I hope every one had a happy holiday season, and are enjoying the start of the new year. Today I would like to discuss type of heel injury not uncommon this time of year, especially for those with kids who leave their new toys lying about the house. A stone bruise of the heel is an annoying injury that occurs when one steps on a rough, protruding object that hit’s the foot directly on the bottom of the heel. The object is often a loose or protruding stone, but can also be another material, such as a root, wood chip, child’s toy, or any thing else that is small enough to stick directly into the heel. Usually, one becomes injured when walking barefoot, but flimsy soled shoes such as flip-flop sandals or house slippers can also allow the object to hurt the heel tissue. Pain is felt directly under the heel with every step, and essentially feels like there is a deep bruise in that area.
There are three types of tissue that are injured by the hard contact of this object. The plantar fascia, a ligament I have discussed in prior posts, can become directly bruised where it attaches to the heel bone, leading to plantar fasciitis. This debilitating condition ultimately can be come chronic is it spreads beyond a simple bruise, leading to long term heel and arch pain if not treated appropriately with stretching, anti-inflammatory medications/injections, icing, and arch support. Another tissue potentially injured by the object is a pad called a bursa. Also known as a bursal sac, this pillow-like tissue provides some degree of protection and shock absorption to the bottom of the heel bone, and a protruding object can irritate this tissue and cause it to become inflamed. Bursitis, as it is called, can be difficult to treat in the heel, and can take awhile to recover from. Treatment is similar to treatment for plantar fasciitis. The body has many bursal sacs throughout the body providing the same sort of bony protection, although the heel bursa seems to take much more of a beating than any of the others. Finally, the heel bone itself can be injured when stepping on a small protruding object. The bone does not typical fracture in this case, but does become bruised in the process, with minor bleeding occurring within the bone from the shock of the injury. It is this type of bruise that is typically associated with the stone bruise process. Of the three injured tissue types, a bone bruise is the hardest to treat because there is not much that can be done for treatment other than activity rest and heel support (like using a walking boot). It can take several months before the pain goes away, and if one does not take it easy during recovery the continued shock and pressure from lengthy walking or running can lead to a stress fracture of the heel bone, which can take even longer to heal.
As you can see, a stone bruise has a nasty reputation for being both annoying and difficult to quickly treat. Keep this in mind when navigating the minefield of your children's toy cars and Lego parts after the holidays.
Until next time,
Scott R. Kilberg DPM
www.inpodiatrygroup.com - foot doctor and podiatrist in indianapolis
thediabeticfoot.blogspot.com - diabetic foot information
YouTube videos on foot conditions
A foot doctor in Indianapolis Noblesville Fishers Carmel Westfield and Fortville Indiana.
My daughter is complaining of heel pain. She is 11 and plays soccer. She doesn't remember stepping on any "stone" or other object. How can I know for sure what is causing her pain and how to heal it with the least expense possible.
ReplyDeleteJennie
Most heel pain at that age is from inflammation of the heel bone growth plate, which usually resolves with rest from sports for a couple months, heel/Achilles gentle stretching, heel padding, and daily icing. I recommend seeing a foot specialist to be sure it is not something more uncommon, and for more specific treatment recommendations based on her foot structure.
ReplyDeleteI was walking barefoot yesterday and stepped on my flip flop which has a plastic object on top. It cut my foot, where the arch is, and I put a band aid on it and that was it. The next afternoon i began to notice the heel of my foot felt like a bruise everytime i put pressure on it. the cut is not bothering me at all, it's very small. but this pain im feeling in my heel is very annoying. I can't walk normally! Could that have been caused my stepping on my shoe? Do you think this is serious? Thanks!
ReplyDeletei play soccer and have noticed a random stone bruise could it be from the blades of my boots digging into my heel when i run??
ReplyDeleteAt Melbourne Podiatrist, our experienced podiatrists come-out with the most effective treatment solutions for shin pain, knee pain, ankle pain and heel pain.
ReplyDeleteI broke my leg in feb and it has nearly healed. I tripped yesterday and now i have pain on the heel of my foot. It does not hurt were it is broken. Is it to do with my leg or is it just a bruise???
ReplyDeleteYou should see a foot specialist for an evaluation. The heel pain is probably not related to the leg fracture, but only someone aware of your specific fracture and examining your foot directly can make that determination.
ReplyDeleteI banged my heel very hard during a fall last september and ever since even a small amount of running results in a couple of days of pain, even standing too long on the heel gives me pain now. what do you think is the problem??
ReplyDeleteCould be one of several different conditions, including plantar fasciitis, heel bone inflammation/stress fracture, or bursitis, amongst others. See a foot specialist for proper evaluation and treatment.
ReplyDeleteFrom what I've read online I have Plantar Fasciitis, I think. I've done a lot of the treatments for it and the morning pain has gone away. But I still have a lot of pain on the inside part of my heel. walking is very uncomfortable and I don't seem to have free movement of my foot. When I got Dr. Scholls inserts for this condition they initially really made my hip hurt on that same side. Do I really have PF or is there soemething else that just causes that heel pain. I had swelling and redness there and it feels like a bruise when I rub it.
ReplyDeleteI can't say for certain just based on a description. There are several conditions that can cause heel pain and can mimic the symptoms of fasciitis. Go see a podiatrist for a medical evaluation so a proper diagnosis can be made. It very well may be plantar fasciitis, but you need a physician to examine your foot to be certain, and they can provide medical treatment you can't do on your own.
ReplyDeleteI got X-rays on my heel and everything, no breakage. The swelling has gone down. Is it smart to ice or just use heat after a week from injury? What can i put in my soccer cleats to prevent it from being painful everytime i put weight on it?
ReplyDeleteI would still use ice for awhile for the inflammation. Soccer cleats will probably hurt until the condition is nearly healed, but maybe a gel pad can help reduce shock to the heel if you can fit it in the cleat and keep it secure. If it still hurts in a couple weeks be sure to follow up with a foot specialist for more care.
