Our feet take a lot of abuse. According to the American Podiatric Medical Association, they log an impressive 75,000 miles by the time we reach 50.
The bottoms of your feet are padded with shock-absorbing fat. While they can withstand a lot of wear and tear, they’re not invincible. It’s not uncommon for them to bruise due to things like injury, sporting activities, unsupportive footwear, and more.
What are the symptoms?
A bruise is called a contusion in medical terms. They can occur anywhere on the body when your soft tissues are injured. Following the injury, small blood vessels under the skin break and allow blood to leak out.
Initially, the bruise might be tender and reddish or purplish. As it heals, the tenderness subsides and the blood will be metabolized. As this occurs, bruised skin turns from red to bluish to yellowish, and finally back to normal. It generally takes about two weeks for a bruise to resolve completely.
In some cases, your foot may feel as though it has a bruise. It may be tender or swollen, but there’ll be no discoloration. This may be because the broken blood vessels lie deeper under the skin or because your skin is thick, camouflaging the pooled blood.
There are a wide variety of reasons why the soles of your feet may bruise. They include:
1. Sports injury
Your heel pad takes the brunt of the impact when your foot lands after moving forward. That means it’s a prime spot for bruising.
The bruising often results from repetitive, forceful heel strikes. These can occur while playing basketball or volleyball, or running or tackling the long jump in track and field competitions. People who do a lot of marching, such as musicians in a marching band or people in the military, are also at higher risk.
Part of the normal aging process is the thinning of skin and the loss of collagen and fat deposits throughout the body. Have you ever noticed a thinning in the face in older people? The same goes with the fatty pads on the heel and ball of the foot.
According to the Institute for Preventive Foot Health, by age 50 we’ve lost roughly 50 percent of the fat on our feet. When these fat pads thin, there’s less cushioning. This makes the sole more prone to bruising.
3. Unsupportive shoes
If you walk around barefoot or in thin-soled shoes, you’re setting your foot up for bruising. Without proper protection, a pointy rock, sharp stick, or other debris can easily damage soft tissue and create a bruise.
4. Fractures or breaks
An injury severe enough to damage a bone is also severe enough to break the blood vessels under the skin and cause bruising. Depending on where the injury is, you can experience bruising on the bottom of the foot. With a broken or fractured bone, you’re also likely to experience pain, swelling, and perhaps even cuts.
This condition, also known as a stone bruise, is generally caused by a change in the way you walk. For example, you may develop this condition if you’ve changed your gait because you’ve gained weight, have developed arthritis or gout, or you’re wearing poor-fitting shoes.
This change in gait can put undue pressure on the ball of your foot, where you’re likely to experience sharp, shooting pains. The toes may also be numb or tingly. You may also have bruising on the ball of the foot. It’s possible to have this condition with no visible bruising as well.
According to the American College of Foot & Ankle Orthopedics and Medicine, many people describe the feeling as “walking over pebbles.” This is where the name stone bruise comes from.
6. Plantar fascial rupture
Plantar fasciitis is a common cause of heel pain that occurs when the plantar fascia becomes injured and inflamed. The plantar fascia is the tough, fibrous band that connects the toes to the heel bone. This is more common in athletes due to repetitive, forceful movements in sports. It’s also seen in people who are:
- have flat feet
- wear ill-fitting shoes, which adds pressure to the fascia
If the fascia fully ruptures or tears — which can happen when the elastic fascia is stretched beyond its limit — you’re likely to feel immediate and intense pain in the heel and arch of the foot. You’re also more likely to experience bruising with a ruptured fascia.
7. Lisfranc injury
Named after a 19th century French surgeon, a Lisfranc injury occurs when the bones or ligaments of the midfoot are broken or torn. The midfoot is important for stabilizing the arch. This injury often occurs following a slip and fall.
Symptoms include pain and swelling on the top of the foot, as well as bruising on the bottom.
8. Medications or bleeding disorders
Medications, such as the blood thinners warfarin (Coumadin) or rivaroxaban, make it easier to bruise areas of the body. This includes the bottom of the feet. Certain diseases can also result in easier bruising, such as hemophilia or thrombocytopenia.
When to see a doctor
See your doctor if:
- you can’t walk
- you’re in extreme pain
- the swelling doesn’t subside with self-care
Your doctor will do a physical exam and ask you some questions. They’ll want to know:
- when the bruising started
- if you’ve fallen or encountered a trauma to the foot
- what type of shoes you wear
- what sporting activities you regularly participate in
Your doctor may order imaging tests such as X-rays and MRIs to see what’s happening inside your foot. These can help them see if you have a broken bone or another internal injury.
They may also recommend physical therapy to help with recovery.
Bruising on the soles of your feet usually indicates some kind of injury. To speed recovery, try:
- Rest. Get off the injured foot as soon as possible. If you continue to use it, you can cause more harm
- Ice the foot for 15 to 20 minutes every three to four hours for the first 48 hours after an injury.
- Wrap the foot in a compression bandage if swelling is substantial. The bandage should be snug, but not so tight that it constricts circulation.
- Elevate your foot above your heart level to reduce swelling.
- Take over-the-counter anti-inflammatories, such as ibuprofen (Advil, Motrin), to reduce pain and inflammation.
- Begin stretching and strengthening exercises once your doctor gives you the OK.
How is this treated?
Depending on the cause of your bruising, your doctor may recommend non-weight-bearing casts or boots to help immobilize the foot and prevent further damage. Severe swelling, such as what you may experience with plantar fasciitis or a facial rupture, may need cortisone injections.
Whenever there are broken bones and subsequent misalignment of the joints — which is often the case with a Lisfranc injury — surgery is often recommended.
How to prevent bruising on the bottom of your foot
While you can’t always prevent bruising on the bottom of your foot, there are some things you can do to reduce your risk.
- Wear properly fitting shoes. Your heel shouldn’t slip, your toes shouldn’t be crammed into the toe box, and the shoe should be wide enough to accommodate your midfoot comfortably. A shoe with a sufficiently cushioning sole is also important.
- Wear the right shoe for the right sport. For example, basketball shoes are made for playing on a wooden court, which is much more forgiving than running on cement. Running shoes, on the other hand, have more cushioning in the sole to absorb extra impact.
- Use shoe inserts for extra arch support if you have flat feet or plantar fasciitis.
- Avoid going barefoot or wearing thin-soled, unsupportive shoes.
- Lose weight if you’re overweight.
- Stretch your arches by rolling a tennis ball back and forth under your feet.
What’s the outlook?
Given the daily punishment feet take, bruising on the soles isn’t uncommon. Depending on the cause, you can be fully recovered in a few weeks to a few months. And with a little forethought and preparation, many injuries can be prevented altogether.