The heel bone and the surrounding soft tissues including the fat pad are highly evolved in withstanding a lot of stress and shear forces as well as heavy loads / impact. Too much stress however can push them over their limits and lead to repetitive strain or more acute injuries.
There are many causes of heel pain and it is important to seek medical advice early to prevent developing a chronic condition leading to more problems and taking longer to recover. The treatment will depend on the cause of the pain in the first instance. The pain beneath the heel often results from bruising of the soft tissue or fat pad otherwise called a stone bruise, it can also affect the deeper structures such as the plantar fascia causing plantar fasciitis otherwise known as Policeman’s heel or heel spurs by some practitioners. Pain behind the heel may be caused by bursitis or insertional Achilles tendon disorders and can also be due to increased bone formation such as Haglund’s lesion.
The heel bone is particularly susceptible to stress fractures as an important cause of swelling and pain in this area.
A sudden fall from a height can also cause acute heel bone fracture and it is paramount to get urgent assessment and treatment for optimal results.