A bruise is called a contusion in medical terms. There are some instances in which you should go straight to the emergency room. It involves inflammation of a thick band of tissue that runs across the bottom of each foot and connects the heel bone to the toes (plantar fascia). There are a wide variety of reasons why the soles of your feet may bruise. A medium size bruise appeared on my foot by my ankle. You can also try applying a cold or hot compress to reduce pain. Contact your healthcare provider to discuss your symptoms. Metatarsalgia centers under the five bones at the bases of the toes, the metatarsals. Many people find that improving their posture evens out the stress on their feet and improves their pain. Deep vein thrombosis (DVT) can also cause a blockage of blood flow leading to the calf as well as foot redness, swelling, warmth, and pain. Plantar fasciitis can be caused by: A lack of arch support. In some cases, such as in major trauma or complications of an underlying disease, a foot bruise may occur with other symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Autoimmune disease. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. This eventually becomes a bone and is called a heel spur. Depending on the individual, different treatments may be more effective than others. Losing weight, if needed, can reduce the stress on your feet. Given this, a problem with your feet can cause irritation and pain any time you stand or take a step. Sometimes a single factor can lead to metatarsalgia. As we walk, the plantar fascia pulls on its attachment at the heel. AIDP is often triggered by an infection, such as the flu or a respiratory illness. You may opt-out of email communications at any time by clicking on Your doctor can begin or change your treatment to help you manage depression. Am Fam Physician. Bring someone with you to help you ask questions and remember what your provider tells you. Try exercises. For many people, the first sign of GBS is pain, weakness, or tingling in their toes, feet, or legs. If you are a Mayo Clinic patient, this could All rights reserved. Ankle sprains are the most common causes of lateral foot pain and are more common in people with high arches, according to Dr. Hunt. A neuroma can cause pain at the toes. 2014 Apr;5(2):146-150. doi:10.5312/wjo.v5.i2.146, Ganguly A, Warner J, Aniq H. Central metatarsalgia and walking on pebbles: Beyond Morton nueroma. This may be because the broken blood vessels lie deeper under the skin or because your skin is thick, camouflaging the pooled blood. Learn what symptoms to look for and how to treat this condition. What happens when your immune system attacks your joints? But it's best not to ignore foot pain that lasts more than a few days. 2014 podiatric practice survey. Laken Brooks (she/hers) is a freelance writer with bylines in CNN, Inside Higher Ed, Good Housekeeping, and Refinery29. Diagnosis and Tests. The Best Shoes for Plantar Fasciitis of 2023, wear ill-fitting shoes, which adds pressure to the fascia, the swelling doesnt subside with self-care, if youve fallen or encountered a trauma to the foot, what sporting activities you regularly participate in. Centers for Disease Control and Prevention. J Gerontol A Biol Sci Med Sci. Because feet are so involved in movement, bear impact from the weight of your body, and are at the extreme end of the body, they are more prone than many other body parts to contact injuries that may cause bruising. Less commonly, autoimmune disorders such as lupus, Sjogren's syndrome, Guillain-Barr syndrome, rheumatoid arthritis, and multiple sclerosis can cause tingling in your . over-the-counter (OTC) pain medication such as aspirin, OTC pain relievers such as ibuprofen (Advil) or naproxen (Aleve), changing to a different style of shoe (wide, low heal, soft sole). information submitted for this request. There is a problem with Peripheral nerve injury. The ice should be used on heels and arches (not toes) for about 20 minutes three times a day. Foot & Ankle Specialist. University of Michigan Health. privacy practices. http://www.aofas.org/footcaremd/conditions/ailments-of-the-smaller-toes/Pages/Metatarsalgia.aspx. The body fills the torn area in with calcium. the unsubscribe link in the e-mail. These include: Metatarsalgia is inflammation and pain in the ball of your foot and is commonly considered an overuse injury. Additionally, the foot of the shorter leg falls to the ground harder, putting more pressure on that foot. Metatarsalgia, or pain in the ball of your foot, may be caused by a variety of factors. The plantar fascia is the ligament that connects the heel to the front of your foot. Accessed Aug. 23, 2016. Sharp or shooting pains in the toes. Clinical factors associated with Guillain-Barr syndrome following surgery. Wearing shoes with too little cushioning. It can also be caused by high foot arches, flat feet, or feet that roll inward when walking. This condition is usually diagnosed on the basis of your description of your symptoms. Plantar fasciitis tends to develop as we get older and the fascia become less elastic. Your provider may do several tests based on each possibility. Medline Plus, a service of the National Library of Medicine National Institutes of Health. What causes peripheral neuropathy in the feet? American Orthopaedic Foot & Ankle Society. After treating the infection or after resting the feet, normally the burning sensation settles. There is a problem with With Guillain-Barr syndrome, your provider will likely consider the possibility of other conditions that can affect your peripheral nerves. You may also have bruising on the ball of the foot. fungal infection known as "Athlete's foot") or due to tiredness. Peripheral neuropathy can be harder to treat than other foot conditions. https://www.footcaremd.org/conditions-treatments/heel/plantar-fasciitis. Plantar fasciitis. Your healthcare provider may recommend an x-ray or other imaging, depending on the circumstances. Plantar fasciitis. Severe swelling, such as what you may experience with plantar fasciitis or a facial rupture, may need cortisone injections. Our team has a wealth of experience in the fields of journalism, TV and video production and the healthcare industry. Not all of the causes of metatarsalgia are known. This causes the foot on the longer leg to carry the body's entire weight longer than normal, stressing the fascia on that foot. Your doctor will do a physical exam and ask you some questions. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Some people describe the pain as feeling like a bruise or an ache. 7,752,060 and 8,719,052. Other treatments might include: Repetitive force from overuse such as long-distance running can cause tiny cracks, called stress fractures, in the bones of the foot. The plantar fascia is band of tissue that connects your toes to your heel bone. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Metatarsalgia is the term for pain and inflammation in the ball of the foot. information is beneficial, we may combine your email and website usage information with People who do a lot of marching, such as musicians in a marching band or people in the military, are also at higher risk. All of these parts, from your toes to your Achilles tendons, help you stand upright, balance, and walk. 2018 Aug;3(3):1-11. doi:10.1177/2473011418790078, Franettovich Smith MM, Collins NJ, Mellor R, et al. Also know what the side effects are. Over-the-counter pain relievers may help, too. When your foot makes contact with an object, you might feel the pain immediately, or it may take 24 to 48 hours for the bruise to materialize. A foot bruise occurs when blood leaks out of the blood vessels in the foot into the tissues of the skin, muscles or bones. Causes of Foot Pain and Treatment Options, The 8 Best Insoles for Plantar Fasciitis in 2023. Are Nerve Problems Causing Your Foot Pain? American Academy of Orthopaedic Surgeons. 2013;65(11):1804-1812. doi:10.1002/acr.22049. This causes an abnormally strong pull on the heel where the plantar fascia attaches. High arches put extra pressure on the metatarsals and heels. If you step down hard on a small object such as a stone or pebble its painful, and often the pain lasts long after your foot is off the pain-causing object. A foot bruise may be accompanied by other symptoms that vary depending on the underlying disease, disorder or condition. GBS tends to set in a few weeks after the infection took place. Know how you can contact your provider if you have questions. Your doctor may recommend that you use a metatarsal pad, a surgical shoe, or a shoe insert to offload the painful part of your foot. Metatarsalgia causes pain in the ball of the foot. A tendency to roll your feet one way or another. This is the area between the arch and the base of your toes, under your metatarsal bones. While they can withstand a lot of wear and tear, theyre not invincible. During the NCS, your provider may also do an electromyography (EMG). This complexity is due to the elements that make up the structure of your foot. Treatment may involve pain relief, lifestyle changes, physical therapy, and in severe cases, surgery. The pain is often described as tingling, burning, or stabbing sensations in the feet or hands that may spread upward into your legs or arms. There are more than 100 causes of peripheral neuropathy. J Am Acad Orthop Surg. The sesamoids are two small bones beneath the pad of the big toe. Pelvic fractures are typically the result of high impact injuries. 2017;58(2):92-97. doi:10.11622/smedj.2016143, Pearson JM, Moraes LVM, Paul KD, et al. Review/update the 10 Things to Know About Psoriatic Arthritis. A healthcare provider may diagnose and treat your foot pain, or refer you to a foot and ankle specialist. A surgical procedure called a sesamoidectomy may be necessary for very severe cases of sesamoiditis that do not respond to physical therapy. An MRI or ultrasound can help your provider rule out these other conditions. Easy or unexplained bruising on the feet can be caused by age, gender and lifestyle factors, such as: Female gender (women tend to bruise more easily than men). Factors that increase your chances of developing sesamoiditis include: Though less common, additional causes of foot pain must also be considered. Mayo Clinic Staff. Based on their assessment, they may point you to a podiatrist (foot specialist) or orthopedist (bone specialist). When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. https://www.uptodate.com/contents/search. You might also have another condition such as metatarsalgia, plantar fasciitis, a heel spur, a stress fracture, or Mortons neuroma. Your healthcare provider may refer you to a physical therapist if your foot pain interferes with your daily life, activities, or mobility. Approach to the patient with foot & ankle pain. Metatarsalgia. Use a hand to gently pull the toes back toward the body . The most common cause of a stone bruise is an impact injury to the bottom of your foot caused by stepping down hard on a small hard object such as a rock. Plantar fasciitis. A sudden injury. This can happen when the foot rolls rolls, twists or turns too much. Doing a lot of walking barefooted. Episodes of more-severe pain may occur after prolonged running, stair climbing or sprinting. 2020 Jul;2(1):1-7. doi:10.1186/s42466-020-00064-2, Turchin O, Lyabakh A. If youre struggling with foot pain, cramps, corns or calluses, consider these aids to keep aches and pains at bay. When to See a Doctor for a Sprained Ankle, 7 Symptoms Never to Ignore If You Have Depression. Know what to expect if you do not take the medicine or have the test or procedure. The metatarsals help form the arch of the foot, which are essential for weight-bearing and walking. Well explain the types, how theyre treated, and the recovery timeline. Metatarsalgia Symptoms To Pay Attention To. This condition, also known as a stone bruise, is generally caused by a change in the way you walk. Surgery for foot stress fractures are rare. A single copy of these materials may be reprinted for noncommercial personal use only. 2015 Jul;50(4):438-444. doi:10.1016/j.rboe.2015.06.018. This content does not have an Arabic version. Purpura that results in tiny spots on the skin is called petechiae. Often, youll also feel pain in the toes. information and will only use or disclose that information as set forth in our notice of More often, several factors are involved, including: Almost anyone can develop metatarsalgia, but you're at higher risk if you: Left untreated, metatarsalgia might lead to pain in other parts of the same or opposite foot and pain elsewhere in the body, such as the low back or hip, due to limping (altered gait) from foot pain. High-impact activities like running might add to your foot pain, though. Appointments & Locations. Named after a 19th century French surgeon, a Lisfranc injury occurs when the bones or ligaments of the midfoot are broken or torn. It supports the arch of the foot and absorbs shock when walking. This puts pressure on the plantar fascia, which has very little stretch. Do structural changes of the foot influence plantar pressure patterns during various stages of pregnancy and postpartum?. A tendency to roll your feet one way or another. 2005-2023 Healthline Media a Red Ventures Company. In addition to being a frequent runner, wearing ill-fitting shoes or high heels can cause metatarsalgia. It's not always possible to know which of the numerous causes of plantar fasciitis is at work. Depending on what your healthcare provider finds during the physical examination, they may order special imaging tests to diagnose bottom-of-foot pain and rule out other causes. Bruises. information and will only use or disclose that information as set forth in our notice of National Institute of Neurological Disorders and Stroke. This site complies with the HONcode standard for trustworthy health information: verify here. They include: If you have any of these ongoing symptoms, you should see your doctor. A large area of purpura is called ecchymosis, although any type of bruising of the skin is often