Bruise and Contusion Injuries: A Runner’s Perspective

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All of us sports and none sports people take knocks and bumps in our lives, sometimes minor and sometimes more serious. This highly informative article will show you how to deal with any problems you might encounter.

 

Bruise and contusion are common skin injuries that cause a skin discoloration. It happens that blood from the blood cells that have been damaged collects somewhere near the skin’s surface, and causing what is perceived to be a blue and black mark.

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Bruise and Contusion

There are so many activities that can lead to a bruise, but mostly, people get bruises when they accidentally bump into an object or something bumps into them.  Bruises are common to people who exercise strenuously like weightlifters and athletes. This type of injuries mainly comes as a result of the microscopic tears that happen in the blood vessels.  There are also certain bruises that happen for no apparent reason, and these may be as a result of a bleeding disorder, particularly if bleeding gums and nosebleeds are frequently witnessed. In most cases, what are perceived to be unexplained bruises on the thigh or shin, for instance, are caused by bumping into objects like bedpost and ignoring the injury or just failing to recall it completely. Bruises are also experienced by older adults due to their skins have grown thinner. The tissues that are charged with offering support to the latent blood vessels become weaker. Additionally, those who take various medicines meant for thinning the blood also encounter bruises.

 

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Signs and Symptoms

The original color of a fresh bruise is always red. Within few hours, it will then turn from the reddish color to either dark purple or blue.  As it heals after a few days, the bruise will then turn to green or yellow.  A bruise is very painful especially for the first few days and is very tender. But as the color fades, the pain will also go away.   There is usually no risk of any infection since the skin does not break in a bruise.

The Right Time To Seek Medical Attention

• If the bruises are accompanied by extreme pain and swelling, then you need to call a doctor immediately, particularly if you are using a blood thinning medication.
• You should also call the doctor if the cause of the bruise is not apparent.
• You should also call the doctor if the bruise is under either your fingernail or toenail.
• If the bruise fails to improve within two weeks or does not entirely clear after four or just three weeks, then you need to make a call to your doctor.
• If you feel you have a broken bone alongside the bruise, then you should visit the emergency center.

Certain bruises, particularly those in the eye or head can bring in too much anxiety. If a bruise happens just above the area of the eye, it is expected that the bruise will definitely move to the area under the eye, and this can results into a black eye due to the gravity effects.
If you do not notice any change in your vision even if you move the affected eye in different directions, then you need to the nearest hospital for a check-up.

Tests And Examinations For A Bruise

If the injury is evidently a bruise and no broken bones are suspected, then no tests are supposed to be carried out by the doctor.  The doctor should, however, obtain an X-ray of the affected area to ensure that no bones are broken.   For any bruise that happens most regularly and for no visible reason, a blood test should be done to check the bleeding disorder.

Treatment

The treatment of any bruise is very effective when the bruise is still in its reddish color, immediately after the injury. To the affected area, a cold compress like an ice pack should be applied for about thirty minutes. This is meant to speed the healing and also lowers the swelling. The ice should not be directly applied to the skin, use a towel to wrap it in.  If the bruise has consumed a big part of the foot or leg, then it should be elevated as much as possible in the first 24 hours after the occurrence of the injury.

 

To lower the pain, you can use Acetaminophen as indicated on the content, but avoid ibuprofen or aspirin since they slow the clotting of blood and may increase bleeding.   A warm washcloth should be applied to the bruise for about ten minutes to increase the blood flow to the affected area and also to enable the skin to absorb the blood faster.  Apart from the techniques that are described in the home remedies, doctors do not have any particular treatment for bruises.  A social worker can be able to help a suspected victim of domestic abuse.

Prevention

I. Put on protective gear like shin guards when participating in a contact sport like football.
II. Put furniture far from common walking areas or doorway at your home.
III. Keep your floors free from any clutter
IV. If blood-thinning drugs have been prescribed to you by your doctor, ensure that you carry out frequent monitoring and adjust them as required.
V. The bruises will take close to two weeks to go away.

