A bruised heel, or heel contusion, is a common and painful injury affecting the fatty pad beneath the heel bone. This soft tissue cushions and protects the calcaneus, the largest bone in the foot. Excessive force can damage this protective fat pad, leading to discomfort and limited mobility. Understanding how to recognize and manage this condition is important for effective recovery.
Understanding a Bruised Heel
A bruised heel occurs when the soft tissues and fat pad under the heel bone are injured. The calcaneus itself can also be involved, leading to a bone bruise. Common causes include landing hard from a height, high-impact sports like running or jumping, or repetitive stress from walking on hard surfaces. Improper footwear lacking cushioning or support can also contribute.
Symptoms typically include localized pain directly under the heel, ranging from a dull ache to a sharp sensation. The area may feel tender, and swelling or discoloration may be visible. Pain often worsens with weight-bearing activities like standing or walking, making movement difficult.
Immediate Self-Care for a Bruised Heel
Immediate care for a bruised heel focuses on reducing pain and swelling. The RICE protocol—Rest, Ice, Compression, and Elevation—is a recommended first aid approach. Resting the affected foot is important; avoid putting weight on the injured heel as much as possible, and consider using crutches if walking causes significant pain.
Apply ice to the bruised area for 15 to 20 minutes at a time, every two to three hours, for the first 48 to 72 hours. Wrap an ice pack in a thin cloth. Gentle compression around the foot and ankle with an elastic bandage helps minimize swelling; ensure the wrap is snug but not too tight. Elevating the foot above heart level also aids in reducing swelling.
Over-the-counter pain relievers, such as NSAIDs (ibuprofen or naproxen) or acetaminophen, can help manage pain and inflammation. These medications provide temporary relief, aiding rest and recovery. Always follow dosage instructions.
Ongoing Recovery and Management
As initial pain subsides, transitioning to ongoing recovery strategies is important for complete healing and to prevent re-injury. Gradually return to activities; avoid pushing through pain, as this can worsen the injury or lead to chronic issues.
Wear supportive footwear with adequate cushioning and arch support. Shoes with a deep heel cup and a firm heel counter stabilize the foot and absorb impact, reducing pressure on the injured area. It is highly beneficial to avoid walking barefoot or wearing unsupportive shoes like flip-flops during recovery.
Heel pads, gel inserts, or orthotics provide additional cushioning and support. These redistribute pressure away from the bruised area, promoting comfort and healing. Some inserts are designed to increase the density of the natural fat pad under the heel. Gentle stretching exercises for the calf muscles can be incorporated once pain allows, improving flexibility and foot mechanics.
When to Seek Professional Medical Attention
While many bruised heels improve with self-care, professional medical attention may be necessary. Seek immediate medical care if you experience severe pain, cannot bear weight on the injured heel, or notice a visible foot deformity. These signs may indicate a more serious injury, such as a fracture.
Other warning signs include numbness or tingling in the foot, or pain that worsens despite several days to a week of diligent self-treatment. Signs of infection, such as increasing redness, warmth, pus, or a fever, also warrant prompt medical evaluation. If you heard a distinct snap, grinding, or popping sound at the time of injury, it is important to consult a healthcare provider to rule out a fracture or other significant damage.