Causes of a bruised heel
A bruised heel is either caused by injury to the heel fat pad or stress to the heel bone (calcaneus). This may be due to either an acute or chronic injury.
Acute causes of a bruised heel include:
- Jumping or falling and landing awkwardly on the heel from a height.
- A forceful blow to the heel such as a kick.
- Stepping or landing on a stone or similar object causing a heel injury.
Chronic causes of a bruised heel include:
- Walking or running with poor foot mechanics and poor shock absorption.
- Walking or running on hard surfaces.
- Repetitive forces on the heel such as jumping.
- Poor footwear and shock absorption.
- Increase in training, walking or running.
Factors that increase your risk of a bruised heel include:
- Heel fat pad atrophy
- Being overweight
- Excess foot pronation or flat feet.
Heel fat pad atrophy is a common cause of heel pain
Heel fat pad atrophy is a common factor in a lot of plantar heel pain cases seen by our podiatrists. The heel fat pad is a thick layer of fatty tissue designed to protect the heel bone (calcaneus) from forces. In heel fat pad atrophy the fat pad under the heel bone is reduced and fails to shock absorb the heel. This results in more forces being absorbed by the heel bone leading to bone bruising.
Heel pad atrophy can be the result of genetic anatomical factors, the ageing process or other health conditions such as diabetes, lupus, and rheumatoid arthritis that can cause shrinking of the heel pad.
Heel pain symptoms in cases of heel fat pad atrophy are often exacerbated by poor foot mechanics or excess foot pronation (inward roll of the foot). This causes more forces to be directed on the medial heel bone rather than being distributed across all of the heel. Repetitive activities such as walking or running may then lead to an increase in heel bone stress.
Bruised heel diagnosis
A bruised heel or heel bone stress is usually easily diagnosed clinically by our Melbourne podiatrists, who are experts in identifying heel pain conditions of the foot. Our podiatrists also have diagnostic ultrasound on site which can help diagnose heel fat pad atrophy as well as other heel pain conditions. In acute cases or where there is suspicion of a heel fracture or stress fracture our podiatrists will refer you for an MRI scan to aid diagnosis.
Gait analysis is often a useful tool in chronic cases of heel bone bruising to help identify any underlying biomechancial factors that may be associated with causing the condition.
Podiatry treatment for a bruised heel or heel bone stress
Treatment for a bruised heel by our Melbourne podiatrists is aimed at initially reducing forces on the heel bone to allow for healing. In chronic cases of heel bone stress or bruising we will also look to address any underlying biomechanical factors that may exacerbate symptoms.
Common podiatry treatment options include: