Plantar Fasciits or a Bruised Heel?

Heel pain is probably the most common type of foot pain that I see in my clinics on a regular basis, often several a week. Although often diagnosed as Plantar Fasciits there are many other causes, and the treatment is different for each one, so vitally important that you have the correct diagnosis to avoid wasted time.

Recently a patient came in to see me having been referred to me with a diagnosis of Plantar Fasciitis. A keen long distance runner, she had been getting heel pain for some time during and after long runs. Having gone through the assessment process, including an ultrasound scan, it was clear from the scan that her Plantar Fascia was undamaged, however there were signs of irritation and inflammation in the heel pad itself, indicating a ‘heel bruise’.

What is a Bruised Heel?

Heel Fat Pad syndrome, or HFPS, commonly called a Heel Bruise, is a lesser known but common cause of heel pain in long distance runners and walkers who have reduced padding under their heel due to ageing, combined with lots of repetitive impact which can bruise the heel bone, leading to quite a lot of pain. I often describe it as like running or walking on a flat tyre as the heel pad loses its cushioning qualities, and the pain is often at the sides of the heel rather than underneath as the heel pad spreads outwards under load, rather like a flat tyre does, increasing pressure at the sides. Unlike Plantar Fasciitis, the pain can be continuous on weight bearing and very painful to walk or stand on.

What is the treatment for a Bruised Heel?

The treatment plan is to increase cushioning under the heel by wearing cushioned trainer type shoes with a deep heel cup, along with orthotic shock absorbing insoles to increase heel support, then reducing impact exercise until symptoms settle. Shockwave therapy if the pain is long term, or laser therapy if more recent, can really help to get the pain down and promote healing, leading to an earlier return to previous levels of exercise. The pain that comes with a heel bruise is quite similar to that of a stress fracture, so it is really important to get a proper diagnosis.

Get a proper diagnosis

If you are not certain what is causing your heel pain, book an appontment at Active to get a proper diagnosis and treatment plan that will get you back on your feet more quickly.

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