CONTUSION

Popularly known as the cork, muscle contusions can be best referred to as an excruciating direct injury of the muscle that comes as a result of blunt trauma to the tissue.   Contusions are regarded as the most common forms of injuries that are associated with sports. Its severity varies from dull skin to bone and muscle contusions and even to internal organ contusions.

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The Feeling

  • The contusion injury mostly results in a dull and diffuse pain with some bruising and swellings that are sore even to touch.
  • Contusions also affect the function of the muscles regarding flexibility and strength. The affected part’s variety of motions is usually restricted as a result, like for instance; a contusion to the front side of the thigh will reduce the ability of the patient to bend his/her knee.
  • When the pain is experienced in the muscle, it becomes very hard to work and even contract. More pain can also be experienced each time the patient stretches the muscle.
  • Bruising or bleeding comes as a result of tearing of the sheath that surrounds the bundle of the muscle, which also enables the blood to spread all over the belly of the muscle.
  • Contusions are mostly caused by a direct blow and are very common in the sporting fields.
  • When the knee of an opponent collides with a thigh of another player, then contusion may occur. The severity ranges in most cases and the injuries are regarded as moderate, mild, or severe based on the level of contact force, and how contracted the muscle is.
  • One of the most common locations is in the area of quadriceps, which are the muscles on the thigh’s front areas.

The Management Services Of A Contusion

The management can be subdivided into three various phases; the resolution phase, the acute phase, and the sport functional phase.   The acute phase is the core injury management for a contusion. It is supposed to be done with the first 24 to 72 hours of the injury. It is administered under the protocol of “PRICE,” which represents,  Protect, Rest, Ice, Compression and Elevation.

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Steps In Managing A Contusion

  1. Protect – the primary objective of this initial step is to provide protection to the tissues that have suffered injury from any further damage. Crutches or other taping techniques may be substantial if the injury is serious.
  2. Rest – it is essential for the patient to have some rest, but it doesn’t necessarily mean keeping the affected part crippled for some days. Once in a stable condition, you can start moving the limbs slowly. Weight bearing should, therefore, begin as tolerated, but you should only do what appears comfortable and not painful.
  3. Ice – ice helps in lowering the pain and preventing more damage to tissues. Ice can also be applied to reduce the flow of blood, muscle inhibition, and spasm. To obtain great body relief, you should consider reducing the temperature of the body to help in managing the pain.  You can effectively reduce the temperature of the local tissues by applying crushed ice as compared to gel packs or frozen vegetables. When you notice any sign of extreme effects like more pain, skin irritation or swelling, then it will be important to stop applying the ice.
  4. Compression – Compression bandages are necessary for reducing the pain, swelling and also helps in circulation. You should make the area compressed but not painful or uncomfortable in any way.
  5. Elevation – the primary aim of elevation is to help in circulation and lower the swelling. The injured area should be elevated for close to twenty minutes.

Contusion Injuries

Contusion injuries are always described as a blunt trauma. It is a type of harm that produces blood suffusions without any break in the surface. There are, however, several ocular effects that blunt injuries can cause without releasing blood.

What Causes Contusion Injuries?

Contusion injuries are caused by muscle contusions and are also one of the leading causes of morbidity from injuries that are associated with sports. The severity of these types of injuries mainly depends on many factors that may include the age of the affected person, the location of the impact, the presence of fatigue, and the status of activation of the muscles that are involved.  A quadriceps contusion injury is another common type of injury that is mostly witnessed in the sporting fields. In most cases, it goes untreated and later results in severe complications for the participating athlete.

Diagnosis

The diagnosis of these kinds of injuries has initially been regarded as one of the clinical judgments.   However, with advancement in technology especially in the medical sector, more modalities have been introduced to help in managing contusion injuries. These modalities have been very helpful and have aided in identifying and even delineating the extent of a particular injury. Some of these modalities include magnetic resonance imaging, ultrasonography, and spectroscopy.

