Treatment of a heel bruise: how to distinguish it from a fracture, how to relieve symptoms and speed up treatment

A heel bruise is an injury that is easy to get; it causes great discomfort, but is easy to treat. This injury can have various serious complications, to avoid which it is important to accurately diagnose and undergo proper treatment.

Author of the article / Site experts Shulepin Ivan Vladimirovich, traumatologist-orthopedist, highest qualification category

Total work experience over 25 years. In 1994 he graduated from the Moscow Institute of Medical and Social Rehabilitation, in 1997 he completed a residency in the specialty “Traumatology and Orthopedics” at the Central Research Institute of Traumatology and Orthopedics named after. N.N. Prifova.

Causes of injury

A heel bruise is a common closed injury that occurs as a result of an incorrect landing after a jump or fall from a height. Damage to the heel area is accompanied by pain and discomfort during movement.

People of all ages are susceptible to this problem, especially athletes, teenagers and children. A heel bruise is caused by the following reasons:

• unsuccessful landing or fall from a great height;
• hitting a hard surface;
• falling on the heel of any heavy object;
• fast running or walking in shoes with thin soles;
• long-term wearing of high-heeled shoes (from 5 cm).

What kind of damage can there be?

When a heel is bruised, only soft tissues are injured, while the integrity of the skin is not compromised. In case of a fracture, in addition to the bone, muscle tissue, ligaments and tendons are damaged.

Recovery and prevention

Absolute recovery is determined by the complexity and severity of the injury. In practice, moderate injuries disappear 2 weeks after intensive treatment. You should not stop treatment after complete elimination of pain when walking. Discomfortable sensations disrupt gait, and this can lead to pain and curvature of the spine.

To prevent bruises, it is advisable to choose comfortable shoes for sports, and do not walk for a long time in heels. You should not jump from a great height on your heels. To prevent bruises, you need to choose the right casual shoes. Children should choose safe places to play, and ensure that children are supervised.

Classification of injury by severity

Depending on the severity, there are 4 degrees of bruise in the heel area:

1. I – minor injuries, usually expressed by scratches and abrasions on the skin, and healing without drug treatment.
2. II – the presence of a bruise and small lumps; in some cases, swelling forms in the injured area.
3. III – internal damage to the muscle structure is observed, accompanied by extensive hemorrhages. In a more severe situation, the integrity of the bone tissue is compromised.
4. IV – as a result of a bruise, a fracture of bone tissue occurs, resulting in serious internal injuries to the soft tissues of tendons and ligaments.

Note!

In case of a fracture, the victim requires immediate assistance from specialists, otherwise there is a high probability of disability.

Complications

Early diagnostic measures and modern treatment ensure rapid recovery of the heel. Healing time is at least 3 weeks, the period depends on the severity of the damage. Many bruises disappear within a few weeks. But active sports may be banned for several months.

If you continue to exercise with a damaged heel, the injury can develop into chronic inflammation of the periosteum - the connective tissue film that surrounds the bones from the outside. This phenomenon is a more debilitating condition.

In extreme cases, a complication may be avascular necrosis of bone - death of bone tissue due to insufficient blood circulation. If a section of bone dies, the damage is considered irreversible.

Symptoms and signs

The following symptoms are characteristic of a heel bruise:

1. Pain in the heel area resulting from compression of the surrounding tissues and nerve endings by accumulated blood.
2. The formation of bruises due to damage to the blood vessels located in this area. Blood entering the subcutaneous fat layer and muscle tissue contributes to the appearance of a hematoma. In this case, the size of the bruise depends on the force of the blow, as well as on the age of the person: in older people it is larger due to a depleted vascular system.
3. Swelling at the site of injury caused by the accumulation of pathological fluid in the tissues.
4. Distortion of gait (lameness), caused by the reluctance of the victim to step on the injured leg, so as not to increase pain.

Important!

If lameness occurs, the patient must undergo a differentiated diagnosis, since a similar symptom is observed when the heel bone is cracked or fractured.

Pain from a heel bruise usually goes away within 2-3 hours from the moment of injury, swelling and hematoma - within a few days, depending on the effectiveness of the treatment.

What is the difference between a bruise and a calcaneal fracture?

The differences between a heel bruise and a fracture are as follows:

1. With a fracture, unnatural mobility is observed at the site of injury; with a bruise, this symptom does not occur.
2. A fracture makes it impossible to put even a minimal load on the injured leg; if there is a bruise, movement using the injured leg is quite acceptable, despite severe pain.
3. Acute pain resulting from injury only intensifies with a fracture. With a bruise, it increases only in the first hours, and then gradually goes away.

