Foot Bruise

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What is a foot bruise?

The foot’s major structures are the toes, arch and heel, which are made up of bones, joints, muscles, tendons and ligaments. A foot bruise occurs when blood leaks out of the blood vessels in the foot into the tissues of the skin, muscles or bones. Foot bruising can affect any part of the foot, from the toenail to the very back of the heel. A foot bruise may appear on a small part of one foot or large areas of both feet, depending on the cause.


The foot helps provide stability, balance and movement for the entire body. Because feet are so involved in movement, bear impact from the weight of your body, and are at the extreme end of the body, they are more prone than many other body parts to contact injuries that may cause bruising. Different types of foot bruising include contusions, hematomas and purpura.

Contusions

Contusions are common types of bruises that are caused by trauma. The trauma can range from mild impact, such as from improperly-fitting shoes, to a more moderate or serious blunt-force injury that damages and breaks open the blood vessels in the tissues of the skin, muscles or bones. Contusions are often accompanied by pain and swelling due to the body’s inflammatory response to injury.

When a contusion develops on your skin, it turns red, then black and blue or purple, and finally a greenish-yellow shade as the blood is broken down and absorbed by the body. 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

Foot 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 than contusions. 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

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, and Henoch-Schonlein purpura

  • 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 can cause problems with clotting)

  • Vasculitis (blood vessel inflammation)

Seek prompt medical care if you have easy or frequent bruising on the feet or elsewhere on your body, especially if it is associated with nosebleeds or bleeding gums. Seek immediate medical care (call 911) if you, or someone you know, develop petechiae (small, flat purple-colored spots), high fever, severe headache, change in alertness, or a stiff neck, which can be symptoms of meningitis or other serious conditions.

What other symptoms might occur with a foot bruise?

A foot bruise may be accompanied by other symptoms that vary depending on the underlying disease, disorder or condition. Foot bruises are often associated with foot pain, swelling, and skin discoloration. Easy bruising or unexplained bruising of the feet or any body part may also be accompanied by other bleeding symptoms.

Foot symptoms that may occur along with a foot bruise

Foot bruising may occur with other symptoms related to the foot including:

Other symptoms that may occur along with a foot bruise

A foot bruise may occur with symptoms outside the foot. Symptoms may include:

Serious symptoms that might indicate a life-threatening condition

In some cases, such as in major trauma or complications of an underlying disease, a foot bruise may occur with other symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these serious symptoms:

  • Confusion or change in level of consciousness or alertness, such as passing out or unresponsiveness

  • Deformity or sudden loss of function or sensation in the foot

  • Difficulty breathing, wheezing, or severe shortness of breath

  • Extreme pain, swelling, or feeling of pressure in the bruised area

  • Petechiae (tiny pinpoint red or purple dots from bleeding under the skin)

  • Seizure

  • Stiff neck

  • Sudden, severe dizziness or light-headedness

  • Vomiting blood, bloody stools, or heavy rectal bleeding

What causes foot bruises?

Most foot bruising is caused by a minor contusion or injury, such as from minor bumps, scrapes, trips or falls. You may find that you bruise more easily on your feet and legs than on other body parts. This is because those areas are generally more prone to injury and to the effect of gravity on blood flow. Easy bruising may simply be a familial, or inherited, tendency and not necessarily a cause for concern. Easy bruising is referred to as purpura simplex. 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. Contact your healthcare provider to discuss your symptoms.

Injuries and trauma that can cause a foot bruise

Foot bruises can be caused by everyday injuries or more serious trauma including:

  • Blunt force or crush injury, such as a direct blow to the foot, dropping something on your foot, or crushing your foot under a very heavy object

  • Falling or tripping

  • Foot or ankle fracture

  • Sports injury, such as from running, skiing, snowboarding, or sports that involve person-to-person contact, including football and ice hockey

  • Sprained ankle

  • Walking, running or jumping on hard surfaces

Age, gender and lifestyle causes of a foot bruise

Easy or unexplained bruising on the feet can be caused by age, gender and lifestyle factors, such as:

  • Aging skin

  • Alcohol abuse (decreases blood clotting)

  • Female gender (women tend to bruise more easily than men)

  • Overweight

  • Wearing the wrong size or fit of shoe

Serious underlying diseases and other conditions that can cause a foot bruise

A variety of diseases, disorders and conditions can cause bruising symptoms on many areas of the body. Some serious underlying causes of unexplained bruising or purpura include:

  • Aplastic anemia

  • Autoimmune diseases, such as lupus and rheumatoid arthritis

  • Certain infectious diseases, such as meningitis, mononucleosis and measles

  • Cushing’s disease

  • Hemophilia and Von Willebrand's disease (inherited bleeding disorders)

  • Insect bites

  • Leukemia

  • Organ failure

  • Thrombocytopenic purpura diseases (potentially life-threatening platelet disorders that cause problems with blood clotting)

  • Vasculitis

  • Vitamin C deficiency (scurvy)

Medications that can cause bruising

The following medications may cause easy bruising or purpura on the feet and elsewhere on the body:

  • Anticoagulants (blood thinners), such as warfarin (Coumadin), enoxaparin (Lovenox), and heparin

  • Antidepressants, such as fluoxetine (Prozac) and paroxetine (Paxil)

  • Antiplatelet medications such as clopidogrel (Plavix)

  • Aspirin

  • Fish oil

  • Ginkgo biloba

  • Interferon

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn)

  • Penicillin

  • Radiation or certain cancer chemotherapies

Always tell your doctor about any medications or treatments you are using, including prescription drugs, over-the-counter medications, dietary supplements, and herbal or alternative treatments.

What are the potential complications of a foot bruise?

Complications associated with foot bruises can be progressive and vary depending on the underlying cause. Because easy or unexplained bruising of the feet or any part of the body can be due to serious diseases, failure to seek treatment can result in complications and permanent damage. It is important to contact your healthcare provider when you have any kind of persistent or recurrent foot bruising. Once the underlying cause is diagnosed, following the treatment plan outlined by your doctor can lower your risk of potential complications including:

  • Compartment syndrome (severe swelling that leads to permanent muscle damage, disability, tissue death, and gangrene)

  • Myositis ossificans (bruised muscle that become calcified by growing bone cells instead of muscle cells as it heals, which can lead to chronic pain and reduced flexibility)

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 2
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Bleeding into the skin. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003235.htm
  2. Bruises. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/bruises.html
  3. Heel Pain. American Podiatric Medical Association. http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=985
  4. Henoch-Schonlein purpura. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001461/
  5. Muscle Contusion (Bruise). American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00341
  6. Purpura. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003232.htm
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