Heel Pain / Bruised Heel

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A bruised heel can be caused by either a sudden impact (such as landing heavily) or repetitive pounding. The heel bone (calcaneus) is protected by a pad of fat. Repeated pounding of the heel can cause the fat pad to be pushed up the side of the heel leaving less of a protective layer causing heel pain. This injury is also sometimes known as Policeman's heel. It is common in sports requiring a lot of impact onto the heel and in particular soldiers marching up and down on the parade square.


Causes Of Heel Pain
Heel pain is a common complaint, especially amongst those who spend a lot of their time on their feet for work, or who are involved in repetitive impact sports. The cause of this pain can be varied and should be thoroughly investigated to ensure the right course of treatment is undertaken.

Common causes include
  1. Tight calf muscles.
  2. Faulty foot biomechanics – such as overpronation or oversupination.
  3. Sudden increases or changes to training.
  4. Unsupportive footwear.Wearing high heels frequently.

                             Treatment For Heel PIan / Bruised Heel
Conditions that cause heel pain generally fall into two main categories: pain beneath the heel and pain behind the heel.

Pain Beneath the Heel
If it hurts under your heel, you may have one or more conditions that inflame the tissues on the bottom of your foot:
  • Stone bruise - When you step on a hard object such as a rock or stone, you can bruise the fat pad on the underside of your heel. It may or may not look discolored. The pain goes away gradually with rest.
  • Plantar fasciitis (subcalcaneal pain) - Doing too much running or jumping can inflame the tissue band (fascia) connecting the heel bone to the base of the toes. The pain is centered under your heel and may be mild at first but flares up when you take your first steps after resting overnight. You may need to do special exercises, take medication to reduce swelling and wear a heel pad in your shoe.
  • Heel spur - When plantar fasciitis continues for a long time, a heel spur (calcium deposit) may form where the fascia tissue band connects to your heel bone. Your doctor may take an X-ray to see the bony protrusion, which can vary in size. Treatment is usually the same as for plantar fasciitis: rest until the pain subsides, do special stretching exercises and wear heel pad shoe inserts.
Pain Behind the Heel
If you have pain behind your heel, you may have inflamed the area where the Achilles tendon inserts into the heel bone (retrocalcaneal bursitis). People often get this by running too much or wearing shoes that rub or cut into the back of the heel. Pain behind the heel may build slowly over time, causing the skin to thicken, get red and swell. You might develop a bump on the back of your heel that feels tender and warm to the touch. The pain flares up when you first start an activity after resting. It often hurts too much to wear normal shoes. You may need an X-ray to see if you also have a bone spur.

Treatment includes resting from the activities that caused the problem, doing certain stretching exercises, using pain medication and wearing open back shoes.
  • Your doctor may want you to use a 3/8" or 1/2" heel insert.
  • Stretch your Achilles tendon by leaning forward against a wall with your foot flat on the floor and heel elevated with the insert.
  • Use nonsteroidal anti-inflammatory medications for pain and swelling.
  • Consider placing ice on the back of the heel to reduce inflammation.