referred to as ecchymosis. This is more common in athletes due to repetitive, forceful movements in sports. Foot bruising may occur with other symptoms related to the foot including: A foot bruise may occur with symptoms outside the foot. All rights reserved. It can feel like: burning, aching pain. Plantar Fasciitis. The plantar fascia is a band of tissue (fascia) that connects your heel bone to the base of your toes. An injury severe enough to damage a bone is also severe enough to break the blood vessels under the skin and cause bruising. Symptoms include pain and swelling on the top of the foot, as well as bruising on the bottom. It's generally treated with medications such as anti-seizure drugs and antidepressants. This may include hypothyroidism (underactive thyroid) or a vitamin B deficiency. In general, your primary care provider (PCP) should be the first person you see for any foot pain, injury, or other condition you are experiencing. 2023 Cedars-Sinai. Depending on the cause, you can be fully recovered in a few weeks to a few months. These type of feet are relatively inflexible, usually have a high arch and a short or unusually tight plantar fascia. It results in red, flat spots or patches on the skin and mucus membranes. If you walk around barefoot or in thin-soled shoes, youre setting your foot up for bruising. Foot bruises can be caused by everyday injuries or more serious trauma including: Blunt force or crush injury, such as a direct blow to the foot, dropping something on your foot, or crushing your foot under a very heavy object, Sports injury, such as from running, skiing, snowboarding, or sports that involve person-to-person contact, including football and ice hockey, Walking, running or jumping on hard surfaces. They may watch to see how the bottom of your foot hurts when you walk, and ask you to stretch your toes. This is a thick, pearly white tissue with long fibers that begins at the heel bone and then fans out along the under surface of your feet to the toes. Different types of foot bruising include contusions, hematomas and purpura. Continuing your running routine while dealing with plantar fasciitis is possible, as long as your pain is mild. In some cases, it can result in permanent nerve damage, paralysis, or death. These long bones in your forefoot connect your ankle to your toes. As an integral part of your everyday life, your feet experience a lot of wear and tear. X-rays and CT scans both involve radiation. It's often found in undercooked poultry, putting people who eat it at an increased risk of campylobacter infection. 2016;62(3):289-295. doi:10.1159/000442089, Riskowski JL, Dufour AB, Hagedorn TJ, Hillstrom HJ, Casey VA, Hannan MT. Conditions that cause similar symptoms to neuroma include intermetatarsal bursitis (inflammation of the bursa sacs between the metatarsals), instability in the metatarsophalangeal(MTP)joint, and a tear in the plantar plate ligament. include protected health information. In some cases, your foot may feel as though it has a bruise. Hocker S, Nagarajan E, Rubin M, Wijdicks EFM. When the plantar fascia becomes irritated and swollen, the condition is called plantar fasciitis. Johns Hopkins Medicine. How effective is acupuncture for reducing pain due to plantar fasciitis? To accomplish this, your physical therapist will put together a program that rehabilitates your foot so that you can walk and stand without pain. With every step we take, our body weight comes to rest first on the heel and then gradually over the length of the foot. A sprain is caused by the ligaments being stretched too far or tearing. THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. World J Radiol. Metatarsalgia, or pain in the ball of your foot, may be caused by a variety of factors. A differential diagnosis is the process in which your healthcare provider rules out all the other possible conditions that could explain your symptoms. Mayo Clinic is a not-for-profit organization. Treatment for plantar fasciitis includes: A heel spur is a bony protrusion (osteophyte) that typically grows on the front of your heel bone and extends toward your foots arch. Treatment for foot pain depends on your diagnosis. This surgery involves removing the sesamoid bone. This complexity is due to the elements that make up the structure of your foot. information highlighted below and resubmit the form. https://orthoinfo.aaos.org/en/diseases--conditions/plantar-fasciitis-and-bone-spurs. 2018 Apr;210(4):821-833. doi:10.2214/AJR.17.18460, Lehmann H, Wunderlich G, Fink G, Sommer C. Diagnosis of peripheral neuropathy. