Foot Conditions A-Z
A bruise will initially appear red, reflecting the color of the blood in the skin. But in a day or two, the site appears as a familiar black-and-blue mark. By about day six, the color changes to green and by day eight or nine, the bruise will appear yellowish-brown. Generally, a bruise is repaired by the body and the skin returns to normal in two to three weeks. Foot bruising can occur at any spot on the foot, from the toenail to the back of the heel, and often produces pain or discomfort in the area where it occurs (forefoot / toes, arch or heel).
Most foot bruising is caused by a minor trauma or injury--from bumps, dropping something on your foot, scrapes, trips or falls, sports injuries, sprained ankles or even just walking, running or jumping on hard surfaces.
Easy bruising may simply be a familial, or inherited, tendency and not necessarily a cause for concern. Easy bruising, often called “purpura simplex,” also can happen because of age, gender (women bruise more easily than men) and lifestyle factors, such as alcohol abuse (which decreases blood clotting), obesity or simply wearing the wrong size shoes or improperly designed or fitted shoes.
However, frequent and unexplained bruising on your feet (or any part of your body) can be a sign of something more serious, such as a blood clotting disorder or a blood disease. A bruise forms when blood vessels near the surface of the skin break, allowing a small amount of blood to leak into the tissues under the skin.
Foot bruises are classified as “contusions,” “hematomas” or “purpura” based on the nature and severity of the injury.
Contusions are caused by any blow that damages and breaks open the blood vessels in the tissues of the skin, muscles or bones, from mild impact to serious blunt-force trauma. Contusions may be accompanied by pain and swelling. Foot bone contusions and deep muscle contusions can be very painful and take longer to heal than contusions that only affect the skin tissues.
Hematomas are a type of bruising in which significant bleeding results in blood pooling under the skin at the site of injury. Hematomas can be caused by the same forces that cause contusions, but they generally cause more pain, swelling and complications. Hematomas can also be caused by surgical procedures or the spontaneous rupture of a blood vessel. Common hematomas affecting the foot include subcutaneous hematomas (collection of blood beneath the skin) and subungal hematomas (collection of blood under a toenail).
Purpura is caused by spontaneous leaking of blood from tiny blood vessels (capillaries). It results in red, flat spots or patches on the skin and mucus membranes. Purpura that results in tiny spots on the skin is called “petechiae.” A large area of purpura is called “ecchymosis” (although any type of bruising of the skin is often referred to as “ecchymosis”).
Purpura is not caused by trauma, as are contusions and hematomas, but by a variety of diseases, disorders and conditions including autoimmune diseases such as lupus, rheumatoid arthritis; certain infectious diseases such as meningitis, mononucleosis, Rocky Mountain spotted fever and measles; certain medications, such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, antihistamines and anticoagulants (blood thinners); insect bites; leukemia; thrombocytopenia (low platelet count that causes problems with clotting); and vasculitis (blood vessel inflammation).
Separate from the above is a bone bruise, which is much more painful and the pain lasts much longer than a bruise on the skin or in the muscle. It is considered to be one step below a fracture. Human bone is made up of interconnected fibers which, taken collectively, are called “cortex.” When only a few fibers break but the bone does not break, a bone bruise results. If enough fibers break, the result is a fracture.
Prevention and Treatment
Prevention is difficult if not impossible to completely achieve. Totally protecting the feet from any possibility of injury would be the only way. For optimal foot protection, IPFH suggests wearing only properly selected and fitted, as part of an integrated approach, padded socks with shoes with non-slip outsoles and any inserts or orthotics prescribed or recommended by a doctor or foot health professional. Peer-reviewed, published studies have shown that wearing clinically tested padded socks can help protect against injuries to the skin/soft tissue of the foot due to impact, pressure and/or shear forces.
Light bruises typically heal on their own. The immediate application of ice while elevating the bruised area may reduce or completely prevent swelling by restricting blood flow to the area and preventing internal bleeding. If you suspect a bone bruise, see your doctor immediately to avoid further bone damage.
Complications associated with foot bruises can be progressive and may vary depending on the underlying cause. Easy or unexplained bruising of the feet can be due to serious diseases, so it’s important to see your doctor if you bruise easily and/or frequently for no apparent reason. Once an underlying cause is diagnosed, following the treatment plan outlined by your doctor can lower your risk of potential complications.