Foot Bruise

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 causes 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.