ReplyDeleteI saw an orhopedic doctor this morning for a deep bone contusion of the heel. He put me in a walking boot and it seems to be hurting worse now. It is very difficult to be off of my feet during the day as I am a stay home mom of two young boys. Is it normal for it to hurt worse for a while in a boot?
ReplyDeleteIt was the 4th of the July the other day. I thought I wouldn't be walking much, so I wore flip flops. I ended up walking a lot. My feet were killing me and the next day my feet were sore, but nothing that rest wouldn't fix. Then by 8pm that night my heel started to hurt. I can't walk on it. I went to bed and the pain woke me up.
ReplyDeleteThe pain is on the edge of the heel and its extremely sensitive. Could this be the bursa sac you are talking about? My mom says it's just bruised, but I am wondering if I need to go to the doctor?
It is probably not the bursa, as this would not really hurt while in bed. A bruise would not usually be this sensitive. If it still hurts now, have your mom take you to see a foot specialist.
ReplyDeleteHello! I read about your heel pain description and am trying to determine whether I have something similar. The other day about half way through the day I had a sudden pain in my heel. When I step, it hurts (sort of like a shooting pain) if I put any weight on my heel. It does not hurt in my arch and it does not hurt if I step on the ball of my foot. If I'm not standing, I can feel pain on the inside portion of my heel area, about an inch from the bottom of the foot (so imagine if you feel the inner part of the ankle and go down about two inches). The pain is similar to something it would feel like if I had happened to pop a blood vessel in my wrist/hand during volleyball. But there is no blood vessel popped that I can see.
ReplyDeleteIs this something I should worry about? The pain is more tolerable if I put tennis shoes on vs. walking in bare feet. I've been struggling with getting my hip/spine alignment back after pregnancies and don't want to risk walking incorrectly for too long to mess up all the alignment exercises I've done so it would be great to know if this is something I should get checked out or something I should just rest a bit and wait for it to heal.
thanks for taking your time to post this,good karma your way
ReplyDeleteCindy-
ReplyDeleteI would suggest you see a foot specialist. If the pain has not resolved in a week or two, it will likely continue as it probably sounds like plantar fasciitis or a related irritation to a sensory nerve on that side of the heel. See a podiatrist to get a proper diagnosis and start treatment, otherwise this can drag on for a while.
Thanks! I will call this week to make an appointment (and add it to my long list of specialists for my falling apart body...lol)! Love all the info you provide on your blog. :)
ReplyDeleteHello Scott! I have a question regarding foot problem. My husband cant step on his heel and it has been very long time. When he steps on his heel and it is like very sharp thing sticking so unbearable. Do you know what is it? and how to heal it? pls pls pls give us some hint :)
ReplyDeleteIt would be impossible for me to simply give you a specific diagnosis and treatment plan over the internet without examining him as there are numerous conditions that can cause sharp pain in the heel. These can include plantar fasciitis (the most common cause), nerve irritation, bruising, and stress fracture of the heel bone amongst other causes. He needs to be evaluated by a foot specialist to determine the proper diagnosis and come up with a proper treatment plan. Sorry I can't be of more help.
ReplyDeletemy daughter stepped on a rock she thinks she has a big knot on her heel its white looking kinda like a blister and she says it hurts really bad could this just be a bruise or something in her foot?
ReplyDeleteI had plantar fascitis 20 yrs ago. Now i have again but was getting better with icing, stretching, nsaids, etc. I then stepped on an anchor with left heel in a lake. Read about, resting, icing etc but it has been three weeks and hurts but not as bad as did originally. I assume I bruised and all i can do is rest it, ice, and take nsaids. I also wear gel cups in heels for shoes when i wear close shoes. Thanks for any additional suggestions.
ReplyDeleteTo anonymous-
ReplyDeleteIt could be simply the skin blanching from being raised by the bruise underneath. However, it it is 'squishy' like a blister, then there may be fluid under the skin. Both of these should go away after a week or so, if not see a podiatrist for evaluation.
To Kim-
ReplyDeleteYou should see a podiatrist as trying to treat this on your own at home will only prolong the condition. What you are doing is a good start, but there is more that may need to be done, including better foot and fascia stabilization (something a gel heel pain does not actually provide), as well as a possible corticosteroid injection as long as the fascia has not been partially ruptured by the blunt force of the anchor. There may be another injury involved as well to surrounding tissue.
I went to see a podiatrist about a month ago concerning my heel pain. He took x-rays of my foot and it was fine. Was told to wear sneakers (with inserts) 24/7, ice and stretch. I am a runner and was told by the doctor I could continue to run. It now seems that my heel pain has gotten worse. What next??
ReplyDeleteWell, without knowing what your actual diagnosis was, there is quite a bit more involved with heel pain treatment than simply support, icing, and stretching, especially if your inflammation is persisting. See your podiatrist again and discuss you continued pain, or get a second opinion if you feel your condition is not being addressed fully.
ReplyDeleteRight on the back of my heel it feels like a bruise but no visable signs its a sharp pain and interest right where the hard part of the heel gets softer...
ReplyDeleteI was playing softball and injured my heel. I was running in the outfield and came down on my heel very hard - not sure if it was a rock or if I stepped in a hole and came down awkwardly. The pain was instant and very strong in the heel area. There was no bruising until 4 days later when the inside of my foot bruised(no pain in that area). I got an MRI-negative and recieved a cortizone shot in the heel from a podiatrist. She seemed to think that it is a bad bruise. For the first few days the pain decreased but over the next 5 I have not noticed any improvement. I am having a hard time walking due to the fact that when I put pressure on my heel I feel strong pain. I am not sure if i need to wait it out or take other measures-get an MRI. Any help would be greatly appreciated. Thank you
ReplyDeleteHeel bruises can last for several weeks. I would advise you to continue to follow-up with your podiatrist, sometimes the plantar fascia becomes damaged eventually from this injury, and needs further care. A repeat MRI is usually not necessary unless symptoms change or a new injury occurs.
