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Bruised Heel (Fat Pad Contusion) Symptoms & Treatment

Of all the bones in the foot, it is the calcaneus — also known as the heel bone — that bears the most of our weight when we are standing, walking, jumping, and running. For this reason, it is more prone to injuries than other bones in the foot.

The calcaneus is the sole bone that makes initial contact with the ground as the weight of your foot is transferred from the tibia through the talus (smaller tarsal bone) and to the calcaneus during heel strike before the weight is transferred through the other small tarsal bones on through the metatarsals and out through the toes.

Surrounding the calcaneus is elastic adipose tissue that cushions and protects the calcaneus from impact injuries. A heel bruise — also known as a stone bruise or a calcaneal fat pad contusion — is caused by excess force directed to the bottom of the heel.

This is a painful injury that can be the result of either one acute injury or from repetitive impact on the foot. Although moderate injuries can result in a contusion to the fat pad surrounding the calcaneus or a deep bone bruise, repetitive injuries can result in a calcaneal stress fracture.


A heel bruise is most often caused by a one-time incident or from repetitive trauma over time. In moderate cases, the injury will be restricted to the fat pad alone or to a bruise on the surface of the heel bone, but serious cases can involve a true fracture of the bone itself or even several fractures at once.

That being said, there are certain factors that can increase the risk of heel bruises, including:

Inadequate footwear: The harder the surface upon which you are running or walking, the more important it is to have shoes that provide shock absorption in order to shield the heel from excessive stress and strain. At Delray Beach Podiatry, Dr. Ian S. Goldbaum, a podiatric physician and surgeon with over 30 years of experience, believes that a custom-made orthotic shoe insert is the best way to safeguard feet from the punishment they endure throughout the day.

Weight: Being overweight places additional stress on weight bearing bones such as the calcaneus, which can increase the risk of injury.

Age: It’s a fact of life that as we get older our bones become more brittle, increasing the risk of an injury to the calcaneus.


Common symptoms of heel bruises include all of the following:

  • Swelling in the heel area
  • Swelling around the heel area
  • Pain while walking, running, or jumping
  • Pain while standing still


A bruised heel can be diagnosed by a podiatrist a through a clinical evaluation. If a stress fracture is suspected, x-rays will likely be required to determine the extent of the damage.


Most heel bruises are treated using the .R.I.C.E. principles – Rest, Icing, Compression, Elevation. Ice can be applied either through an ice bag or through cold water immersion. Ice should be applied to the area for twenty minutes at a time every two hours for the first two to three days.

The goal during recovery is keep all weight off the injured heel in order to reduce swelling and alleviate pain.

Returning to activity too quickly will not allow the fat pad to heal completely, resulting in a new bruise and resetting the healing process.

Follow Delray Beach Podiatry on Twitter @Delray_Podiatry

The content on this website is for informational purposes only. Do not rely or act upon information from without seeking professional medical advice. If you live in South Florida and would like a consultation with Dr. Ian Goldbaum, a podiatric physician and surgeon with over 30 years of experience, please see our contact information below:


16244 S. Military Trail #290, Delray Beach, FL 33445



8198 Jog Road #100, Boynton Beach, FL 33472



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