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). They include: If conservative treatments fail, cortisone injections may work for: For severe pain, you may be given an opioid (narcotic) drug such as: These drugs can be addictive. Always tell your doctor about any medications or treatments you are using, including prescription drugs, over-the-counter medications, dietary supplements, and herbal or alternative treatments. A blunt trauma injury can cause your spleen to rupture. Its possible to have this condition with no visible bruising as well. In that case, low-impact activities like swimming, rowing, or Tai Chi might be a better option. Hematomas can be caused by the same forces that cause contusions, but they generally cause more pain, swelling and complications than contusions. Each foot has 26 bones, 30 joints, and almost 100 muscles and ligaments to connect them. Contusions Plantar fasciitis. Make a donation. These change how your nervous system functions. Whether your foot pain is near the toes or at the heel, the pain may affect you with every footfall. Picking shoes with good soles, a wide toe box and a lower heel, Soaking and using pumice stone on your feet to help remove calluses. Tension and stress on the fascia can cause small tears. When you have a migraine, you'd try anything to feel better. Using ice packs to cool (not freeze) your foot helps reduce pain and swelling. Though they can be painful, bruised sesamoids are considered warning signs that your big toe and your other toes may be in danger of experiencing significant damage. Metatarsalgia (met-uh-tahr-SAL-juh) is a condition in which the ball of your foot becomes painful and inflamed. People with high arches also have metatarsalgia more than others. You might also experience tenderness or stiffness, especially in the morning, which . Without treatment, the plantar fascia will eventually tear partially away from the heel. sharper image deep tissue massager won't charge; macken mortuary island park; arizona rummy rules; winona state men's basketball: roster; zoe doyle edmonton GET SCOUTED. AskMayoExpert. Treatment often includes selecting shoes with good soles, avoiding walking barefoot and using pumice stone to remove calluses from the feet. A neuroma is an abnormal clump of nerve cells. A 501(c)(3) non-profit organization. Heel spurs can be painful. You may need an X-ray to rule out stress fractures or other problems that could be causing your pain. American College of Foot and Ankle Surgeons. For example, you may develop this condition if youve changed your gait because youve gained weight, have developed arthritis or gout, or youre wearing poor-fitting shoes. In fact, 77% of adults say that foot pain has affected their life in one way or another. If we combine this information with your protected Foot & Ankle Ortho. Causes of sharp pain in the bottom of foot are Plantar fasciitis Metatarsal fracture from a direct injury Metatarsal stress fracture Morton's Neuroma Sesamoiditis Therefore, if you experience bottom foot pain that is worsening, it may be a sign of a serious medical condition. This injury is common in athletes. All Rights Reserved. The American College of Foot & Ankle Orthopedics & Medicine. If a deformity is to blame, a metatarsal osteotomy can be done to realign the metatarsal bone(s). Metatarsalgia is usually easily treated without surgery. Foot bone contusions and deep muscle contusions can be very painful and take longer to heal than contusions that only affect the skin tissues. Foods with turmeric, lemon water, and antioxidants may help reduce foot inflammation. Blood Blisters They help support the tendon that flexes this toe. Plantar fasciitis can cause intense heel pain. (Feet that pronate tend to break down the inner side of the shoe; feet that supinate tend to break down the outer side of the shoe.). All rights reserved. Here are eight possible causes for bruising on the bottom of your foot and what you can do to treat the condition. Mayo Clinic; 2020. Your provider inserts a small needle through your skin and into your muscle. A retrospective study. Plantar fasciitis is usually characterized by a stabbing pain in the sole of your foot, typically near the heel. Have you ever noticed a thinning in the face in older people? The pain is typically more prevalent when wearing shoes or participating in an activity that includes running or walking. shooting pain. Toenails get thicker over time, are a likely a symptom of a fungal infection. For example, plantar fasciitis can lead to pain at the heel. These include: Movement therapies like yoga or tai chi may help with muscle strength, flexibility, and balance. For example, if your provider suspects you have sesamoiditis, they may also order medical imaging to rule out osteoarthritis, a dislocated sesamoid bone, or a compressed nerve