Contusions In Adults

What are contusions?

Contusions (bruises) may appear as black and blue marks on your skin after an injury. A bruise happens when your blood vessels tear, but your skin does not. When blood vessels tear, blood leaks into nearby tissue, such as soft tissue or muscle.

What causes contusions?

You are most likely to get a bruise because you were hit by a hard object. You may get a bruise to a bone if you twist your knee or ankle. A strained muscle can also leave a bruise. You may get a bruise near an area where you have blood taken for medical tests.

Why may I be more likely to get contusions?

You may be more likely to get bruises if you have any of the following:

• Illnesses: Bleeding disorders make you more likely to bleed, which increases your risk of bruising. Other illnesses, such as kidney and liver diseases or infections, can also increase your risk of bruises. Tell your caregiver if you or someone in your family bleeds easily.
  
  
• Medicines: Some medicines, such as blood thinners, will make you more likely to bleed and bruise. Some over-the-counter (OTC) medicines and herbal medicines may also make you bleed more easily. Tell your caregiver if you are taking any OTC, prescription, or herbal medicines.
  
  
• Other conditions: You have a greater risk of bruises if your skin and muscles are weakened. This may include people who are elderly or those with poor nutrition.

What are the signs and symptoms of contusions?

Signs and symptoms may appear right away, or they may not appear until 24 to 48 hours after your injury. You may have any of the following:

• Pain that increases when you use the area around the bruise. You may have pain that increases when you touch the bruise or when you try to walk.
  
  
• Swelling or a lump at the site of the bruise or near it.
  
  
• Changes in the color of your skin, which may be red or brown in the first day or two. Over the next few days, your skin may change to green and then yellow.
  
  
• Stiffness or problems moving the bruised area of your body.

How are contusions diagnosed?

Your caregiver may ask you about any injuries, infections, or bleeding problems you had in the past. He will check the skin over the injured area. He may touch it to see where it hurts you. He may ask you to point to where it hurts the most. He may also check for problems you may have when you move your bruised area. Caregivers may want you to return within a few days to a week to check your injury again. You may need any of the following tests:

• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Magnetic resonance imaging: This test is also called an MRI. During an MRI, pictures are taken of the part of your body that has a bruise. An MRI can show damage to your bones, muscles, blood vessels, and other tissues. It can show if a hematoma (pooling of blood) has started to form. You need to lie still during an MRI. Never enter the MRI room with any metal objects. This can cause serious injury.
  
  
• X-ray: An x-ray is a picture of a body part that shows any broken bones near the bruise.
  
  
• Ultrasound: This test uses sound waves to see the bruise and how deep it is. An ultrasound can also show if any of your organs, such as your liver, are injured.

How are contusions treated?

Your bruise may heal without any treatment. Treatment depends on the part of your body that is injured, and how serious your injury is. You may need any of the following treatments:

• Medicines:
  
  
  • Pain medicine: You may be given medicine to decrease or take away pain. Do not wait until the pain is severe before you take your medicine.
    
    
  • Steroid medicine: Steroid medicine may be given to decrease redness, pain, and swelling.
  
  
• Surgery: Caregivers may do surgery to drain blood from a hematoma that is very large or is not getting smaller. Surgery may also repair a tear in the muscle or relieve pressure in the muscle caused by swelling.

What can I do to help my contusion heal?

• Rest: Caregivers may tell you to rest more than usual. If you have a muscle bruise, you may need to rest the area. Keep your bruised area still for the first few days after your injury. Your caregiver may suggest you use an elastic bandage or tape to keep your injured muscle in the same position. If you bruised your leg or foot, you may need crutches or a cane to help you walk. This will help you keep weight off your injured body part. Use crutches or a cane as directed. Rest may help you prevent further damage and help your injury heal faster.
  
  
• Ice: Ice may help decrease pain and swelling, especially when used right after an injury. Use ice on the bruised area for only 15 to 20 minutes at a time. Your caregiver may suggest that you put ice on your bruise every hour for a certain period of time. Do not apply ice directly on your skin. Wrap the ice pack in a towel or place a towel on your bruised area and then apply the ice pack.
  
  
• Compression: Apply pressure to a bruised muscle with an elastic bandage to help decrease swelling. Your caregiver may ask you to keep the elastic bandage on at the same time that you apply ice. Ask your caregiver for instructions on how to apply an elastic bandage.
  
  
• Elevation: Put the injured area at or above the level of your heart to decrease pain and swelling. The easiest way to do this is to rest the injured area on pillows or rolled up blankets.
  
  
• Do not massage or use heat: Heat and massage may slow the healing of the area.
  
  
• Avoid alcohol: Alcohol may slow healing of your injury.
  
  
• Avoid stretching injured muscles: Ask your caregiver when and how you may safely stretch after your injury.

How can I prevent contusions?

• Stretch and warm up before you play sports or exercise.
  
  
• Wear protective gear, such as shin guards, whenever you play sports.
  
  
• If you begin a new physical activity, start slowly to give your body a chance to adjust.

What are the risks of contusions?

• You may cause tissue damage if you leave ice on a bruise for longer than 20 minutes at a time. Some bruises may scar your muscles. Scar tissue may make you more likely to get bruises in the future. Bone bruises may lead to osteoarthritis. Osteoarthritis affects joints, such as the knees and shoulders, and can cause stiffness and pain. You may have a hematoma (swelling filled with blood) that does not get smaller, and need surgery to drain it. You may get a hernia if you get a tear in the thin layer of tissue that covers the muscle. A hernia happens when muscle and fatty tissue push through the tear.
  
  
• Bony deposits may form within your muscles. You may also develop compartment syndrome. Compartment syndrome occurs when a hematoma or swelling at the injured site presses on nearby tissue. Muscles and blood vessels may be damaged. You may need surgery to relieve the pressure caused by swelling. If you do not get treatment for your bruise, it may not heal well. Treatment may decrease your pain, prevent further injury, such as muscle scarring, and help your bruise heal faster. Talk with your caregiver about questions or concerns that you have about your bruise, treatment, or medicines.

When should I call my caregiver?

Call your caregiver if:

• Your pain and swelling get worse within 3 weeks of the injury.
  
  
• You find a new lump in the injured area.
  
  
• Your symptoms do not improve with treatment after 4 to 5 days.
  
  
• You have questions or concerns about your bruise or treatment.

When should I seek immediate help?

Seek care immediately or call 911 if:

• You have new trouble moving your injured area.
  
  
• You have tingling or numbness (no feeling) in or near the injured area.
  
  
• Your hand or foot below the bruise gets cold or turns white.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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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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