Despite the fact that controlled clinical studies are not so sufficient, animal research into the topic of muscle contusions has given an opportunity for a process of natural healing. The natural healing process covers a full balance between regeneration, muscle repair, and the formation of scar tissues. Various studies have also been launched so as to ascertain the actual effects of operative repair, corticosteroids, exercise protocols and anti-inflammatory medications.
Much stress has also been put on treatment and prevention of complications like myositis ossifacans.
One thing that has so far been able to improve the outcome of contusion injuries is recognition.

How To Prevent Contusion Injuries

In participating sports that need protective equipment, athletes should be very careful to ensure that the protective pads are sized perfectly to fit the front side of the thigh.  They should also be positioned in the right way before any form of competition. Contusion injuries can be easily prevented in sports like hockey and football. The treatment would mainly include the proper utilization of the ‘PRICE’ Protocol.

 

BONE BRUISE

A bone bruise is a traumatic injury that occurs to the bone and is usually less severe than a bone fracture. A bruise always happens when your small blood vessels are damaged by an injury that causes the fluid and blood to leak into the tissues and blood vessels nearby.  Bone bruises are very common and can occur to people of almost all ages. Any bone that is in your body can be injured anytime. Other injuries may also occur alongside the bone bruises like damage to a ligament that is nearby.   Bones that are situated next to your skin’s surface are more prone to bruises than others.

Causes

A bone bruise can be resulting from any kind of injury. Among these injuries, the ones that are most common are sports injuries, a fall from a higher place, or a motor vehicle-related accident. These types of bruises can also be caused by twisting injuries such as those that cause joint sprains. There are also other medical conditions such as arthritis that may also cause a bruise in the bone. This is because where there is arthritis; the surfaces of the bones are not well protected and therefore grind against each other. Multiple bruises of bones can also occur as a result of child abuse.

What Are Their Risks?

• If you do not use the right safety gear for your sport, then you may be at a higher risk of having a bone bruise. You may also be at a risk of a bone bruise if any or more of the following factors directly apply to you.
• If you are active in high-impact sports
• If the job you are doing is physically demanding
• If you fail to wear the right protective equipment
• If you participate in an exercise that is physically demanding

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If you have a condition known as osteoarthritis, then bone surfaces rubbing against each other may result in bruising. The treatment of this condition mostly includes injecting corticosteroids into the joints, and this can also lead to a bone bruising in some cases.  There are also other risky actions like failing to wear seatbelts that may increase up your chances of getting a bone bruise.

Symptoms

You can easily assume that you have a normal bruise if your skin appears black, purple, or blue. But this type of injury may go a bit deeper. Some of the symptoms that suggest that one may be suffering a bruised bone include:

a) Tenderness and pain in the affected part
b) Change in color of the injured area
c) Stiffness at the joint that is injured
d) Swelling of the joint that is injured
e) Swelling in the affected part and soft tissues around it

Compared to a soft tissue injury, the pain of a bone bruise is very severe and lasts for a longer period. The severity of your symptoms and the time that they take will depend on the gravity of the bruise.

Diagnosis

The first thing that a healthcare provider will also for is your medical history and the symptoms you have witnessed. They would want to know how you developed the injury, and then an exam of the injured area will be given to you. This test checks for the swelling, bruising and pain.
The healthcare provider will only be able to tell if you have a bone bruise after the examination. This type of ailment cannot be seen on an X-ray, though it can be used to rule out a bone fracture.

Treatment

Treatment of a bruise on the bone may involve so many things that include:

• Applying ice to the affected area various times in a day
• Resting the bone or joint
• Using medicine that reduces swelling and pain
• To reduce swelling, you can also raise the injury above the level of your heart
• If there be a need, you can wear a brace or any device that can lower movement.

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You are also likely to get advice about your diet. This is due to eating food that is rich in protein, calcium, and vitamin D can aid your quick recovery.   You should also stay away from certain over-the-counter medicines that reduce pain since they may at times delay the healing of the bone. Another activity that can also delay quick bone healing is smoking, so you should put away your cigarettes if you are a smoker.

Possible Complications

Most of these bone-related bruises can heal without the patient experiencing any problem. If you have a large bruise on your bone, your body may encounter some problems especially in having blood to flow back to that area. This can lead to a condition known as avascular necrosis of the bone, and ultimately resulting in the death of that particular bone.

