Consumer Information

Contusion

WHAT YOU SHOULD KNOW:

A contusion, also called a bruise, is a result of bleeding into your child's soft tissue, muscle, or bone. A bruise may be caused by a fall, bump, or direct blow, such as being kicked or hit. Medical problems such as hemophilia or von Willebrand disease may also cause or increase your child's risk of having bruises. A bruise occurs when the blood vessels in your child's skin or muscles are damaged. A soft tissue bruise causes an area of skin to change color. A muscle bruise happens when muscle cells are damaged, causing bleeding in the muscle. A bone bruise is when a bone is damaged. Most bruises get better without treatment. Your child's caregiver will tell you if your child needs his bruises treated. Treatment may help decrease pain and swelling, and can help the injured area heal faster.
Your child may have pain in the area, a lump may appear, and his skin may change colors in the injured area. The area may be swollen, and your child may have trouble moving the body part with the bruise. He may need to have tests such as a computed tomography (CT) scan and x-ray. He may also need an ultrasound or a bone scan. A bruise is treated with rest and applying ice on the injured area. Your child may also be given medicine to decrease pain and swelling. Bruises may get better without treatment. When treatment is needed, this can help your child's pain and swelling to decrease or go away.

AFTER YOU LEAVE:

Medicines:

Keep a list of your child's medicines: Keep a written list of the medicines your child takes, the amounts, and when and why they are taken. Bring the list of your child's medicines or the medicine bottles when you visit your child's caregivers. Ask your child's caregiver for more information about the medicines. Do not give any medicines to your child without first asking your child's caregiver. This includes prescriptions, over-the-counter drugs, vitamins, herbs, or food supplements.
Give your child's medicine as directed: Always give your child's medicine as directed by his caregivers. Call your child's caregiver if you think your child's medicines are not helping. Call if you feel your child is having side effects. Do not quit giving the medicines to your child until you discuss it with your child's caregiver.
Non-steroidal anti-inflammatory drugs: This medicine, also called NSAIDs, may help decrease pain and swelling. You may need to give it to your child for a short period of time (less than a week).
Pain medicines: You may need to give your child medicine to decrease pain.
Steroids: Steroid medicine may be given to decrease inflammation which is redness, pain, and swelling. Your child may take it for a short period of time, such as less than a week.

Ask your child's caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you and your child may have. This way you will remember to ask these questions during your child's next visit.

Using R.I.C.E.: Rest, ice, compression, and elevation (RICE) may help decrease pain and swelling caused by bruises.

Rest: Tell your child to try not to move the injured area. For muscle bruises, your child should avoid moving the injured area for a short period of time. Your child may need to rest for 24 hours (one day) if the bruise is mild, and for 48 hours (two days) if the bruise is very bad. Your child may start moving the body part slowly if he does not feel any pain.
Ice: Place an ice pack on the injured area. A package of frozen peas or other small vegetables can be used instead of an ice pack. Put the towel over the body part next to your skin, and then place the ice pack on top of the towel. Do not leave ice or an ice pack right on top of your child's skin.
Compression: Apply pressure to your child's injured muscle by wrapping it with an elastic bandage. Do not wrap it too tightly. Ask your caregiver for more information about elastic bandages.
Elevation: Place your child so that his injured body part is raised. For example, if his arm is bruised, have him lie down with his arm propped up, resting on pillows. Raise the bruised area above the level of your childs heart if possible.

Treatment for a soft tissue bruise: An ice or cold pack may decrease pain and swelling. You may apply an ice bag to the injured area for about 20 minutes. Do this several times for the first few hours after the injury.

Treatment for a muscle bruise:

Non-steroidal anti-inflammatory drugs: This medicine, also called NSAIDs, may help decrease pain and swelling. You may give it to your child for a short period of time (less than a week). This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before giving it to your child.
Steroids: Steroid medicine may be given to decrease inflammation which is redness, pain, and swelling. Be sure you understand why your child needs steroids. Stopping use of this medicine without the caregiver's OK may cause problems. Your child may take it for a short period of time, such as less than a week. Ask your child's caregiver how long your child needs to take this medicine, and for more information about it.
Aspiration: If too much blood has pooled in your child's muscle , aspiration (draining) may be done. This will help prevent increased pressure in your child's muscle.
Surgery: Your child's caregiver may repair tears in your child's muscle using surgery.
Rehabilitation: This is a program that helps your child's injured muscle heal faster. Caregivers teach your child special exercises to stretch and strengthen his muscles.

Treatment for a bone bruise: Rehabilitation is a program that can help your child's injured bone heal faster. Caregivers teach your child special exercises to stretch his muscles and strengthen his bones. Exercises that bear weight and increase range of motion may be done as your child's pain decreases. For bone bruises in the legs and thighs, your child should wait for a time before full weight bearing exercise. Ask his caregiver if your child should use crutches to walk, and stop playing sports for awhile. This can help decrease pain, and prevent the bruised bone from breaking. Ask caregivers for more information about using crutches.

Ways to help prevent injuries, including bruises, in children: Do the following to help prevent your child from being injured:

Do not leave your baby alone on the bed or couch. Watch him closely as he starts to crawl, learns to walk, and when he plays.
Have your child do warm-up exercises before, and stretching exercises after sports practices and games. This helps prepare the muscles for a change in activity.
Make sure that your child is drinking enough liquid. He should be drinking liquids before and during exercise. Good liquids for most children to drink include water, juice and milk.
Make sure your child wears proper padding and protective gear such as shin guards when playing sports. Teach your child about safe equipment and places to play, and teach him to follow safety rules.
As a very young child learns to walk, he is more likely to get injured if there are hard items such as tables in the area. Remove these items, or place soft pads over sharp edges and hard items in your home.
Take your child to his caregiver for a medical check up before he begins playing a sport. The caregiver will make sure he is ready for the sport, and check if your child has medical problems that may put him at risk for injuries.

For more information: Contact the following for more information:

American Academy of Family Physicians
PO Box 11210
Shawnee Mission, KS 66207-1210
Phone: 1-913-906-6000
Web Address: http://www.aafp.org

American Academy of Orthopaedic Surgeons
6300 North River Road
Rosemont, IL 600184262
Phone: 1-847-8237186
Web Address: http://www.aaos.org/

CONTACT A CAREGIVER IF:

The injured area is warm to touch.
There is more pain, swelling, and redness, and your child has more trouble moving the injured area 2 to 3 weeks after the injury.
Your child begins to complain of pressure or a tight feeling in his injured muscle.
Your child has a fever.
Your child still has pain from a muscle bruise after 4 to 5 days of treatment including R.I.C.E.
You have questions or concerns about your child's condition and treatment.

SEEK CARE IMMEDIATELY IF:

Your child suddenly cannot feel or move his injured arm or leg.
Your child suddenly has more pain when he moves the injured area.
Your child has sudden and severe pain in the area of the bruise.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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