Contusions and Bruises

This article contains self-care information for the selected condition. If you have questions or need more comprehensive treatment advice, please consult a medical professional.

Contusion is the medical term for a bruise.A bruise forms when small blood vessels under the skin burst. This is usually due to an injury to soft tissues.

Symptoms can include pain, swelling, muscle soreness and bluish discoloration of the skin that will usually start to decrease after a couple of days.

Diagnosis is usually based on a physical examination of the bruised part of the body. Imaging tests may be needed to rule out other causes.

Treatment may include resting the affected body part, applying cold packs, compression bandages and taking painkillers.

Bruises can be avoided through proper protection against injuries.

Depending on its severity, a contusion can take anywhere from a few days to weeks to fully heal.

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Contusions are caused by blunt trauma to the body. 1 It might be a direct blow or repetitive blows causing tissue damage and bleeding in the injured area. Bruises are among the most common sports injuries. ref2 2 3

But bruising may also result from car accidents, falling, landing on or running into an object or hard surface. 4 Sometimes contusions are caused by seemingly minor traumas. A bruised knee or toe may be a result of a simple bump into a chair or a table. So the location of the injury often depends on the circumstances. For instance, contact sports are a common cause of quadriceps contusion or a bruised thigh. 5 Bruised shoulder is a common injury in athletes playing sports such as football or hockey.

Skiing, snowboarding or skateboarding can often lead to bruised thighs, hips, knees or elbows. A coccyx contusion or a bruise to the tailbone can be the result of an injury to the tailbone area or damage during childbirth. Prolonged pressure on the tailbone, such as from sitting, is another cause. Bruises can also be a sign of physical abuse. 1

Symptoms of contusions may include:

• Pain
• Swelling
• Tenderness
• Blue or purple discoloration of the skin
• Stiffness of the bruised area. 1 2 4

It is often difficult to freely move the injured part of the body. It might mean difficulty walking, bending or straightening the limbs. The muscles might feel weak too and sometimes a collection of blood might form a palpable lump. Bruises change color over time from pink through bluish, greenish-yellow until it comes back to the normal color of the skin.

Do these symptoms sound familiar? Try Ada to find out more.

To assist with the diagnosis of a contusion a doctor will have to take the person’s medical history and conduct a physical examination. It is important to establish what exact trauma has led to the symptoms. History of easy bruising or bleeding might be a significant reason to explore other possible causes. Imaging tests such as X-ray, ultrasound, CT or MRI may be necessary to assess the extent of the injury in detail. They can also help to rule out other conditions. 1

There are established measures to take as soon as possible to relieve the symptoms of contusions. They are also crucial for the proper healing of the bruised part of the body.

Initial treatment should always follow the RICE protocol:

• R for rest. Try to avoid strenuous activity involving the bruised part of the body. This means cutting back on physical exercises or sports.
• I for ice. Apply ice packs on the bruised area using a cloth or a towel to wrap the ice. Don’t place the ice directly on the skin. You could even use a bag of frozen vegetables. Apply the ice for up to 15 minutes several times a day.
• C for compression. It means continuous pressure of the bruised area. Wearing an elastic bandage around the injured part of the body may help reduce swelling.
• E for elevation. Try to raise the bruised area above the level of the heart. It, too, can help with the swelling. Cushion or pillows may come in handy when elevating your limbs.

Follow these principles in the first 24 to 48 hours after the injury. This period is called the acute phase. During this time don’t put any heat on the contusion. Massaging the bruise should also be avoided.

In case of mild injuries, pain can be tolerable. However, taking painkillers may sometimes be needed. The following can be recommended to relieve contusion-related pain:

• Acetaminophen
• Anti-inflammatory painkillers. They are also called non-steroidal anti-inflammatory drugs (NSAIDs) and a number of them can be purchased over the counter (e.g. ibuprofen). 1

Severe injuries require proper management after the acute phase. The recovery from a contusion may involve physical and occupational therapy. Education and instructions from specialists can help to adjust the routines after the injury. Returning to regular physical activity may take several weeks. Sometimes special equipment (e.g. padding) is used to prevent reinjuries.

Contusions can be avoided by reducing the risk of injuries:

• Use protective sports equipment (pads, guards, helmets)
• Wear proper shoes
• Prepare for the exercise. Always warm up and stretch before a physical activity
• Exercise caution around the house (e.g. while housekeeping, climbing ladders, etc.)
• Wear seatbelts. 2 4 5

The outlook depends on the severity of the injury. Proper management is an important factor as well. Generally, a contusion can take a few days or weeks to fully heal. The most severe contusions can prevent athletes from taking part in sport for months.

Most people fully recover with no further consequences. However, possible complications of contusions include:

• compartment syndrome
• myositis ossificans
• rhabdomyolysis.