A stone bruise, medically known as a subcalcaneal contusion, is a deep bruise affecting the heel pad or even the underlying heel bone. This condition often feels as though a small object, like a stone, is constantly jabbing the bottom of the foot with every step. It commonly results from direct impact, such as stepping forcefully on a hard object, or from repetitive stress activities like running and jumping. While pain can manifest immediately, it may also develop gradually over 24 to 48 hours following the injury. Not all stone bruises present with visible discoloration, but they typically cause localized pain and tenderness.
Immediate Home Care
Initial self-care for a stone bruise focuses on reducing pain and inflammation to promote healing. The R.I.C.E. method—Rest, Ice, Compression, and Elevation—provides a structured approach for immediate relief. Resting the affected foot by avoiding weight-bearing activities is important, allowing the bruised tissue time to recover. Depending on the severity, a stone bruise typically takes between two to six weeks to heal.
Applying ice to the heel for 10 to 20 minutes at a time, several times a day, helps to decrease swelling and pain. It is important to wrap the ice pack in a cloth to protect the skin from direct contact. Compression, such as using an elastic bandage, can provide support and further reduce swelling. Elevating the injured foot above heart level, especially when resting, assists gravity in minimizing fluid accumulation and swelling.
Managing pain with over-the-counter medications like ibuprofen or acetaminophen can also provide comfort and reduce inflammation. Incorporating protective padding or gel inserts into footwear helps cushion the heel and distribute pressure, which is particularly beneficial when resuming activity. Avoiding walking barefoot, especially on hard surfaces, is advisable to prevent further irritation to the healing heel.
When to Seek Professional Help
While many stone bruises improve with home care, certain signs indicate the need for a medical evaluation. If heel pain is severe, persistent, or worsens despite several days or weeks of home treatment, consulting a healthcare professional is advisable. Increased swelling that does not subside, or an inability to bear weight on the heel, suggests a more significant injury that requires medical attention.
Signs of infection, such as increasing pain accompanied by redness, warmth, or pus around the bruise, necessitate immediate medical assessment. A healthcare provider can accurately diagnose the condition and rule out other issues that present with similar symptoms, including stress fractures, plantar fasciitis, or heel spurs. Diagnosis typically involves a physical examination and may include imaging tests like X-rays, MRI, or CT scans to check for bone damage. Depending on the diagnosis, a doctor might recommend specific treatments, including physical therapy or custom orthotic inserts.
Preventing Recurrence
To minimize the likelihood of future stone bruises, selecting appropriate footwear is an important step. Shoes should offer ample cushioning and proper arch support, especially for individuals engaging in activities that involve repetitive impact. Regularly inspecting shoes for wear and tear and replacing them when cushioning degrades helps maintain protective qualities.
Considering orthotic inserts or specialized heel cups can provide additional shock absorption and support, reducing direct pressure on the heel. These inserts help distribute weight more evenly across the foot.
Being mindful of walking and running surfaces can prevent re-injury. Choosing softer terrain over hard or uneven ground helps absorb impact. Gradually increasing the intensity of workouts and maintaining a healthy weight also contribute to reducing stress on the heels.