What Causes a Bruised Heel and How to Find Relief
Medically reviewed by Sarah Richards, DPM
A bruised heel is an injury to the fat pad that protects the heel bone (calcaneus). It can develop from repeated impact through the heel bone or from a single event, such as jumping from a significant height and landing on your heel. The longer you've had heel pain, the more time it can take to heal.
This article discusses a bruised heel, including causes, diagnosis, home remedies, and medical treatments.
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Related: What Causes Heel Pain and How Is It Treated?
What Are the Symptoms of a Bruised Heel?
The primary symptom of a bruised heel is pain in the bottom of the heel bone. The pain is typically sharp and worsens when pressure is applied to the back of the foot.
Other symptoms of a bruised heel can include:
Swelling
Bruising
Difficulty walking
Inability to put weight on the affected heel
Symptoms of a bruised heel can be similar to those of other foot problems, such as a broken heel bone or plantar fasciitis.
Bruised Heel vs. Broken Heel
It can be challenging to distinguish between a bruised heel and a broken heel. Imaging is an essential part of diagnosing these injuries. A broken heel—also called a calcaneus fracture—is diagnosed (or ruled out) with X-rays and sometimes computed tomography (CT scan).
Bruised Heel vs. Plantar Fasciitis
Bruised heels are commonly misdiagnosed as plantar fasciitis. However, these conditions can occur together.
The plantar fascia is a large ligament that starts at the heel and runs along the arch of the foot. Plantar fasciitis can cause heel pain when stepping on the foot. Pain from plantar fasciitis can sometimes lessen with walking, but pain from a bruised heel will typically worsen the longer you walk on it.
Related: The 10 Best Insoles for Plantar Fasciitis, Tested and Reviewed
What Causes a Bruised Heel?
A bruised heel can be caused by an acute event, such as a fall from a tall height, or participating in an event that requires a lot of jumping, such as a basketball tournament. It can also occur from stepping on a sharp object like a rock.
A bruised heel can also be chronic and develop gradually from repeated impact on the heel, such as walking in inflexible shoes or on hard surfaces.
Certain risk factors can increase your chances of getting a bruised heel, such as:
Advancing age (the heel fat pad gets thinner as a person ages)
Being overweight
Endurance running
History of cortisone shots in your foot
Other medical conditions (such as diabetes or rheumatic diseases)
Prior injury to your heel
Wearing improper shoes for a particular activity
How Is a Bruised Heel Treated at Home?
Home remedies can help you manage the symptoms of a bruised heel.
Use RICE
The R.I.C.E. protocol helps treat heel pain:
Rest: Avoid activities that aggravate your heel pain. Resting your heel can be difficult as walking is a big part of daily life. If you have difficulty bearing weight on your heel, consider using crutches for support.
Ice: To decrease pain and inflammation, apply ice to your heel for 10 to 15 minutes at a time. You can also consider freezing a bottle of water to roll along the bottom of your foot.
Compression: Wear a compression wrap to support your heel and reduce swelling. You can also apply kinesiology tape to your arch for support. See a physical therapist for assistance in choosing the best heel support for your lifestyle.
Elevate: Prop your foot up when lying down to allow gravity to decrease swelling.
Take a Pain Reliever
Non-steroidal anti-inflammatory drugs (NSAIDs) can help treat inflammation and pain associated with a bruised heel. Examples include Aleve (naproxen), Motrin/Advil (ibuprofen), and Bayer (aspirin).
Tylenol (acetaminophen) is another medication that can help reduce pain.
Check with your healthcare provider to ensure these medications are safe.
Protect Your Heel
You can place over-the-counter heel pads or cups in your shoes to provide additional padding for your painful heel.
Stretch the Foot and Heel
Stretches can help reduce pain and tightness in your foot and heel after an injury. These exercises should not be painful—you should feel a gentle stretch or pulling sensation along the bottom of your foot.
Follow these steps:
Place your hands flat on a wall with your arms extended at shoulder height.
Step your injured foot back approximately 12 to 18 inches. Keep both heels flat on the ground.
Keeping your knee straight on your back leg, bend your front knee and lean toward the wall until you feel a stretch along your calf and foot on the injured side.
Hold for 10 seconds. Do three repetitions several times per day.
Other Tips to Find Relief
Try these tips to provide additional pain relief for a bruised heel:
Avoid walking barefoot, especially on hard surfaces
Wear comfortable shoes that provide cushioning for your heel
Stop any activity that causes pain
Consider wearing a night splint to keep your foot in a stretched and supported position
If your pain does not improve with home remedies, a healthcare provider might recommend physical therapy, custom orthotics (shoe inserts), or prescription shoes.
How Is a Bruised Heel Diagnosed?
A healthcare provider, such as a podiatrist—a doctor specializing in treating foot conditions, begins the diagnosis process with a physical exam and symptom review.
Imaging is often needed to help rule out a broken bone or other soft tissue damage. Types of imaging your provider may recommend are X-rays, computed tomography (CT scan), or magnetic resonance imaging (MRI).
How Long Does It Take a Bruised Heel to Heal?
Healing time after a bruised heal depends on many factors, including the severity of the injury and whether or not you continue to participate in the activity that initially caused your symptoms. The longer you've had symptoms, the more time it can take to improve.
Be patient—fully recovering from a bruised heel can take several months.
Complications and When to Contact a Healthcare Provider
If a bruised heel is left untreated, it can worsen, leading to more pain and difficulty walking. If you continue to have symptoms of inflammation—pain, redness, warmth, difficulty with daily activities—after a week of home remedies, see a healthcare provider.
If you are unable to bear weight on your foot without sharp pain, seek medical attention to rule out a more serious injury, such as a broken bone.
Summary
A bruised heel occurs when the fat pad over the heel bone—and sometimes the heel bone itself—is injured. This can occur from trauma, such as jumping off a tall surface and landing on the heel, or over time from repetitive pressure through the heel (such as endurance running or walking in hard shoes). A healthcare provider diagnoses a bruised heel through a physical exam and sometimes imaging to rule out more serious conditions.
Treatment includes home remedies, medications, and modifications such as taping or orthotics. Stretches and shoes with increased cushioning can also help. If home remedies do not improve your symptoms, it's important to see a healthcare provider for an accurate diagnosis.
Read the original article on Verywell Health.
