From the Guidelines
You should not put a boot on a bruised heel bone for a few weeks to heal, as immobilization is not typically recommended for this type of injury. Instead, treatment for a bruised calcaneus (heel bone) typically involves the RICE protocol: rest, ice, compression, and elevation. Rest by limiting weight-bearing activities and using crutches if walking is painful. Apply ice to the heel for 15-20 minutes every 2-3 hours during the first 48-72 hours to reduce swelling and pain. Compression can be achieved with an elastic bandage wrapped around the foot and ankle. Elevate the foot above heart level when possible to minimize swelling. For pain management, over-the-counter medications like acetaminophen (Tylenol) at 650mg every 6 hours or NSAIDs such as ibuprofen (Advil, Motrin) at 400-600mg every 6-8 hours can be effective, but should not exceed maximum daily doses (4000mg for acetaminophen, 3200mg for ibuprofen) 1.
Some key points to consider when treating a bruised heel bone include:
- Limiting weight-bearing activities to reduce stress on the heel
- Using ice and compression to reduce swelling and pain
- Elevating the foot to minimize swelling
- Using over-the-counter pain medications as needed
- Gradually returning to normal activities after the acute phase (3-5 days)
It's also important to note that if pain persists beyond 2-3 weeks, worsens significantly, or if you're unable to bear weight, you should seek medical attention as this could indicate a more serious injury like a stress fracture rather than a simple bruise 1.
In terms of specific treatment recommendations, the American College of Foot and Ankle Surgeons suggests that initial treatment options may include open-backed shoes, heel lifts or orthoses, NSAIDs, decreased activity, stretching exercises, and weight loss (if indicated) 1. However, immobilization is not typically recommended for a bruised heel bone, and instead, patients are encouraged to gradually return to normal activities after the acute phase.
Overall, the goal of treatment for a bruised heel bone is to reduce pain and swelling, promote healing, and prevent further injury. By following the RICE protocol and using over-the-counter pain medications as needed, most people can recover from a bruised heel bone within 1-3 weeks.
From the Research
Treatment for a Bruised Calcaneus (Heel Bone)
- The recommended treatment for a bruised calcaneus is not explicitly stated in the provided studies, but some studies suggest that rest, ice, compression, and elevation (RICE) therapy may be beneficial in reducing pain and swelling 2, 3, 4.
- A study on calcaneal bone bruise after surgery for insertional Achilles tendinopathy found that modified symptom-free loading and cautious rehabilitation can help resolve the bone bruise 5.
- There is no direct evidence to support the use of a boot for a few weeks to heal a bruised calcaneus, but immobilization and protection of the affected area may be necessary to promote healing.
- The treatment for a bruised calcaneus may vary depending on the severity of the injury and individual patient needs, and should be guided by a healthcare professional.
Rehabilitation and Recovery
- Rehabilitation for a bruised calcaneus should focus on pain-free loading and gradual return to activity 5.
- Early motion and mobility are recommended, but ligamentous strength may not return until months after the injury 4.
- A study on ankle sprains found that chronic ankle instability can occur if the injury is not properly managed, and that updated clinical practice guidelines emphasize the importance of diagnosing, managing, and preventing acute ankle sprains and chronic ankle instability 6.