ReplyDeleteI have been reading your blogs and I haven't read anything about a foot problem I have been experiencing lately. Sometimes if I step on my foot a certain way, I get a horrible stinging sensation. The first time it happened I thought I had a bee sting. The area then swells and is followed by a bad bruise. The area is right under my pinky toe and the side of my foot. Just wondering if you had any ideas what this could be. This area of my foot remains sensitive even now. Thank you
ReplyDeleteI accidentally tapped the back of my heel against the corner of a hard wood stereo speaker that sits on the floor. Right on the corner of the speaker directly on the back of the heel. I thought I was stepping around it lightly and slowly but when i hit it, it hurt. Seems a little tender when I try to lay in bed but doesn't look red or bruised yet, a day later. (I don't tend to bruise when I fracture something). Could I have fractured it or bruised it?
ReplyDeleteA fracture would likely be fairly painful, so you probably bruised it but there could be delayed damage to the Achilles tendon. If the pain is not improving in the next several days, see a foot specialist.
ReplyDeleteSarah-
ReplyDeleteUnder this area could be a padded tissue called a bursa that forms to keep pressure off bones, and a nerve also travels in this area. Depending on your foot structure and if the bone at the base of the little toe is prominent (a Tailor's bunion), you may have an inflamed bursa sac that could be pressing on the toe nerve if you hit it just right, although that does not necessarily explain the bruising which is due to tissue bleeding under the skin. There can also be a small extra bone that forms at this area, or one of several other less common things. I suggest you see a foot specialist to get an accurate diagnosis and treatment, especially since it keeps bruising.
Hi Doctor Scott, I wonder if you could comment and suggest some ways to try and fix this, my Wife's left heel is in pain and here is a description. Left foot inner arch above/on the edge of the heel pad from 12 o'clock around to 2 o'clock. Feels like walking on bone, like there is no padding left, might be getting getting worse, not as sore in high heel shoes, only sore when standing on that foot, when feet up or lying down no pain.It has been like this for about 3 weeks and we thought it may have been an old pair of boots that through wear have become uncomfortable. We look forward to your comments, Thank you, Lawrence.
ReplyDeleteThis may be one of several conditions, including plantar fasciitis, heel bursitis, or neuritis. My suggestion is to see a foot specialist since you say it may be getting worse. The boots may have created enough instability to injure the tissue in the heel (plantar fascia, nerve, or bursal sac). High heels reduce pressure to this area, but are not the solution to the problem. A proper diagnosis may make the difference between a quick recovery or a long, drawn out chronic issue.
ReplyDeleteI hope she gets well soon.
I had surgery to reattach my achilles tendon and I am now in a walking boot but I can not walk without crutches because the pain in my heel pad is keeping me from putting any weight on that foot any suggestions
ReplyDeletei steped on a brick from a fire place yesterday and it keeps hurting i try not to walk much on it but when ever i do it hurts but only on my heel hurts what should i do to make it stop hurting
ReplyDeleteAnonymous who had Achilles reattachment:
ReplyDeleteYou need to see your surgeon about the heel pain, as there can be a few causes and treatments.
Anonymous who stepped on a brick:
ReplyDeleteTry using a solid gel heel pad, limiting your activity, and icing the heel. If it has not improved at all in a few days see a foot specialist if you can, or your family physician if a specialist is not available.
I am a skateboarder and have bruised my heel dozens of times. For the last year I have noticed a somewhat floating type chunk in the bottom of my heel. It is easily irritated when I skate. When it becomes inflamed it is pretty painful. Is this a bursa or possibly something else. What can I do to heal this injury?
ReplyDeleteIt may be a bursal sac, but any soft tissue masses in the foot, loose or otherwise, needs to be evaluated by a foot specialist before treatment can be properly suggested.
ReplyDeleteI went to a podiatrist last week and he ran an ultrasound of my heel. He told me that the "chunk" that I described above was a ganglion cyst. He then attempted to aspirate the cyst. He needled what he thought to be a cyst quite aggressively, nearly 20 times in an attempt to get fluid out of it. He didn't get much fluid out and was somewhat puzzled. He injected a steroid into the "chunk" after the attempted aspiration. I waited a week and returned to the doctor's office this morning. There is still a "chunk" in my heel although it did reduce a bit in size. The doctor felt the lump and told me that since it didn't go away after the aspiration that he is now convinced that it is a bursa. He told me that I need to set up an appointment to have it surgically removed. Is this the next step? Is there anything else that I can do to try and get this bursa to go away? Staying off of my feet for an extended period of time is not really an option.
ReplyDeleteIt has been just the last 2-4 months that ive noticed that every week I get this pain in about the middle of my right foot. I went and got a mueller foot/ankle ace bandange type thing but isn't really a "brace". Sometimes it lasts for 3 or 4 days and sometimes I feel the pain once a week. It's hurting rightnow and I have the wrap thing. It seems to come and go whenever it pleases but I was wondering if I should go to the doctor and have him check it out or just keep this thing on when it starts to hurt. Any suggestions?
ReplyDeleteI have heel pain in both feet that feels like I'm walking on rocks or marbles. It comes and goes but you can actual feel the lumps in the heel and move them around. Please help
ReplyDeleteTo flowman,
ReplyDeleteIt is rare to actually feel a bursae under the heel, unless you have very little fat tissue. If you have a mass in your heel, I would suggest an MRI to determine some tissue characteristics prior to simply removing it- bursae are not well defined bodies when under the heel, and removal can be difficult. I have treated thousands of heel pain cases both conservatively and surgically, and have never had to remove a bursae. It is plausible the mass is something else. Of course I would defer to the surgeon examining your foot, but this scenario sounds unusual.
