The heel is very important in standing, walking and running.
The major bone in the heel is the calcaneal bone, it is the biggest bone in the foot and plays a major role in walking and weight-bearing. This bone has a protective shock-absorbing fat pad that is found directly under it.
A bruised heel occurs when this pad gets injured. It is also called a policeman’s heel because of the recurring marching and stamping they do while training, impacting the heel pad.
What Causes It?
- Landing directly on your heel after jumping off a high place.
- Repetitive running or walking in uncomfortable shoes.
- Walking, training and running bare feet.
- Training on an uneven surface.
- Training in the wrong shoes, especially shoes that do not provide enough support.
- Being overweight.
- Stepping on a hard surface or a stone.
Bruised Heel Symptoms
- Pain in the middle of the heel
- Pain while standing or walking
- A noticeable red or purple bruise on the heel
How Is It Treated?
This is an acronym for Protect, Rest, Ice, Compression, and Elevation.
- The heel needs to be protected from further injury. No serious physical activity should be done while the heel is healing.
- Walking should be placed on hold. The heel needs to be well-rested. This may be the use of walking aids like crutches or bed rest or wearing heel support.
- Ice helps to reduce swelling and can also help reduce the flow of fluid causing the bruising at the heel. This can be done by placing the heel in a bowl of iced water or by placing a cold pack on the heel itself. Ice should not be used for more than 15 minutes.
- Compression is the use of an elastic bandage to reduce the swelling at the heel.
- The elevation is necessary to decrease the swelling and pain by raising the heel, This can be done when lying down by placing your feet on pillows.
2. Pain Medications
Anti-inflammatory pain medications like NSAIDS can help to reduce the swelling and relieve pain at the heel joint.
Your doctor might refer you to a physiotherapist who will assess the heel and gradually get you back to play if you are an athlete or get you back to normal daily activities.
The physiotherapist will:
- Relieve pain based on the findings during their assessment which may involve other joints like the ankle. Pain can be relieved by the use of ice, heat or other electrical modalities.
- Gentle forms of massage like kneading and stroking can help to relieve pain and prevent any tightness that may occur at the heel.
- Check for any form of muscle weakness that may arise from inactivity and may prescribe some exercises as the heel heals.
- Retrain your walking cycle and correct any abnormalities
- Prevent a relapse. This means as you start to bear weight on the heel, they will take your shoes and other things into consideration and provide lifestyle modification in order to avoid an injury.
Follow up sessions will be requested to ensure that the heel has properly healed and to also avoid any complications.
Possible Complications If Not Well Treated
- A bruised heel bone. Since the protective internal heel pad is not properly treated, the shock from the ground while walking is placed on the bone itself. This can cause injury to the bone.
- A stress fracture can occur in the heel bone. Since the heel bone is not used to absorbing all the shock, it can lead to a fracture.
- It can affect your walking pattern and you may begin to walk on your toes or with a limp because you are still avoiding weight bearing on your heel.
- Muscle weakness and wasting. The body has a way of compensating when there is an injury. The calf muscles, for example, may reduce in size because they are not being used properly for walking.
- Ankle stiffness. The heel needs to move with the ankle and vice versa. If there is no movement, the ankle is forced to be in a particular position that can cause joint stiffness.
If the heel is treated properly from the onset, it will take about a week to three weeks to heal but if not properly treated, it may take about six weeks to heal.
How Can It Be Avoided?
- Wear appropriate shoes while walking or exercising. Wearing the right type of shoes provides support for the heel pad while exercising or doing other forms of activities.
- Stop doing activities barefooted.
- Invest in heel pads which can add extra protection to the already injured heel pad.
- Lose weight in order to reduce the pressure on the heel pad.
- Check your sporting shoes. Check the soles to ensure that they are not wearing off as this can cause the heel pad to absorb more shock than the shoe itself.
- Check your playing or training surfaces and ensure they are even