When Is The Right Time To Call The Healthcare Provider?

If your symptoms fail to get better within few days, then you should call the healthcare provider. You should also call him immediately if you encounter severe symptom like high fever.  Most bruises on the bone slowly heal for a period of one to two months, but a large one may take longer time. A healthcare provider should be able to explain to you the amount of time you should avoid putting weight on your bone.

 

BRUISED SKIN

A bruised skin occurs as a result of a common skin discoloration that brings the breakage of small blood vessels that leaks under the skin after a traumatic injury. The blood from the blood cell that has been damaged under the skin collects around the surface and appears like what is seen as a blue and a black mark. This is the mark from the discoloration of the skin by red blood cells. Most bruises do not cause so much concern and disappear on their own.

Causes Of A Bruised Skin

Usually, people get bruised skins each time they bump into an object or maybe an object bumps into them. If you are fond of having a vigorous exercise activity, then you are more likely of having a bruised skin. A bleeding disorder in your body may also lead to a bruised skin.  There is also a tendency of older people to develop bruises on their skins. Bruised skins for older adults are mainly as a result of the older age that makes their skin weaker. Once the tissues that provide support to the blood vessel have become weak, the skin then becomes bruised.

Signs And Symptoms Of A Bruised Skin

The main symptoms of a bruised skin are swelling, pain and the discoloration of the skin. It mainly begins on the skin as a pinkish red color and at times becomes so tender even to touch. Bruised skin can make it so hard for the patients to walk properly.   The bruised skin changes to a bluish color before it turns to the greenish-yellow and then the normal color of the skin as it heals. For those who bruise so easily, just a minor bump can cause the whole skin to be bruised. The common locations for bruised skin are always legs and arms.

Skin bruising may also be an indicator or even more dangerous thing like blood clotting issue, significant injury, physical abuse or a blood trauma. It is therefore recommended that any individual who has painful and large bruises should visit a health professional and get medical assistance.  Some of the signs and symptoms described up above can be an indication that the person has either abnormal functions or low level of platelets. Blood can clot easily after an injury with the assistance of platelet compounds.   Skin bruising that takes place around the area of the naval may be as a result of a dangerous internal bleeding, while bruising at the backside of the ear, commonly known as Battle’s sign may be as a consequence of a fracture in the skull.

Diagnosis Of A Bruised Skin

Usually, skin bruising is not regarded as a huge problem, and therefore it does not necessarily need a medical diagnosis. But skin bruising in certain areas may prompt a medical practitioner to evaluate the health of the person by testing samples of blood like platelets counts and blood clotting.   An x-ray may be important if the bruised skin becomes strangely hard.

Complications

Occasionally, the bruised skin may at times begin to increase without disappearing after becoming very firm. It would also continue to be very painful. Getting a timely medical attention and strictly following the advice of a doctor on rehabilitation can assist the person to prevent other medical complications. Such complications may include myositis ossificans and compartment syndrome.

Myositis ossificans is a condition where the muscle that has been bruised grows into a bone instead of new muscle cells. This condition can be developed by young athletes who try to rehabilitate a seriously bruised skin so fast. The condition can be even worsened by extreme stretching exercises. Some of the things that can assist a patient in this state are rest, compression, ice, and elevation that lower the rate of inflammation.

Compartment syndrome – in other cases, too much bleeding may bring in certain painful swelling within muscle groups in various parts of the body. The build up of pressure several hours after a bruise on the skin can affect the flow of blood and prevent the muscle group underneath the bruised skin from getting its nourishment. To drain the extra fluid, an urgent surgery may be recommended.

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Treatment

Not much can be done to treat skin that has bruised. In most cases, it disappears as the body reabsorbs the blood. Application of ice packs on and off especially after the first 24 hours of injury can help in managing it.   Other ways of treating a bruised skin are by applying moist heat that increases that aids circulation and healing of the tissue. The accumulation of the blood can also be retarded by other activities like rest and elevation of the affected area.