To AlysonHope-
ReplyDeleteSee a foot specialist. ACE-type wraps help in limited situations and are primarily used to compress swelling. See a local podiatrist, and have the underlying condition treated instead of simply bracing the foot for months on end.
To anonymous-
ReplyDeleteSounds unusual- see a foot specialist for an assessment as you should not feel moveable objects in your heel.
Thanks so much for all of your insight! I went to another podiatrist last week. After taking an x-ray of my foot, he believes that I have a hematoma from deep bruises to my heel from skateboarding and not allowing them heal for long enough. I do not have any fractures or heel spurs. I do skate on average 6 days a week for at least 4 hours.He said that he has seen basketball players with a similar injury. I am going to take a few weeks off and have been using warm epsom salt foot baths and cold packs as well as muscle rub. The doctor told me that the hematoma should dissolve on its own after a few weeks of taking it easy. I have been seeing a bit if healing after a week? Does this sound anymore realistic?
ReplyDeleteSounds reasonable to me.
ReplyDeleteHello Dr. Scott, About 2 months ago I stepped on a broken transformer toy of all things, on the heel of my foot. It quickly developed into a small (unbroken) blister like sore, and very sensitive to pressure. Since then, the pain has intensified and the whiteness of the blister has expanded, and the skin has broken up somewhat, almost like an inverted wart. I cant put any pressure on it now, unless super padded with callus pads. I thought Callus medicated pads would help but not sure if the Salicylic acid will make it worse. Yes, I have an appt with a pediatrist next week, but any thoughts on what it is or what I should do in the meantime? Thank you & happy holidays! Lydia
ReplyDeleteHello, I having been suffering from heel pain alot lately it is in my left heel it occurs after I have been standing or walking for a couple of hours and if I have been on my feet all day the next morning it still hurts. now for 8 years(2000-2008) I was a cashier and always on my feet toward the end of those 8 years I would go home sometimes with my feet hurting really bad. Oh and I have really flat feet and in 2001 had knee surgery on my left knee cause where my knee cap rest it was really shallow and he took out little bone fragments. And in 2006 was told I have bursitis in my left shoulder. And over those years slowly gained weight. And the past 3 years (2008-2011) I had an office job and gained even more weight. I would The past 6 months have been out of work and not doing much. And after a couple of hours on my feet my left heel starts to ache really bad . I have lost a few pounds and and trying to lose all that weight I gained over the years since it is not good on my knee or my flat feet. Could just losing weight make this pain disappear
ReplyDeleteTo Lydia-
ReplyDeleteI do not generally recommend medicated callus pads to anyone as they can be caustic to skin, especially injured or damaged skin. It sounds reasonable to keep it comfortable with padding, although without seeing it myself I can offer no concrete advice. Get in to the podiatrist sooner if the skin takes a sudden worsening turn.
To anonymous-
ReplyDeleteWeight loss may help, but will probably not cure the pain which likely has several contributing factors. See a foot specialist for a proper diagnosis and comprehensive treatment.
I've sprung my foot on 12//28/11 and returned to work this Monday. Now I have a bruise on my toes. And it looks worse after work today. It started out all green then after work this Monday it had some black areas and tonight more black and some reddish purple. Is this getting worse? Should I return to the dr for more x-rays and another MRI?
ReplyDeletei sprained my foot in november 2011 the ankle got better but now i have a bad pain under my big toe and the next toe that hurts. i saw a doctor who put me in a walking cast ,its been 4 weeks and the pains steady and getting worsre as i move around.he said i might have a bone contusion, how long will this take to heal?
ReplyDeleteDear Scott, I accidently slipped into a pool and landed very heavily staight down on my right heel. about a 3-4 foot drop. instant pain in my heel. could hardly walk need assistance getting back to car. symptoms. No pain when i press the bottom of my heel with my fingers only when walking, however if i squeeze the sides of my heel i get sharp pain. also after 24 hours i got a circular bruise under the arch of my foot. but no external bruising on the heel.
ReplyDeleteits been 48 and seems to be getting better but still cant walk on my heel every step a problem.
does this sound like a bad bruise or perhaps a break? im worried about the bizzare circular bruise under my arch also.
regards
zachary
sorry i forgot to mention the bruise is approx 1 inch in diamter on the right side of my right foot just behind the the fatty lump of big toe
ReplyDeleteregards
zachary
Zachary,
ReplyDeleteJust go see a foot specialist for an evaluation. Heel fractures from that height can occur, and need prompt treatment.
To anonymous with the bruising foot after work-
ReplyDeleteIf your foot is bruising nearly 2 weeks after your injury and worsening, you should probably return to your doctor. Bruises can take time to evolve after an injury, but after two weeks this process is usually finishing, not worsening.
To anonymous with the bone contusion-
ReplyDeleteThese can take several months to heel, but usually at least improve in a walking cast after 4 weeks rather than worsen. You should call your doctor to express your concerns, he/she may want to see you earlier than scheduled.
Hello Dr. Kilberg, I was playing indoor soccer a couple months ago, and it seemed like the day after the last game, it felt like I had a bruise on my heel. It's not right on the bottom though, like the kind that has been described. It's not a visible bruise either. It just feels like a bruise kind of pain on the inside edge of my heel, like where the side of my heel and the bottom of my heel meet. It has been about a month since it first hurt, and it still hurts. I have been taking ibuprofen about once about six days a week. I am not on my feet that much throughout the day. However I have played some pickup here and there and sometimes the ball hits that part of my heel and it hurts really bad.
ReplyDeleteIs this something that could turn into a chronic problem for the rest of my life? Or does it just need more rest. And if I were to ice how often and long should I do it? Thanks a ton for this awesome service! -Alex
Alex-
DeletePain on the inner edge of the heel often indicates injury to the plantar fascia, which can feel like a bruise in its initial stages. Since you have had continued pain for awhile, you should see a foot specialist for treatment. A simple injury would have long since healed.
