injury requiring a medical evaluation. The inability to bear any weight on the foot immediately following the injury warrants professional attention. Persistent, severe pain that does not improve after a few days of rest and at-home treatment is also concerning.
Other signs include severe, rapidly increasing swelling, a visible deformity, or symptoms of nerve involvement like numbness or tingling in the foot. If the pain persists beyond six weeks despite consistent conservative care, the injury may not be a simple bruise.
A doctor will perform a differential diagnosis to rule out other possible conditions that present with heel pain, such as a calcaneal stress fracture, plantar fasciitis, or tendonitis. This typically involves diagnostic imaging. An X-ray checks for a fracture, or an MRI may be used to visualize a deep bone bruise or soft tissue damage that is not visible on a standard X-ray. Receiving an accurate diagnosis ensures the treatment plan is tailored to the specific injury and prevents a chronic condition.