Ask a Podiatrist: What is a stone bruise?

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You may have heard someone complaining about something called a stone bruise on the ball of their foot. This term makes it sound like they struck their foot down hard on a rock and caused an injury, but that’s not quite right. A stone bruise is another term for the condition known as metatarsalgia. This condition in marked by inflammation and pain in the forefoot (metatarsal) especially between the phalanx bones. It is a deep bruise on the fat pad of the heel, usually between the second and fourth metatarsophalangeal joints. Because of the painful swelling, it is often reported as feeling like walking on a pebble.

A stone bruise is a common problem, especially among physically active people. Risk of occurrence is higher in high impact sports, such as those that require a lot of running and jumping.

Signs and Symptoms of Stone Bruise

If you suffer from a stone bruise, you will feel pain around the forefoot. The pain increases over time and usually becomes unpleasant and noticeable when walking. More pain is felt when the toes are pulled upwards (dorsiflexion) or when the joints are pressed, as these movements increase pressure on the area.

Though symptoms develop gradually, there are instances of sudden pain especially when there is an increase in exercise(s) that puts excessive strain on the feet.

Risk factors and Causes of Stone Bruise

Runners are prone to stone bruise as a result of injury or overuse. Structural defects in the foot can also cause stone bruise. There are toe nerves between the metatarsal bones of the foot. When the tips of the metatarsal bones press against each other, the small nerves caught in-between become inflamed. Increased weight on the foot can further worsen the situation; this is because with each step, the metatarsal bones rub together increasing the pressure, irritation and inflammation on the nerve.

There are also specific medical conditions and other factors can result in stone bruise. Examples of these medical conditions are Diabetes, Gout, and Rheumatoid arthritis.

Other factors include:

  • excessive body weight, which exacerbates the problem of pressure and strain on the foot
  • aging, which reduces the fat pad that protects the foot
  • stress fractures
  • Stiff ankles
  • buildup of fluid in the foot


It is recommended that a patient consult a podiatrist to report any chronic pain in the forefoot that doesn’t clear within a couple of days. The foot doctor will normally examine medical history, lifestyle, hobbies, and type of footwear worn by the patient. Your podiatrist may want to know more about the pain – how it began, how frequently it occurs and whether the pain is getting worse. Further tests may be necessary to rule out other underlying conditions.

Treatment of Stone Bruise

If you believe you have a stone bruise, try using the RICE method (Rest, Ice, Compress, Elevate) to see if swelling and pain can be alleviated at home. If symptoms don’t decrease within 5-7 days, see your podiatrist.

Symptoms could be ameliorated in patients by making changes to foot positioning using the customized orthotic devices and insoles. A change in footwear could also be recommended, especially for women who favor high heel shoes.

For severe cases of stone bruise, you may also ask about other minimally invasive procedures including steroid injections or platelet-rich plasma treatment.

Call Houston Foot and Ankle Care if you suspect you foot pain is due top stone bruises (metatarsalgia). Podiatrist Gabriel Maislos, DPM, FACFAS will help you identify the cause quickly and accurately, and provide a treatment plan that ensures quick and total recovery. Call (713) 541-3199 for an appointment. We offer same-day and next-day appointments.

Call (713) 541-3199 if you experience:

  • constant sensation of stepping on a pebble
  • pain in the ball of the foot when standing
  • pain, burning or tingling when flexing toes upward

Houston Foot and Ankle