Two years ago I was diagnosed with plantar fascitis, My question is am I always going to have foot pain? I am 53, and very active, I play competitive tennis, walk, and do aerobics, my foot hurts every day. I wear inserts in all my shoes, only wear shoes with support, never go barefoot, and even ice after strenious activity.
DeleteThe plantar fascitis changed my whole foot, my arch has dropped a little, and my second toe has curled. Is there any thingelse I can do to relieve the pain?Just recently I injured my heel again by coming down hard and stopping quickly causing a jarring, maybe ruising the heel, i,ve been icing and taking ibuprofen.
Two years ago I was diagnosed with plantar fascitis, My question is am I always going to have foot pain? I am 53, and very active, I play competitive tennis, walk, and do aerobics, my foot hurts every day. I wear inserts in all my shoes, only wear shoes with support, never go barefoot, and even ice after strenious activity.
DeleteThe plantar fascitis changed my whole foot, my arch has dropped a little, and my second toe has curled. Is there any thingelse I can do to relieve the pain?Just recently I injured my heel again by coming down hard and stopping quickly causing a jarring, maybe ruising the heel, i,ve been icing and taking ibuprofen.
Anonymous-
DeleteYou are not always going to have foot pain. If you truly have plantar fasciitis, it needs to be medically treated by someone who treats it on a daily basis. If you are not seeing a podiatrist fro this specific condition then you need to- plantar fasciitis becomes a chronic condition unnecessarily if only half-treated or only treated with home remedies. Inserts and icing are only part of the picture, and that even depends on if the inserts are properly chosen or made for your foot structure. Medical treatment, including anti-inflammatory medications, steroid injections, physical therapy, custom orthotics, and sometimes splints at night to stretch the fascia are part of basic treatment for this condition. Surgery is only needed less than 5% of the time in my experience. Do yourself a favor and make sure you are seeing a specialist for this condition. It really does make a difference in your treatment success.
Hii, I hurt my foot when I was playing handball and I got kinda mad because we ere having a bad game, so I kicked with the inside of my foot and I got a bruise that you can't see.
ReplyDeleteIs there anyway for it to heal faster or ways to make the pain disappear so it won't hurt.
It almost only hurst when I walk.
-Sunna
It simply needs time, although if the pain lasts for longer than a few weeks or is worsening I would advise you to see a foot specialist for care.
DeleteHi Dr. Kilberg,
ReplyDeleteI've been suffering with foot pain for the last 8 months. I had plantar fasciitis but now the symptoms (early morning pain, sharp pain the heel) have disappered. Now, my feet feel really good in the morning but by the afternoon (teaching) my feet ache. There isn't one location of pain, somedays it's my arch, sometimes it's on the side of the heel. I went to a podiatrist last week and he said that it was going to be trial and error to get the pain to go away. I have inserts, new Brooks athletic shoes, I soak my feet with warm water and epsom salt, and I roll my feet on a golf ball. Do you have any suggestions as to what I could do or what my pain could be? I used to run half marathons and full marathons, and now I am lucky to exercise for 1 hour a week. Any advice? Thank you. Lauren
I'm afraid I am going to have to defer any opinion to your podiatrist, as without actually being able to examine your foot I cannot really offer any more comment on your diagnosis or treatment. It is not uncommon for heel pain to move around if inflamed nerves are involved. Possible general treatments for transient heel pain include steroid injections, anti-inflammatory medications, physical therapy, and sometimes surgery (although this is needed infrequently). What you are doing now sounds like a good basic plan to start with at least, but once again I cannot be specific without knowing your actual diagnosis and examining your foot myself.
DeleteMy heel/arch has been sore for a very long time. I have changed shoes twice. I am starting to walk on the outside of my right foot. I just don't know who to go to. What else I can do.
ReplyDeleteHeel and arch pain is very treatable, but can last for many years if left untreated. It is not as simple as a shoe adjustment, although this can be beneficial at least. Go see a podiatrist for definitive treatment. If one is not available in your area, a foot and ankle orthopedic specialist is the next best choice, or at least your family doctor if you do not have access to specialists.
DeleteI keep getting bursitis in my heel. Everytime I go to the podiatrist he just wraps it and puts me in a boot for a week. It gets better but then it comes back a month or so later. Any other suggestions?
ReplyDeleteIf this keeps returning, then there is a problem with either your foot structure, your shoes, or your activity (or a combination of them all) that allows the inflammation to redevelop. Have your podiatrist look deeper into the underlying cause. Sometimes something as simple an orthotic and a change in shoes can provide dramatic improvement in heel bursitis cases.
DeleteDoctor - my wife's foot hurts. Like the ball of the foot. Not the big toe, but the one next to it. What's up with that?
ReplyDeleteThere are many conditions that can cause pain there, including capsulitis, an inflamed nerve, a stress fracture, and joint damage. She should see a foot specialist for evaluation.
Deletemy heel & arch of my foot has been hurting like a tooth ache, this has been going on a few weeks. gets better but if i walk to much starts
ReplyDeleteup again last night even my leg started to hurts what can i do? how long is this going to last. if i wear a shoe with a high arch it feels better
A number of conditions can cause these symptoms. You should see a foot specialist for a specific diagnosis and treatment, as ignoring this may lead to chronic foot pain.
DeleteI've just come home from a 52.2 mile backpacking trip. I've just recently turned 50 & this was a gift from my husband. I've done a bunch of day hikes, but nothing like this before. I also haven't day hiked recently.