BRUISE EASILY

The medical term for a bruise is a contusion. Bruises typically occur as a result of a certain degree of injury to the skin’s blood vessels.

  • Easy bruising therefore may be as a result of skin compression that appears insignificant, or even no skin injuries remembered.
  • Easy bruising mainly occurs anytime blood vessels become weak as a result of illnesses such as scurvy. It can also be caused by frequent use of medicines like prednisone, aspirin, and prednisolone.
  • Aging is another factor that can make a skin to bruise easily.
  • The skin can also easily bruise due to lack of deficient blood clotting elements.
  • Ecchymosis is a local blood leakage into the skin coming from the capillaries. This process occurs naturally without causing any form of injury and always brings in a flat and a discolored purple area that is known as ecchymosis. This condition does not have any association with tenderness.
  • Easy bruises are mostly associated with age, a fact that is very true with women whose capillary walls become so weak and their skins become thin. If you easily develop large bruises, then you could be suffering from a severe condition that requires medical attention.

Connection Between Medications And Easy Bruising

In most cases, medications are required to treat particular health conditions and make the condition life even better. But some medications could be the cause of your easy bruising. Drugs that reduce clotting like warfarin, aspirin, rivaroxaban, and clopidogrel can increase your chances of easy bruising. There are also some herbs that can bring easy bruising since they affect your body’s capability of clotting.

They include ginger, fish oil, ginkgo, garlic, vitamin E, and ginseng. You should also be careful with other elements like non-steroidal anti-inflammatory drugs (NSAIDS) and steroids.

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Some of the medical conditions that are capable of causing easy bruising are the following:

• End-stage kidney disease
• Cushing’s syndrome
• Hemophilia A
• Hemophilia B, popularly known as Christmas disease
• Liver disease
• Leukemia
• Malnutrition
• Low platelet count
• Von Willebrand disease

How To Diagnose An Easy Bruising

Apart from the fact that occasional bruise may not be a serious cause for concern, easy bruising, on the other hand, maybe. You can work with your medical professional to determine the cause of any frequent bruising that you may notice.   Besides the physical tests on your bruises, your healthcare provider should also ask you some questions and carry out a blood test to measure the levels of your platelet and the duration in which your blood clots.

How To Treat Easy Bruises

As earlier stated, bruises mostly disappear on their own without care. Your body will be able to reabsorb the blood that had caused the discoloration.   The first line of treatment would be to apply a cold compress for about fifteen minutes until the swelling reduces. For the pain, you can take ibuprofen or acetaminophen to lower it.  Doctors should be able to modify an effective treatment plan for you if your easy bruising were caused by medical conditions or particular medications.

Preventative Care

Here are some of the ways of preventing easy bruises.

• Practice balancing exercises so that you can avoid bumps and falls
• Take your time when you are walking
• Avoid minor bruises by wearing long sleeves and long trousers
• When exercising, ensure that you wear protective gear like knee pads

Indications of a more serious condition are:

• You need to call your healthcare provider when you notice blood from anywhere in the urine.
• Bruising can also be as a result of abuse or domestic violence.

Conclusion

Apart from swelling, bruises can also be very painful. You can get all the type of bruises that have been discussed; skin, bone or muscle. The most serious ones are the bone bruises.  Easy bruising means that no significant trauma has happened on the skin or even soft tissues to bring the bruising. They are usually large and also frequent.  The causes of these ailments range from those without significant health consequences to hidden diseases that can be very dangerous. They include bone marrow malignancies and bleeding disorders.  Seeking our a right diagnosis and treatment, an appropriate evaluation is imperative.  In certain instances, a referral to a hematologist may be required for further evaluation. This is important before other invasive procedures.

The following sources have been used in this article to provide a back up to various health claims made here. These sources have been obtained from various scientific studies done by renowned medical experts.   However, it is important to note that medical topics are very crucial, and the victims should always see a healthcare provider and get a right diagnosis for the condition they are suffering.

Sources

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  2. Staff Writer, Muscle Contusion, Ortho Information Association, May 13, 2017
  3. Staff Writer, Bone Bruise, St. Lukes Health System, May 14, 2017
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