A bruised heel, or plantar contusion, occurs when the soft tissues and fat pad beneath the heel bone are damaged by impact. This injury usually happens after landing hard from a height or due to repetitive, high-force activities like running or jumping. The impact compresses blood vessels, causing internal bleeding and inflammation within the heel’s protective fatty cushion. While painful, most heel contusions do not involve a fracture and can be managed with conservative care at home.
Immediate Steps for Pain Relief
The acute stage of a bruised heel requires measures focused on minimizing swelling and internal bleeding in the first 24 to 48 hours. The initial treatment protocol often follows the R.I.C.E. principles, starting with immediate rest to prevent further injury to the heel’s fat pad. Resting means avoiding all weight-bearing on the affected foot, which may require the use of crutches or a cane if mobility is necessary.
Ice application is the next step to reduce pain and control inflammation. Apply a cold compress or ice pack wrapped in a thin towel for 10 to 20 minutes, allowing at least 40 minutes between applications. Compression using an elastic bandage helps limit swelling; ensure the wrapping is not so tight that it causes numbness or tingling. Elevating the foot above the level of the heart encourages fluid drainage and reduces throbbing pain. Non-steroidal anti-inflammatory drugs (NSAIDs) may manage pain, but use them cautiously as they could interfere with the initial healing response.
Protecting the Heel During Recovery
After the initial pain subsides, the focus shifts to protecting the healing tissues from repeated trauma during recovery. Walking on a bruised heel can worsen the injury, so mechanical protection is necessary when gradually reintroducing weight-bearing activities. This transition requires footwear that provides significant cushioning and shock absorption to shield the injured fat pad and underlying calcaneus bone.
Choosing shoes with thick, well-cushioned soles is important; flat or hard-soled shoes should be strictly avoided. Specific devices, such as gel or silicone heel cups, can be placed inside the shoe to redistribute pressure away from the most tender area. Temporary modifications to daily activities are necessary, including avoiding standing for long periods or using stairs excessively. Maintaining this protection allows the damaged blood vessels and soft tissue to repair without constant ground impact stress.
Expected Healing Timeline and Prevention
The time required for a bruised heel to heal varies depending on the injury’s severity, ranging from one to three weeks for a mild contusion. If the injury involves a deeper bone bruise within the calcaneus, recovery can extend significantly, sometimes taking four to six weeks or longer. Wait until the heel is pain-free during normal walking before attempting to return to physical activity, as rushing the process risks chronic inflammation or recurrence.
To prevent future heel contusions, focus on footwear and activity mechanics. Runners should check their gait to identify excessive heel strike, which puts undue force on the heel pad. Athletic shoes should be replaced regularly, as the sole’s shock-absorbing properties degrade over time. Utilizing protective padding or shock-absorbing insoles, even after healing, maintains foot health, especially during high-impact sports.
Recognizing When to See a Doctor
While most heel bruises resolve with home treatment, certain signs indicate the injury may be more serious, such as a stress fracture or heel bone fracture. Seek professional medical evaluation if there is an inability to bear any weight immediately following the injury. Persistent, severe pain that does not improve after several days of rest and ice is another warning sign.
Other red flags include visible deformity of the foot, numbness or tingling, or pain that persists for more than four weeks despite consistent home care. These symptoms suggest a deeper structural problem requiring imaging tests, such as an X-ray or bone scan, to rule out a fracture. Seeing a doctor ensures a more serious condition is not mistaken for a simple bruise, preventing long-term complications.