At the time of a fracture, a crunching sound of the damaged bone is often heard; with a bruise, this sound is absent. If a broken bone is close to the surface of the skin, lumps or depressions form. In case of a fracture, strong pressure on the heel will cause acute pain, but in case of a bruise there will be no pain.

Attention!

An accurate diagnosis can only be made by visiting a specialist who, after a visual examination and palpation, will prescribe an x-ray.

FAQ

Is it possible not to treat heel pain?

It is not recommended to ignore this serious symptom. The disease can progress quickly, causing severe pain. In the most critical cases, surgery will be required. The external symptoms of arthritis can mask benign or malignant neoplasms, for which timeliness is a guarantee of successful treatment.

Which doctor should you consult for heel pain?

Make an appointment with a general specialist or orthopedic traumatologist. At the first stage, a comprehensive diagnosis will be carried out and the exact cause of painful manifestations will be established. After this, the patient will be referred to a specialist in the required profile.

How common is heel pain?

A complaint of heel pain when visiting an orthopedic traumatologist is one of the most common symptoms of various diseases. It affects athletes, people with excess body weight, representatives of professions who are forced to spend long periods of time on their feet, and many others. Patients with diabetes, as well as men over 35 years of age, are at risk.

First aid

In the first minutes after a bruise, it is important to take the necessary measures aimed at reducing pain and reducing swelling. Namely:

1. Reduce the load on the heel bone as much as possible, providing it with complete rest. In this case, the affected limb must be located above chest level, which will prevent intense flow of blood and lymph fluid to the heel area, as well as the formation of swelling.
2. Apply cold. For this purpose, you can use ice cubes, a container of ice water, etc. This technique promotes vasoconstriction and prevents hemorrhage in the tissue, which eliminates pain and prevents the formation of a hematoma.
3. If necessary, give the victim a pain reliever, for example, Ibuprofen, Nurofen, Analgin.

It is unacceptable to bandage a damaged limb without examining a specialist and put shoes on it. Because in the event of a fracture, displacement of fragments and bones may occur, which will significantly worsen the further prognosis.

When to see a doctor

If you experience severe pain and are unable to move on your own, the victim must call an ambulance. The doctor will help relieve pain, determine the severity of the injury and prescribe further examination.

Diagnostic measures

A severe heel bruise can lead to serious consequences, such as a fracture of the heel bone. In this regard, an accurate diagnosis is necessary, which the traumatologist makes based on studies conducted, including the following:

1. Anamnesis collection. The specialist listens to the victim’s complaints and assesses the approximate area of ​​damage.
2. Palpation of the injury site, which involves palpating the heel bone to identify other possible injuries. After examination, the specialist determines further treatment for the bruise.
3. X-ray of the heel bone, necessary to confirm or exclude a fracture of the hard base of the heel - the talus.

Based on the obtained images and data, he prescribes therapy for the damaged heel.

Diagnosis of the problem

If you suspect a heel bruise, you should not hope that the discomfort will go away on its own. You should consult a doctor.

To perform a competent diagnosis, the specialist carries out the following activities:

• Questioning, anamnesis collection. Information about the patient's occupation, lifestyle, and events preceding the injury plays a key role.
• Visual inspection, assessment of existing injuries.
• X-ray examination. Used to clarify the diagnosis. It makes it possible not to confuse even a severe bruise with an injury to the talus.

Despite the fact that all the symptoms of mild injury are present, contacting a medical organization is mandatory. A competent specialist will eliminate possible complications and prescribe the correct therapy. Refusal of medical care and self-medication are fraught with serious complications.

Treatment

If the examination did not reveal serious injuries: a crack or fracture, then self-treatment is acceptable. A treatment regimen drawn up by a doctor may include medications for both internal and external use, as well as physiotherapeutic procedures and folk remedies.

Medication

Therapy for a heel bruise that is not accompanied by a fracture or crack is carried out according to the following scheme:

1. On the first day - cold compresses, constricting blood vessels and stopping bleeding in the tissues.
2. On the second and third days - warm compresses using gels: Heparin and Ibufen.

Subsequently, during the treatment process, drugs for external use are actively used with the frequency specified in the instructions. The most effective of them are presented in the table.

