Heel pain from a contusion.

Heel pain is one of the most frequent complaints and disabling conditions we see at Okaped. It is basically a
sore heel. There are several pathologies related to heel pain, the most common being Plantar Fasciitis, but only one
may be correctly referred to as calcaneal fat pad contusion.
Calcaneal fat pad contusion presents primarily as pain in the centre heel, often generalized over the entire heel fat
pad. It is sometimes referred to as fat pad syndrome, bruised heel, stone bruise, policeman’s heel, or runner’s heel. It
refers to damage, disruption, atrophy or flattening of the calcaneal fat pad. The calcaneus is the largest tarsal bone
that bears all the weight during heel strike. It is the only bone to make initial contact with the ground; so it is at risk
for injury when a person walks, runs, or lands from a jump (Alexander, 1997).
The skin on the sole of the foot is thicker than anywhere else in the human body, particularly the heel. The heel pad
is uniquely designed to absorb shock, protect the underlying structures and allow pain-free ambulation.

Symptoms of calcaneal fat pad contusions include:

1.Swollen heel
2.Painful walking, running or jumping
3.Pain while standing
4.Tenderness on the heel when subjected to pressure
5.Redness or bruising on the bottom of the heel

Calcaneal fat pad contusion pain can cause a person not being able to do their job properly and prevent an active
lifestyle. The patient presenting with fat pad contusion will always describe the pain as “like walking on a deep
bruise” or “a dull ache.” There can be a trauma like a blow to the heel, or landing hard while barefoot or jumping in
dress shoes that have a hard heel. Pain is aggravated by walking barefoot on a hard surface like tile or hardwood
floor, and the gait will be antalgic. Upon examination the patient will experience pain over the entire heel pad. A
thumb pressed in the centre will re-create the pain.
There are many ways to treat calcaneal fat pad pain. It could involve physiotherapy, over-the-counter arch supports,
footwear changes or custom foot orthotics. It is important to see a Pedorthist to have your mechanics and gait
analysis checked to have a proper treatment plan designed for you. To learn more about how OKAPED can help
with heel pain please call one of our clinics to book an appointment.