Heel Pain Feels Like a Bruise? It May Be Plantar Fasciitis

Understanding Heel Pain That Feels Like a Bruise

Waking up one morning only to find that your heel is bruised and hurts with every step can be alarming. The intense pain in your heel makes walking normally almost impossible, and you likely have no idea what caused this sudden onset of symptoms.

If you are experiencing heel pain that feels like a bruise, chances are you are dealing with a condition known as plantar fasciitis. This common foot ailment affects more than 2 million people every year in the United States alone. Thankfully, with proper treatment, most patients are able to find relief within a few months.

What Is Plantar Fasciitis?

Plantar fasciitis refers to inflammation of the plantar fascia, which is a thick band of tissue that runs along the bottom of your foot. This connective tissue extends from your heel bone to your toes and supports the arch of your foot.

When the plantar fascia becomes irritated and inflamed, it essentially develops small tears and becomes weaker. This causes stabbing pain in the heel, especially with the first steps in the morning or after long periods of inactivity.

What Are the Symptoms of Plantar Fasciitis?

The classic symptom of plantar fasciitis is sharp, stabbing pain in the bottom of the heel. Many patients describe it as feeling like a bruise in their heel that makes every step excruciating.

The pain is often most severe with the first steps after getting out of bed in the morning or getting up after prolonged sitting. The pain may then improve somewhat after walking for a few minutes, but it usually worsens again toward the end of the day.

In addition to pain in the heel, plantar fasciitis can also cause:

• Tenderness or pain if pressure is applied to your heel
• Tightness and limited flexibility in your Achilles tendon and calf muscles
• Swelling around your heel
• Numbness or a burning sensation in your heel

If left untreated, the pain can worsen over time and start limiting your everyday activities. Some patients even develop heel spurs as a result of the excessive stretching and pulling on their plantar fascia.

What Causes Plantar Fasciitis?

A variety of factors can contribute to the development of plantar fasciitis, including:

• Overuse: Excessive running, jumping, or walking can overstretch the plantar fascia and cause small tears in the tissue.
• Obesity: Excess weight places additional strain on the plantar fascia and contributes to inflammation.
• Flat feet: Those with flat feet or fallen arches are at higher risk due to decreased arch support.
• High arches: On the other end of the spectrum, high arches put more tension on the plantar fascia.
• Poor footwear: Shoes without proper arch support or cushioning increase pressure on the heel.
• Standing for long periods: Jobs that require prolonged standing on hard surfaces put a lot of stress on the heel.
• Aging: The tissues become less flexible and elastic with age.
• Sudden increases in activity: Abrupt changes in exercise routine without proper conditioning.

When to See a Doctor

You should make an appointment with your doctor if:

• Your heel pain does not improve with at-home treatment after 2-3 weeks
• The pain is severe and limiting your daily activities
• You experience swelling, redness, or bruising in the heel
• You have numbness, tingling, or burning sensations in the heel
• You have a fever, which could indicate an infection
• You have leg or heel pain only at night or while resting

Seeking prompt medical attention is crucial to get an accurate diagnosis and appropriate treatment plan. Your doctor will likely ask about your symptoms, medical history, and lifestyle habits. They may recommend imaging tests like an x-ray or MRI to check for heel spurs, stress fractures, or other issues.

How Is Plantar Fasciitis Diagnosed?

To diagnose plantar fasciitis, your doctor will perform a physical exam of your feet and ask about your symptoms. They will likely press on different areas of your heel to pinpoint where you feel pain.

Your doctor may also order imaging tests such as:

• X-ray: Looks for heel spurs or stress fractures
• Ultrasound: Used to observe fascia thickness and check for tears
• MRI: Provides a detailed view of the heel tissues and bones

Blood tests are not typically needed but may help rule out conditions like rheumatoid arthritis or gout in some cases.

The hallmark symptoms of pain with the first steps that improves with walking are usually sufficient for making the diagnosis. Plantar fasciitis is one of the most common causes of heel pain.

How to Treat Plantar Fasciitis at Home

Most cases of plantar fasciitis can be treated at home using conservative measures, including:

• Rest: Avoid prolonged walking or standing to allow inflammation to subside.
• Ice: Apply ice packs to the heel for 15-20 minutes several times per day to reduce pain and swelling.
• Pain medication: Over-the-counter nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen can ease discomfort.
• Stretching: Gently stretch the plantar fascia and Achilles tendon before getting out of bed.
• Heel pads: Use silicone heel pads inside the shoes to cushion the heel.
• New shoes: Wear shoes with good arch support and shock absorption.
• Night splint: Use a splint at night to passively stretch the Achilles tendon and plantar fascia.

If home treatments are not helping after a few weeks, you should follow up with your doctor.

Medical Treatments for Plantar Fasciitis

Your doctor may recommend advanced treatments if your heel pain persists, including:

• Corticosteroid injections: Steroids help reduce inflammation in the short-term but are not a permanent fix.
• Shockwave therapy: Focused sound waves applied to the heel spur microtears to promote healing.
• Orthotics: Custom shoe inserts provide arch support and help distribute weight away from the plantar fascia.
• Night splints: Prescription splints worn overnight gradually stretch the plantar fascia and Achilles tendon.
• Physical therapy: Stretching exercises, massage, and other modalities help relieve tension in the plantar fascia.
• Surgery: Lengthening or removing the plantar fascia in severe, chronic cases that do not respond to other treatments.

Most patients improve with conservative treatments, but discuss all options with your doctor if you are not getting better.

Plantar Fasciitis Exercises

Certain exercises can help stretch the plantar fascia, improve foot flexibility, and strengthen the muscles supporting the arch. This aids recovery and helps prevent future flare ups. Try incorporating these simple exercises into your routine:

• Calf stretches: Hold onto a wall for balance, keep the leg straight, and gently lean forward to stretch the calf muscle. Hold for 30 seconds and repeat on each side.
• Towel stretches: Sit with one leg extended. Loop a towel under the ball of the foot and gently pull back to stretch the plantar fascia. Hold for 30 seconds and repeat on each side.
• Tennis ball massage: Roll a tennis ball under your bare foot for several minutes to massage the plantar fascia.
• Marble pick-ups: Use your toes to pick up marbles or small objects to strengthen the arch muscles.

A physical therapist can recommend additional targeted exercises based on your individual case.

How to Prevent Plantar Fasciitis

You can take steps to prevent plantar fasciitis flare ups in the future, including:

• Stretch the plantar fascia and calf muscles daily
• Use orthotic inserts or arch support shoes
• Lose weight if BMI is over 30
• Warm up properly before exercise
• Increase physical activity gradually
• Take frequent breaks from prolonged standing
• Ensure proper running/walking technique
• Consider lower-impact exercise alternatives like swimming

Wearing supportive footwear, maintaining a healthy weight, and performing calf and foot stretches can go a long way in preventing plantar fasciitis recurrences.

The Outlook for Heel Pain from Plantar Fasciitis

Plantar fasciitis is very common but fortunately responds well to conservative treatments in most patients. With a few months of home care, stretching exercises, and accommodative shoes, pain typically improves without the need for advanced medical interventions.

However, the condition may become chronic in a small percentage of patients, requiring more aggressive treatments. Some individuals continue to experience heel pain or repeated flare ups over the long-term.

By staying active, maintaining a healthy weight, wearing proper footwear, and doing calf/foot stretches, you can keep plantar fasciitis at bay. But if heel pain does not subside after a few weeks of home care, be sure to follow up with your doctor for further guidance.

With the right treatment plan, most people with plantar fasciitis are able to resume their normal routines and get back on their feet within a few months!

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.