Folk remedies

Treatment of a heel bruise allows the use of folk recipes that allow you to prepare healing baths and compresses. The most effective ways:

1. Compress based on vodka. Apply a linen cloth moistened with alcohol to the sore spot. Cover the top with plastic and bandage it.
2. Cabbage leaves. Mash the leaf until the juice appears, apply to the site of injury and secure with a tight bandage.
3. Beans. Distribute the beans, crushed to a puree, on a sheet of parchment and apply to the sore heel. Cover the top with plastic wrap and secure with a jock strap.
4. Oak bark. Brew 2 tbsp. l. crushed bark, leave for 2-3 hours and use as compresses or medicinal baths.
5. Vegetable oil and vinegar. Combine the components in equal parts, apply to the damaged area and cover with polyethylene.
6. Bodyagi grass. Grind the herb and mix with boiling water to obtain a paste. Apply the mixture to the injured area on the first day after the injury.

Important!

Folk remedies are recommended for use in combination with medications.

Oral medications

When treating a heel bruise, in addition to drugs for external use, tablets that have an analgesic and antiphlogistic effect are indicated. These include:

• Ibuprofen is a non-steroidal drug that eliminates inflammation and pain;
• Nimesulide – has a strong analgesic effect;
• Diclofenac - relieves pain and inflammation.

Attention!

The use of any oral drug is possible only after prior agreement with the attending physician.

How to treat a bruised heel

In most cases, the patient receives treatment for the injury at home. Full recovery occurs within 7–14 days. In this case, a person should limit physical activity as much as possible.

In order to get rid of a bruise, reduce pain and eliminate swelling, use ointments and gels based on heparin, troxerutin, diclofenac, nimesulide. Combination products are also used, which include both components that improve blood circulation and anti-inflammatory painkillers.

Dolobene gel

Dolobene gel contains heparin, dimethyl sulfoxide and dexpanthenol. The drug has a local anesthetic effect, quickly eliminates swelling and relieves inflammation. The product enhances tissue regeneration and promotes the resorption of bruises.

Dolobene relieves pain and inflammation

The gel is applied in a thin layer to the affected area 2-4 times a day. For severe bruises, you can apply a bandage with Dolobene. To do this, the product is applied in a thick layer. After most of it is absorbed and the alcohol, which is part of the drug, has evaporated, cover with a breathable dressing material.

The gel should not be applied to damaged areas of the skin or open wounds, as it contains isopropyl alcohol, which can cause severe pain reactions. It is also not recommended to use the drug when treating children. Do not use the product during pregnancy and breastfeeding.

Rehabilitation measures

Injury to the heel bone negatively affects the motor activity of not only the foot, but the entire limb. This entails atrophy of muscle tissue, impaired blood circulation and metabolic processes. Therefore, the patient must undergo a course of procedures included in the rehabilitation program and aimed at the following:

• restoration of motor functions of the foot and limb;
• returning tendons, muscles and ligaments to their former elasticity and tone;
• activation of lymph and blood flow;
• prevention of inflammation;
• elimination of swelling;
• acceleration of regeneration processes;
• pain relief.

Physiotherapy

For minor injuries, the doctor prescribes several physiotherapeutic procedures:

• Ultrasound therapy – provides microvibration in soft tissues, eliminating hematoma and tumor;
• magnetic therapy – relieves inflammation, stimulates the regeneration process, has an antispasmodic effect;
• phonophoresis - has an effect similar to ultrasound therapy, involves the use of a special ointment to increase the effectiveness of the procedure.

Physiotherapy

Physical therapy is prescribed by a doctor after completing treatment for a heel bruise. Foot rotation exercises involve flexing and extending your toes. The patient is also recommended to walk on his toes and pull the toe toward and away from himself.

Note!

If you experience any discomfort during therapeutic exercises, exercises must be interrupted immediately.

Restorative massage

Sessions are acceptable even in the first hours after a heel injury, but they require maximum care. Massage procedures help increase blood circulation and are indicated for both a regular heel bruise and a fracture.

Heel pain when walking: effective treatment in Moscow

The specialists of our clinic have been successfully dealing with the problem of heel pain for many years, diagnosing diseases that caused painful symptoms, and achieving lasting positive results in treatment. Doctors widely use an integrated approach, including time-tested classical methods of therapy, as well as the latest achievements of modern medicine. The professional arsenal of experienced specialists includes a huge number of rehabilitation programs and methods. The clinic’s doctors regularly undergo training and training in the best medical centers in Israel, the USA, and Germany, and become familiar with the achievements of innovative therapy and surgery. Each patient can attend a free appointment and have their problem diagnosed by our specialists. Therapeutic sessions guarantee a rapid improvement in well-being and pain relief in 1-2 visits.

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