Is there always bruising with a partial rupture or a tear in the plantar fascia? Well, that’s what we’re talking about today on the Doc On The Run Podcast.
If you’re a runner and you’re out on a run, and you suddenly start having extremely sharp heel pain, where you actually think of plantar fasciitis, but then you look at your foot the next day and you have a huge bruise. Well, that’s not plantar fasciitis. That’s where you ripped something.
If you happen to have ripped or torn the plantar fascia ligament, well that can cause a lot of tissue damage and it can cause a big bruise on your foot because the tissue’s bleeding under the skin. One thing I’ve talked about a lot is that if you don’t have bruising, you probably don’t have a partial rupture of the plantar fascia. That’s sort of true, but it’s a partial truth.
The reality is, is that you will get bruising in most cases if you actually have a full rip of the plantar fascia, even if it’s just partially ripped, but it’s ripped all the way across because it’s going to bleed. But sometimes you can actually get a small rip or a tear on the inside of the fascia.
If you’re wondering what that would look like, a simple analogy is if you took a big thick rubber band, and you stretch it really aggressively, over and over and over, and then you pull it out and stretch it so that it’s almost about to break and you hold it up and look at it in the light, you may see these little wavy things on the inside of it where the rubber has actually pulled apart and torn on the inside of the rubber band.
If you get that in the plantar fascia where you have this interstitial tear meaning inside the fascia itself and not extending to the external surfaces of the fascia, the tear’s actually contained on the inside and so it doesn’t bleed and produce a bruise like when you rip the side of the fascia.
So, just because you don’t have bruising does not mean that you for sure do not have a partial tear of the plantar fascia. It could be a small tear, it could be an interstitial tear, it could be on the inside of the fascia itself. What really clues in more than anything else that it’s a partial tear is the excruciating onset of pain. That can be other things too, but it’s probably not plantar fasciitis, particularly if you see a bruise.
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