ReplyDeleteThe boots I was hiking in have been used for 2 or 3 years, so they were broken in. I had issues with blisters for the entire week, which the guides did treated extensively. Blisters were located on my heel - closer to the arch, on my big toe - all on both feet. They believe these were caused by heat (hiking in Florida), too tight of boot - (not allowing the foot to expand enough due to the heat & heavier pack I was carrying) and sand. I've been home for 13 days now & most of my feet seemed to have healed up. I'm still having pain on my right foot heel. This pain hurts when I press on it or have been standing or walking for a while. There is some swelling on heel/arch area. It does respond to NSAID's and I've just started to use a heel cushion. I've been wearing Merrill clogs, which seems to help. I'm assuming it's probably a bruised heel. How long do you think this will last? Are there other treatments that I should be applying?
Heel bruises are probably far less common than irritation of the plantar fascia, which causes far and away the most number of instances of heel and arch pain. NSAIDs may be a good start, as are stretching exercises and icing. Heel cushions can help fasciitis in a very limited manner (unless it is only a bruise), and arch supports are a better option, but good luck finding a decent over-the-counter pair. Powersteps are probably the best, but are not usually sold in stores. Since a heel bruise and plantar fasciitis are treated a little differently, as they have different needs, I would suggest seeing a foot specialist, especially if you are not nearly pain-free in another couple of weeks.
Deletei had this heel pain for over three weeks when iam sleeping and getting off the bed i have to hold on to something or someone cant stand for long cant walk for long periods i babysit but cant remember stepping on any toys its on my right heel only if i press it with a little force it pain sometime its stay just like that and burns it feel like i got hit on my heel and after 3days iam now feeing the pain but that every day please help thank in advance
ReplyDeleteYou should see a podiatrist about your condition and get it treated. This is not something you should try a treat on your own at home, especially if there is burning pain (often indicating nerve inflammation. Many different conditions can cause your symptoms.
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ReplyDeleteHi Doc,
ReplyDeletewonder if you can help me out here, was making a quick dash across the street the other day and landed a little hard on my heel, felt a bit smart but went away quickly enough.
A day later and I felt like I had something small stuck to the bottom of my heel, like when you get a ball of lint between your skin and sock - or like a blister deep under the skin that's not sore at all.
When I check, there is nothing there - no bruise, no lint, nothing it would seem. I'm now three days in and it's still there. It's not painful at all but I find it really annoying and a bit uncomfortable as I'm always aware of it, any suggestions?
A few thoughts- you may have a deep bruise and are feeling the blood pool inside the heel, or are having a numbing effect from irritation to the nerves in the heel during the injury on the street. Regardless, if this is continuing after a couple weeks or is worsening, see a podiatrist.
DeleteHi doc I have horrible pain in my left foot for 3 months now it feels like there is something hard in my heel and seems to be getting worse I don't know if I should be taking this serious but it hurts more when I'm barefoot than when I have shoes on should i see a doctor is this serious?
ReplyDeleteYes, go see a doctor. Don't ignore severe pain in your foot.
Deletehi, i was walking along a footpath last night and fell into a hole i thought i had rolled my ankle, which ive done before in the past but after about an hour or so the bottom of my heal is hurting greatly, i put ice pack i have done the deep heat and woke up this morning to find that its still no better while im not moving or any weight on it its sore but bearable but when i have to stand up or walk its great pain especially on my heel. it feels different than the last time i rolled my foot any help would be great appreciated
ReplyDeleteYou should probably seek medical attention to make sure you do not have a more significant injury. See a foot specialist, or at least your family doctor or walk-in urgent care type clinic.
ReplyDeleteThe bottom of my heel has begun to hurt on the outside (bottom...not back) in the past month. I am no longer a runner (knees both gone after multiple surgeries), but pain is similar to plantar fasciitis (years past) in that it is worse in the evening. It happens regardless of the shoes I wear (even good running shoes all day). It is like a bruise, and if i even lay my foot to the outside, while driving for example, it is very sore to the touch. I also feel more pain if i turn my toe inwards during a calf stretch. This definitely feels similar to when I have had tendonitis in the past, but the pain is definitely not on the back of the heel, and it has started to hurt whether I exercise (bike) or not.
ReplyDeleteThere are several conditions that can contribute to pain in this location, and sometimes the pain is referred from elsewhere in the heel or foot. These conditions include tendonitis from slightly above this area, a heel bruise, plantar fasciitis of the outer fascial band, nerve inflammation, bursitis, and even something called cuboid subluxation. I would recommend a visit to a foot specialist for assessment and treatment.
Deleteam i allowed to ice my foot
DeleteDear Dr Kilberg,
ReplyDeleteI have flexible flat feet, and my Right foot splays out slightly, though this only really affects my walking when I am barefoot, which I very rarely am.
Ten months ago, I was given hard heel wedges by a podiatrist as a first step to countering my overpronation - they had a rising gradient toward my inner heel. These wedges did not taper off in the direction of my foot arch, but had a sharp edge which would have been just below the area where my heels sink into the arches. I did not worry much about this at the time, as I was wearing padding between the wedges and my feet. However, I noticed after a week or two that when I was barefoot in the shower, there was a plucking sensation in my Right inner heel roughly where it meets the arch. This sensation did not happen while I was wearing the shoes with the wedges in.
Within a couple of months I was wearing arch support insoles, but problems with them meant I was back to wearing heel wedges again by the autumn. In January, I removed them altogether due to stinging and tenderness in the distal centre of both heels which I thought was because of the sharp edges of the heel wedges causing a gradual blunt injury of the nerves in that area. (The surface of my heels had become numb.) I did not suspect plantar fasciitis because it was not worse in the morning, and not aggravated by stretching my ball of foot/toes back.
Having removed the wedges, I am now constantly feeling something wrong in the Right inner heel close to the arch. It is the sensation of something "in" there, but there is no swelling or discoloration. The plucking sensation there which I mentioned before has eased but not gone away completely.
Are you able to advise what might be the problem? Is it possible that the sharp edge of the heel wedge beneath that area was the cause, and it is simply taking a long time (2 months and counting) to recover? Does the plucking sensation suggest nerve damage and what is the best thing I can do to treat it? It is not painful as such, but very irritating. I am not an athlete, but was previously quite active and am now much less so.
