A bruise (‘contusion’) in the pillow of fat protecting the heel can result in pain, often worse when walking.
There are a number of causes for this bruise, in particular landing heavily on the feet, or walking in inappropriate shoes (especially those with very thin soles and poor heel protection). Another cause can be steroid injections given for plantar fasciitis, however in this case the fat pad may be damaged as well as bruised.
Usually the bruise will clear on its own provided the foot is rested, and protected with thick well cushioned shoes. Orthoses (shoe inserts) and taping can also speed the healing process. Fat pad contusions are consequently managed by a GP and/or orthotist (shoe modification specialist).
Other causes of heel pain that may seem similar to bruising of the fat pad include:
- Plantar fasciitis
- Small hairline fractures in the heel bone (see calcaneus fracture)
- Pain from the ankle or midfoot that seems to be present in the heel