A bruised heel, medically termed a calcaneal contusion, results from an acute impact or repetitive stress on the heel bone (calcaneus) and the protective fat pad surrounding it. The injury occurs when force crushes underlying tissues and blood vessels, leading to internal bleeding. Compression wrapping is a standard and effective initial step in home care, providing support and reducing the swelling and associated pain.
Identifying a Heel Bruise and When to Seek Help
A typical heel bruise presents with localized, sharp pain directly on the bottom of the heel that worsens significantly with pressure or weight-bearing. Tenderness is common when the area is touched, along with minor external discoloration, such as redness or purple bruising. The pain often causes a noticeable limp as the person attempts to offload the affected area.
It is necessary to rule out a more severe injury, such as a calcaneal fracture, before relying solely on a compression wrap. Signs of a potential fracture include an immediate inability to bear any weight on the foot or severe pain that does not improve after 48 to 72 hours of rest. Seek prompt medical evaluation if you experience numbness, tingling, or a noticeable deformity in the foot or ankle. Wrapping should only be performed if the symptoms are clearly those of a minor contusion or after a fracture has been ruled out by a medical professional.
Preparing for and Applying the Compression Wrap
To prepare for wrapping the heel, you will need a standard elastic bandage (Ace wrap), typically three or four inches wide, along with securing clips or medical tape. The figure-eight technique is the most effective method for the heel and ankle because it provides support and uniform pressure without restricting joint movement. This technique allows the wrap to contour around the complex shape of the heel bone and ankle joint.
Begin by sitting comfortably with the foot held at a neutral, 90-degree angle to the leg. Start the wrap by placing the end of the bandage on the top of the foot, near the base of the toes, leaving the toes uncovered to monitor circulation. Wrap the bandage twice around the ball of the foot, moving toward the arch, to create a secure anchor point.
Next, bring the bandage diagonally across the top of the foot and loop it around the back of the heel, covering the tender area. From the back of the heel, angle the wrap back across the top of the ankle and return to the starting point near the arch, creating the first loop of the figure-eight pattern. Continue this pattern, overlapping the previous layer by approximately half its width, working your way up the ankle and heel.
The tension of the wrap should be firm enough to provide support and slightly compress the tissue, but it must not be excessively tight. A wrap that is too restrictive can impede circulation, leading to throbbing, numbness, or tingling in the toes. Finish the wrap above the ankle joint, securing the end with the clips or tape, and immediately check the toes to ensure they remain warm and pink.
Ongoing Care and Recovery Timeline
The compression wrap is only one component of a comprehensive recovery strategy, which must integrate the other elements of the R.I.C.E. protocol. Immediately following the injury, prioritize rest by avoiding weight-bearing activities on the affected heel for at least 24 to 48 hours. Applying ice for 10 to 20 minutes every two to three hours, with a thin barrier between the ice and the skin, works with the compression to reduce local inflammation and pain signals.
Elevation is another element, as keeping the foot propped up above the level of the heart uses gravity to help drain excess fluid and minimize swelling. The compression wrap should generally be worn during the day when the foot is most likely to be active, but it should be removed before sleeping or during icing sessions. Over-the-counter non-steroidal anti-inflammatory drugs may be used to manage discomfort.
For a minor soft tissue heel contusion, recovery typically takes between one to three weeks before a full return to normal activity is possible. However, if the impact was severe enough to cause a bone bruise within the calcaneus, the healing period can extend significantly, often requiring four to six weeks or longer. The wrap should be discontinued once swelling has substantially decreased and pain is mild, allowing for gradual reintroduction of light weight-bearing activity.