Thanks, Andrew
Without seeing the position of the wedges on your skin, and examining where your pain really is in relationship to this area, it would be difficult for me to say if they contributed to your pain. Sometimes nerve inflammation related to flat feet can produce similar symptoms, including brief twinges of heel pain or heel numbness. This includes conditions like neuritis of a nerve branch on the inner side of the ankle as well as tarsal tunnel syndrome a little lower in the nerve course. Bruising can irritate heel tissue and the nerve bundles under the skin, and can take awhile to get better. The bruising is more internal than seen externally. You should speak to your podiatrist again about these symptoms and your concerns so he/she can reexamine you.
DeleteFirst of all I would like to thank you for this blog. I have learned a lot from it and I am impressed with how you have responded to everyone’s questions.
ReplyDeleteI started having foot pain in the morning about four years ago; I ignored it because it would eventually go away. Last year, the pain in my feet was so bad that I went to a podiatrist. I let him know that I was once a distance runner, a former Marine who ran a lot in boots, that I become 60lbs over weight, and that I have had five knee surgeries in the past. I think all of this info is important because all could be the cause of the pain. He let me know that I had plantar fasciitis. He made custom inserts for me and my feet feel better. I told him that I still have a sharp pain in my left heel (bottom, where heel makes contact with floor) and that the sides of my heel are tender when rubbed. I let him know that it hurts most in the morning, when I don’t wear well supported shoes, and after I mow (uneven lawn). His guess was that I had heel spurs but the x-ray showed that I did not. He told me to continue wearing the inserts and to see him again in a few months. I left the office feeling like he didn’t know how to treat my pain. When I came across your blog I got very excited because I feel as if there is hope. Should I see another doctor? He did not mention any of the potential conditions that your blog did.
Unless you have had some treatment to address the actual inflammation causing your pain, supporting the arch structure is only one part of the treatment course, and is more geared for control once the inflammation is improved or resolved, no matter what the cause of your heel pain. If you are still in pain, you are not cured and an extended follow-up length of a few months in light of this is not my protocol. You likely still need active treatment now to address whatever your inflammation/injury source is. If your doctor does not want to do this, you might want to move on. Take this from a doc that treats heel pain successfully everyday.
DeleteWell today I stepped onto a hard ridged metal staple, in bare feet and I actually jumped a bit as I was trying to clear some items on the ground then landing with all my weight (220 pounds) right onto the heel and onto the staple. It bled quite a bit because there was a puncture wound, but that stopped and I cleaned it out - also have my shots. It hurt like crazy when I did it but now is getting worse as the day goes on. As of now I cant walk or put any weight on that foot without bad pain. It hurts when I move my toes and when I turn my foot outward - the pain is in the general area of the injury but also the surrounding heel mostly feels internal. How long will this take to heal and should I see my doctor?
ReplyDeleteYou should see a doctor as soon as possible for this type of injury as infection and tissue damage are common complications with forceful puncture injuries.
DeleteI am asking for my mom. She woke this morning to excruciating pain in her heel radiating from the bottom center of her heel up the back of it. She cannot put pressure on her foot at all and cannot point or flex her foot without causing pain. She had no symptoms whatsoever before this morning. Any ideas of what it could be and what she can do to relieve the pain?
ReplyDeleteMany conditions can cause this pain and appear suddenly, including Achilles tendon inflammation, nerve irritation, inflamed bursa, heel bone stress injuries, and even plantar fasciitis with nerve involvement. She should ice her heel, reduce her activity, and see a physician (preferably podiatrist)as soon as she can, especially if the pain did not lessen significantly in 1-2 days.
ReplyDeleteHi I last summer I had a pair of tennis shoes rub the back of my right heel. After a month on occasional wearing of the shoes The back of my heel began to hurt. The pain never went away it got worse. I went to a foot Dr. and Physical Therapist and they gave me exercise, heel cushions and told me to wear shoes that have an open heel. I still have the pain today a year later. What should I do? They took an x-ray I thought I saw a spur?
ReplyDeleteIf there is a spur irritating the Achilles tendon/heel area and your pain persists despite supportive treatment, surgical removal of the spur and Achilles repair is sometimes needed.
DeleteThank you for the very informative article.
ReplyDeleteI am 34 years old and have been battling heel pain since I was a teeneager, with it getting it progressivly worse as time goes on. Now I can barely put my heel down when I walk. I've had x-rays (which showed a heel spur), have seen podiatrists, surgeons, and physical therapists who, just by sight and description of pain, agreed that it was plantar fasciitis. Then came the stretching, anti-inflammatories, a night boot, physical therapy, and steroid shot...none of it helped. Today I had a follow-up appointment with a doctor, and after realizing (with shock) that the treatments weren't working, he had me pinpoint the painful areas again, grabbed my foot and pushed right on the bullseye (OWWW!), the middle of my heel, and retracted his plantar fasciitis theory. Now he says it's a stone bruise, can't do anything about it, sorry, bye.
As a mother of 4 children under 5 years old (two sets of twins), I don't get a lot of "activity rest". The doctor just said to try everything, good luck. I can't walk without a limp, it hurts all.the.time. Is there any advise that you can give, treatment options, anything. I know I can obviously schedule to see ANOTHER doctor, but don't want to waste my time if there isn't anything anyone can do.
(It seems to hurt worse when I first stand up from a short rest on the couch, or get up in the morning, (like plantar fasciitis), but none of the treatments help at all. It feels like I am stepping on a pebble with each step (like a stone bruise.)
Your options at this stage probably include either shockwave treatment or out right surgical removal of the the inflamed bursae at this site- not easy to so but possible. If you only had one injection of steroid, a series of up to three can be considered, split apart by two weeks, for more conservative treatment.
