Heel Pain / Bruised Heel

Heel pain can be caused by a variety of problems. It may be due to a traumatic injury, such as landing on the heel on a hard surface, or may be an overuse injury, such as plantar fasciitis. Here are the most common causes of heel pain:

• Plantar fasciitis - Inflammation of the plantar fascia which forms the arch of the foot
• Bruised heel (fat pad contusion) - Often caused by repetitive pounding on the heel
• Calcaneal fracture - A fracture of the heel bone, either caused by a direct trauma, or repetitive pounding resulting in a stress fracture
• Calcaneal bursitis - Inflammation of the sack of fluid which sits under the heel
• Tarsal tunnel syndrome - Entrapment of the plantar nerves as they pass round the outer ankle. Causes pain to radiate into the heel and arch of the foot

What is a bruised heel?

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.

What can the athlete do about the heel pain?

• Rest until there is no more heel pain
• Pad the heel of shoes with a shock absorbing insole or heel pad
• Replace running shoes if they are old (more than 400 miles of running) or the soles are weakened through use

Bruised heel treatment

• A sports injury professional will confirm the diagnosis
• Advise on shoe inserts or heel pads to protect the fat pad in the heel
• Tape the heel to provide pain relief and compress the soft tissue under the heel giving more protection to the bone

How long will it take to recover from a bruised heel?

If you catch heel pain early and rest then it should recover quite quickly - within a few days. If you ignore the first onset of pain and the fat pad gets damaged beyond easy repair then this is a very difficult injury to treat. Rest means rest. There is no point you stopping running for a week if you put up scaffolding for a living and are on your feet every day. If you have to be on your feet then ensure you put a shock absorbing and cushioning heel insert into your shoes.