near the sesamoid bones. The pain is usually the worst with the first few steps after awakening, although it can also be triggered by long periods of standing or when you get up from sitting. Seek immediate medical care (call 911) if you, or someone you know, develop petechiae (small, flat purple-colored spots), high fever, severe headache, change in alertness, or a stiff neck, which can be symptoms of meningitis or other serious conditions. Part of the normal aging process is the thinning of skin and the loss of collagen and fat deposits throughout the body. Since metatarsalgia is a symptom itself, it's important you understand what to look for: Localized pain in the ball of the foot. Always consult a medical provider for diagnosis and treatment. Severe neuromas that don't get better with therapy can be treated with a minimally-invasive procedure called a neurectomy. Its name has two derivations: The term stone bruise tends to be a nonmedical catch-all name for pain symptoms that feel like theres a stone in your shoe, jabbing the bottom of your foot every time you take a step. Accessed Aug. 24, 2016. A stone bruise is a pain on the ball of your foot or the pad of your heel. Older adults are more likely to develop metatarsalgia. Stretching will release tension in your back, hips, and glutes and help you stand more evenly. It is caused by a strain of the ligaments in an area of the foot called the plantar fascia. A "bruised" rib means the supportive muscle and tissues around your ribcage have been hurt. Third Party materials included herein protected under copyright law. Symptoms of peripheral neuropathy vary widely, so it is often misdiagnosed. Healthcare providers usually recommend starting with conservative options and moving to other treatments as needed. All rights reserved. William C. Lloyd III, MD, FACS. Know why a test or procedure is recommended and what the results could mean. 2016;9:1179-1189. doi:10.2147/JPR.S115068, Thiagarajah AG. Accessed Oct. 2, 2021. The content on Healthgrades does not provide medical advice. How we vet brands and products. As the foot begins to bear weight, it flattens. The most common form in the United States is acute inflammatory demyelinating polyradiculoneuropathy (AIDP). Rest. Always follow your healthcare professional's instructions. Ramachandra P, Kumar P, Kamath A, et al. Evaluation and diagnosis of common causes of foot pain in adults. A ruptured spleen can be a life threatening condition and requires immediate attention. Why the bottom of your foot hurts and what to do about it. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition, Exercises to help prevent plantar fasciitis. 2018 Sep;10(9):91-99. doi:10.4329/wjr.v10.i9.91. They include: Ignoring plantar fasciitis can result in chronic heel pain that hinders your regular activities. To provide you with the most relevant and helpful information, and understand which The pain is often described as sharp, aching, or burning pain in the ball of the foot. Request an Appointment. Symptoms can vary depending on what's to blame. Accessed Oct. 2, 2021. Treatment typically focuses on reducing the amount of weight on the area until it can heal. Penn Medicine. People with a second toe longer than their big toe may also experience metatarsalgia more frequently. What is stone bruise or metatarsalgia and how to treat it. American Podiatric Medical Association. If you think you may have a medical emergency, immediately call your doctor or dial 911. And with a little forethought and preparation, many injuries can be prevented altogether. Healthline Media does not provide medical advice, diagnosis, or treatment. Because easy or unexplained bruising of the feet or any part of the body can be due to serious diseases, failure to seek treatment can result in complications and permanent damage. 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. Plantar fasciitis is one of the most common causes of pain in the bottom of the heel, the arch or both areas. You're likely to change your walk to try to avoid plantar fasciitis pain, which might lead to foot, knee, hip or back problems. Minor foot injuries heal relatively quickly with non . Factors that increase your chances of developing tarsal tunnel syndrome include: This rare autoimmune disorder can come in several different forms. How effective is acupuncture for reducing pain due to plantar fasciitis? Get useful, helpful and relevant health + wellness information. If you have. The pain tends to gradually go away once you begin walking around. When you put weight on a painful area on the bottom of your foot, it feels like you are stepping on a small stone or pebble.
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