DeleteLast Friday I had just finished scrubbing my sons carpet (had flip flops on) and as soon as my foot hit the ceramic tile my feet went out from under me and I fell flat on my back with the back of my left heel hitting the tile very hard. The lower inside of my heel bruised instantly. Since then I have had more bruising on the bottom of my heel along with 3 small hard bumps to the right of where it initially hit the tile. My heel now feels cold to the touch in the area bruised. Could I have fractured my heel from the impact of it hitting the ceramic tile? Tried to get in to see my doctor but have to wait 2 days. Thank You for your time.
ReplyDeleteWell, simply put...I don't know. The heel bone is thick and stocky, but it can still fracture either from impact or because of a forceful pull by the Achilles tendon. Your best bet is to have it x-rayed and seen by a foot specialist, which I hope you have done by now.
DeleteA few weeks ago I purchased a new pair of running shoes. I thought that adding some gel inserts to provide additional impact resistance might be good. After my 1st run i began to notice a pain on my arch like i have never experience before. The inserts i used had an arch support, in which I have never used any arch support, and never had had any issues. Could these arch supports caused a bruise from contstant impact against my arch? What must I do to remedy? Thank you for you time and experience in advance.
ReplyDeleteGel inserts typically compress down to a flat surface, so these should not have caused a bruise. The new shoes may have aggravated a previously developing condition, or there may have been a fit issue between the shoes and inserts. For a specific diagnosis and treatment plan, along with help in selecting running shoes and inserts based on your specific foot structure, see a podiatrist.
DeleteI walked on a treadmill for almost 20 minutes during a stress test at the hospital. Part of this was on an incline. I wore the shoes I usually wear when walking, but my feet (especially the heels) have hurt since. It's been 9 weeks and there is no imporvement.
ReplyDeleteSorry to hear about your pain. Go visit a podiatrist to find out what was strained and how it can be relieved.
DeleteIt doesn't look like doctors can do much to diagnose the cause of stone bruise or plantar fasciitis. So depressing. Fourth month and doing everything to no avail.
ReplyDeleteOne traumatic heel fall onto stone and . . . life over.
I hear shock wave works best for a friend with chronic p.f. What do you think of it? Is it worth the $$$$? Of course we would all pay whatever to have a life back. But as the lady above says the beside manner of some doctors is atrocious. "Sorry, your life is over. Just sit and wait for death. You'll receive the bill in the mail."
Went through that with knee pain (it wouldn't go away but did with weight training) and then back pain (they had no idea what caused it but it went away after 11 years of doing everything).
Perhaps the lady above (and myself) just must wait 11 years! Egads.
Actually, plantar fasciitis and stone bruises are quite easy to diagnose and treat, I do it every day and can heal almost every patient that walks in my door.
DeleteWhen severe pain persists, then one of three things has occurred: you have an unusually difficult case to treat due to other contributing health or injury issues, have been initially misdiagnosed (for example stress fractures of the heel bone don't show up on x-rays for weeks to months), or you are not being treated properly for the condition you have.
Shock wave treatment is like many treatments in medicine- it works in some, but not all. You will need to discuss your particular case with the surgeon.
If you are not getting relief despite treatment, it may be time to have the doctor reevaluate your treatment course, or you could get a second opinion. If you live in the US, you do need to make sure you are seeing a podiatrist. Family doctors and even many general orthopedists are often ill equipped to treat complicated foot injury cases. Its not a mark against their skill, its just that we see far more of these kind of cases on a regular basis.
Hi Doctor Kilberg,
ReplyDeleteI bruised my heel a week ago and just took a job where I'm out walking 4.5 hours a day. I made it through one day then am taking time off to heel it. Would gel heel support along with my podiatrist ortho inserts be better for walking then my walking boot that I have from 10 years ago when I had bunion surgery? I've read on some posts that the walking boot would be good to take stress off of the heel....I don't have the money to go to a doctor so I have to self treat this. I'm also icing it 3 or 4 times a day, taking 800 mg 3 x a day (that's the max) and trying to not walk on it much for 6 days before I return to work. Then I'll be out 4.5 hours a day walking....any suggestions to get this bruise heeled and be able to work too?
Excuse my grammatical typos, please. :-)
DeleteIf it is truly only bruised, it will simply take time to heal. Gel pads can reduce shock to the heel tissue. A walking boot from surgery can certainly reduce a great amount of pressure, but after using it awhile the material becomes less supportive (not to mention ten years of fabric degradation sitting in a closet). Icing is good. If it continues to be painful after 2-3 more weeks, you should get it looked at.
DeletePlease reply as soon as you get this please. My ankle hurts really bad, and the other day me and my mom was kicking a soccer ball back and forth and I kicked it with my ankle a few times and now it has a really bad bruise, plus I go to High School and there are a BUNCH of stairs and when i walk up and down the stairs and around school my ankle hurts and from my ankle to my knee hurts too. I really need a fast reply because in gym we are starting soccer soon and I dont want to be in so much pain. So should I go see my doctor tomorrow after I get out of school?????? Please reply ASAP!!!!!!! Please don't wait to long cause I need to know right now so my mom will know what to do after school tomorrow. PLEASE REPLY ASAP!!!!!!!!!!!!!! (kinda like a few min. after I post this if possible please) and thank you for the time to look at this :D
ReplyDeleteThis is not a forum for urgent medical questions. I do not check my blog daily for comments, and cannot give you immediate specific medical advice simply by the description in your comment. If you hurt your ankle, go see your local doctor for care, plain and simple. I am happy to discuss foot and ankle conditions in general, and provide general thoughts on what my readers ask in comments, but I am not a substitute for your local medical providers, nor should I be. Although I am honored that you chose me to seek care advice from, I hope you and your mom, as well as all my readers, understand that the internet is no substitute for real, live, in-person medical care, especially for urgent matters. I with you a speedy recovery.
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