Purple Foot After Cast Removal (Why It Happens & What You Can Do)

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It’s normal to have discoloration on your foot after cast removal. Because you haven’t been moving it normally following your injury or surgery, your body will have difficulty circulating the blood to and from your feet. It will heal over time with regularly elevating your foot and applying a cold compress. In severe cases, a purple foot may signal blood clots, restricted blood flow in your blood vessels, diabetes, hematoma, and other circulatory problems in your lower legs. 

Why is my foot purple after cast removal?

It’s common for post-op patients to have discoloration on their feet after cast removal. It’s normal unless your doctor finds out there are problems with blood circulation in your leg. 

If you’ve been keeping your foot above heart level when your cast was still on, you’ll most likely experience your foot turning purple once you try to put it down after removing it. 

It happens because your legs have been accustomed to having it elevated.

Once you put it in its usual position, your body will take time to circulate blood to and from your feet. It can result to slow or poor blood circulation in that area.

When there’s poor circulation in your leg, blood may pool and turns bluish or purple. 

Either way, the cast may also have put pressure on the arteries and veins in your foot, resulting in restricted blood circulation and causing your foot to turn dark, blue, or purple. 

Sometimes, it could also be due to poor post-surgical management, such as not elevating your leg above heart level or not correctly applying a hot/cold compress.

If nothing significant is causing your foot to turn purple, then expect it to eventually go away as you heal.

Remember to always follow your doctor’s advice on caring for your cast and injury. 

Here’s what you can do

Below are things you can do when you notice discoloration on your foot after cast removal:

  1. Try alternately sitting with your foot down for a couple of minutes to hours, then elevate it above heart level.
  2. If swelling occurs, apply a cold compress.
  3. Do physical therapy to move your joints and muscles and increase blood flow.
  4. Check with your doctor when discoloration doesn’t disappear and worsens with pain.

Can your cast cause nerve damage?

Although it doesn’t happen often, a very tight cast may put too much pressure on your nerves. 

When there’s too much pressure, it will cause damage to the nerves, blood vessels, tendons, and muscles in the area covered with your cast.

A very tight feeling in your cast could be due to swelling from your injury.

Please call your doctor immediately when you feel the following symptoms:

  • Pain, numbness, or tingling in your affected foot 
  • Snug or tight feeling of your affected foot
  • Burning, stinging sensation of the skin under your cast 
  • Excessive swelling below your cast could mean restricted blood flow
  • You can’t feel or move your toes, and they become blue or bruised
  • Red or raw skin around your cast
  • A crack, spot of drainage, and foul odor from the cast

What to do after your cast removal

There are many things that you have to look after when you’ve finally got your cast removed. 

A doctor is helping remove a cast from her patients foot

Below are some common things that you follow:

  1. Wash the area with mild soap and water. If you have had the cast on for over 3 weeks, soak the area with warm water twice a day for 20 minutes.
  2. Pat the area dry and apply a fragrance-free lotion to lock in moisture. Avoid scrubbing or scratching dry, scaly skin.
  3. Wait at least three days before shaving the hair off the area.
  4. Don’t pick on any scabs on the affected skin or injured area. These will go away over time.
  5. Elevate your foot above heart level and apply an ice pack when swelling occurs. Discoloration and swelling will go away over time.
  6. Call your doctor when you experience signs of infections such as redness, abnormal swelling, and high fever.
  7. You can undergo physical therapy or follow your doctor’s advice on what exercises or stretches you can do to regain strength and mobility.
  8. Avoid strenuous activities like sports unless your doctor says it’s finally okay.

Remember that your fractured bone is not yet completely healed as soon as your cast is removed. 

You’ll also experience weaker muscles. So, please take it slowly and avoid high-impact activities. 

It may take 3-6 months, depending on your age, underlying diseases, and the bone that’s fractured, before you can regain your complete strength.

6 causes of foot turning dark, blue, or purple 

Sometimes, when discoloration on your foot doesn’t go back to your normal skin color and gives you other symptoms, it may indicate an underlying health condition.

Below are some possible underlying causes of your legs or feet turning dark, blue, or purple.

1. Injuries

When you drop something on your foot or hit your leg hard into something, these cause small blood vessels under your skin to break. 

Discoloration on your foot will appear when these blood vessels leak, turning into bruises. 

Resting your injured leg, applying ice packs, wrapping the injury with a bandage, and elevating your foot will help treat minor blood clots

Painkillers or anti-inflammatory drugs may also help.

