Heel Contusion

by Madison
(Sioux City, IA)

I have had a heel contusion from an impact injury for the past 4 months and am currently on a Steroid, my doctor told me he could try a cortisone shot and if that doesn't work than we will cast my leg non weight bearing for 4-6 weeks. I am a dancer and have a lot coming up so you think casting it and not using it will make it heal faster? Thanks for the opinion

RESPONSE

Hi Madison,

The critical question I have for you is did you have an MRI? A heel injury of four months duration, that is not getting better needs further investigation to see if you fractured your heel. This might not show up in a standard x-ray.

If you have not had an MRI ask your doctor to order one. If there is a fracture, depending on its nature, you may have to go non-weightbearing in an effort to get it to heal. Additionally, the use of a bone stimulator will be very helpful.

If you have had an MRI and it does not reveal a fracture, then going non-weightbearing will still be very helpful as apparently the constant walking on the heel is only aggravating the situation. As I have stated many times on this site, walking on an injured part of a foot, in many instances, will continue to just aggravate the problem rather then help it get better.

If your problem is just a heel contusion, then along with going non-weightbearing, I would also recommend physical therapy. Physical therapy will help move things along.

Again, if your condition is only a bone contusion, then you might want to consider a plastic heel cup like the ones we sell on this site.

You can try a little test. With your finger, press against the bottom of your heel and get a baseline level of pain (how much does it hurt?).

Now take one hand and cup it around the heel, from side to side, which will force all of your heel fat back under the heel. With the heel cupped like that, take your finger and press against the bottom of the heel again. If you notice a substantial reduction in pain, then a heel cup may be all you need.

These heel cups are known as "eggshell" heel cups and not heel cushions. As I just stated they will cup the heel fat under the heel which in turn will cushion the heel when you walk and should dramatically reduce your pain.

As a side note, this type of heel cup will not be of much value if you actually have a fracture in your heel.

If you have been on oral steroids for four months with minimal improvement, you should probably go off them, but speak to your doctor first. Secondly, I would not recommend a cortisone shot until you have had an MRI, again if you have not already had one. Both oral steroids and injected steroids will slow down and delay healing of a fracture.

Marc Mitnick DPM
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