swelling and soreness on top of foot

by Nancy
(Newkirk OK)

I dropped a heavy shampoo bottle on the top of my foot about a week ago. I can wear yellow box flipper shoes and walk on it most of the time. If I put on other shoes, it is painful. Is it necessary to have it xrayed? I have used ibiprofen, but it is not better. Is it important to ice and elevate this type of injury? How long is normal for the swelling? It is bruised and my toes are darker like some blood has pooled near the beginning of the toes. I have pretty much been able to continue my normal routine, but I keep wondering if I should have done something more.

RESPONSE

Hi Nancy,

The simple solution to your problem would be to see a local foot specialist in your area to see exactly what is going on, everything I am about to say here is just conjecture.

Since it has been over a week since you dropped the bottle on your foot and if you are still having pain then it is probably more than a simple bruise. Most moments of clumsiness ending up causing pain for a day or two and then the problem resolves itself.

The fact that your toes are discolored leads me to believe you probably broke a blood vessel on top of your foot. There happens to be a large network of superficial veins on top of the foot, so dropping a heavy item on them could break one or two and cause some bleeding under the skin as well as pain.

Additionally, there are tendons that travel along the top of your foot; these are the tendons that allow you to bend your toes upward. A heavy blunt object hitting the tendon would also tend to cause pain.

Lastly, depending on what angle the bottle hit your foot, there is always the chance that you may have chipped one of the bones on top of your foot, in particular one of the bones closer to the ankle, if that is where you are having your pain.

I would have thought that the Ibuprofen would have helped but just because it did not, does not necessarily mean the problem is more serious.

The problem with foot trauma is that the foot usually takes longer to heal than other body parts simply because you are walking on it and each step you takes, essentially aggravates the injury. If you had injured your hand for example, you could have put it in a sling, avoided using it and it would probably be better at this point. This is not true for a foot injury.

Whether or not you should have an x-ray is simply a matter of seeing if you did break a bone. Obviously a broken bone as part of the trauma, will take longer to heal and may require a special shoe while the bone is healing.

As to how long it will take your problem to resolve itself depends on what the actual damage is, as well as how much walking you do on a regular basis.

In terms of local treatment, I only recommend icing the area for the first 24 hours, then moist heat thereafter. Ice reduces inflammation and is good initially to reduce the amount of initial pain, but after that you want to increase blood flow to the area as that is how the body heals itself, so moist heat is the best means to increase blood flow.

Wrapping the foot with an ace bandage may also be helpful in walking and certainly avoiding the shoes that make it feel worse, would also be indicated.

As a general rule of thumb, I would say if you are still having substantial pain at the end of two weeks, then chances are this problem is not going away on its own and professional medical care would be indicated.

Marc Mitnick DPM
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