2. Blood clots 

Blood clots in your leg may form when the blood flow in your calf or thigh veins becomes restricted, causing blood to thicken and clump in this area.

When blood clots develop in veins deep in your legs and don’t resolve on their own (deep vein thrombosis or DVT), they may travel through your bloodstream and can reach your lung resulting in pulmonary embolism (PE). 

Blood clots can also form near the surface of your skin, known as superficial venous thrombosis

Wearing grade elastic compression stockings and elevating your leg may help eliminate the swelling. 

Your doctor may also prescribe you anticoagulants and blood thinners to prevent new clots from forming. 

Surgery is also necessary for severe cases of DVT. 

3. Raynaud’s disease

This condition is often triggered to occur with cold weather. 

It causes your blood vessels to spasm and constrict blood flow, resulting in discoloration of the affected area.

People with this disease often experience other symptoms such as pain, numbness, and pins and needles. 

If you have a mild Raynaud’s Disease, you may prevent having attacks by keeping yourself warm and minimizing stress, especially during cold weather.

4. Diabetes

Abnormally elevated blood sugar levels can damage the arteries, affect nerve function and reduce blood circulation in your lower legs or feet. 

This causes your toes or feet to turn blue, purple, or gray. 

The affected areas may also appear swollen and have cuts or bruises that don’t heal properly.

5. Veinous insufficiency

You can develop this condition when the veins in your legs don’t function properly and don’t send your blood back to your heart. 

When this happens, the blood can pool in your legs resulting in swelling and discoloration. 

Often, both common symptoms are accompanied by dry, itchy, and tingly skin, cramps, shooting pain when standing, which only resolves when legs are elevated, veins becoming prominent, and wounds that leak fluid that doesn’t seem to heal. 

Conservative treatment for VI may include wearing compression stockings, regular exercise and losing weight, and moving legs after standing or sitting for long periods. 

Your doctor might also recommend you undergo laser ablation.

6. Hematoma

When the skin or the tissues underneath your leg experiences a traumatic injury, blood can leak and pool outside damaged blood vessels, resulting in a hematoma

It causes bruising on your skin, causing it to appear reddish-purple and become swollen and painful.  

Bruises may take up to 2 weeks before they go away. 

Apply an ice pack within 48 hours following an injury on your leg or feet.

Resting and elevating the affected area may boost healing. Taking pain medications and lightly wrapping the injury with a bandage may also help.

FAQs

Why is my foot purple after surgery?

Swelling and bruising are normal after surgery. It may travel to areas on your foot that weren’t operated on and may go up and down. 

Due to swelling after surgery, your foot may change color. 

Additionally, because you haven’t moved your foot as you do before surgery, the veins on your foot experience difficulty returning blood to your heart. 

The discoloration should slowly go away 6-8 weeks after your surgery if you follow proper post-surgical care methods.

What causes blue-toe syndrome?

Factors that may cause blue toe syndrome include the following:

– Blocked arteries
– Damaged blood vessels
– Restricted blood flow
Kidney failure
– Medications like blood thinners or coagulants and recreational drugs
– Complications during a medical procedure such as a surgery
– Angiogram

When the cells and tissues in your toes don’t get enough blood, they may be damaged and slowly die, causing them to turn purple or blue.

This condition is called the blue toe syndrome, sometimes also called occlusive vasculopathy or trash foot.

What are Covid toes?

The exact cause of Covid toes is still unknown. 

However, medical experts have linked that people may develop swelling and discoloration on their toes when their immune system reacts to an active virus that causes Covid. 

This condition has shown up in people with negative and positive infection results.

People with COVID toes may experience other symptoms like blisters, itching, pain, raised and painful bumps, and rough areas of skin on their toes. 

Takeaway

The discoloration on your foot will eventually resolve if it’s not caused by a serious circulation problem. 

Sometimes, improper care and management of your foot following surgery and after your cast removal will contribute to your foot turning dark, blue, or purple. It’s important to let your surgeon know when cast complications occur. 

For instance, a very tight cast may damage your nerves, blood vessels, tendons, and muscles which results in discoloration.

If your purple foot is caused by an underlying health condition, you may need to receive several conservative treatments, take medications or undergo surgery. 

Reana Jean Cuevas
Mabuhay! I'm Reana Jean Cuevas. A healthy body means living well with no worries-just happiness and more life adventures. Taking care of my body and well-being is an investment for my career and future. I was a volunteer at the Philippine Red Cross. I joined the training to become a first-aider and be able to provide other health and safety services in my community. I love discussing anything but mainly first-aid, home remedies, and women's health.
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