Athletes in all contact sports have many opportunities to get a muscle contusion (bruise). Contusions are second only to strains as a leading cause of sports injuries.
Most contusions are minor and heal quickly, without taking the athlete away from the game. But, severe contusions can cause deep tissue damage and can lead to complications that may keep the athlete out of sports for months.
Contusions occur when a direct blow or repeated blows from a blunt object strike part of the body, crushing underlying muscle fibers and connective tissue without breaking the skin. A contusion can result from falling or jamming the body against a hard surface.
Contusions cause swelling and pain, and limit joint range of motion near the injury. Torn blood vessels may cause bluish discoloration. The injured muscle may feel weak and stiff.
Sometimes a pool of blood collects within damaged tissue, forming a lump over the injury (hematoma).
In severe cases, swelling and bleeding beneath the skin may cause shock. If tissue damage is extensive, you may also have a broken bone, dislocated joint, sprain, torn muscle, or other injuries.
Contusions to the abdomen may damage internal organs.
See your orthopedic physician right away for complete diagnosis. A physical examination will determine the exact location and extent of injury.
Diagnostic imaging tools may be used to better visualize inside the injured area of your body. These tools include ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT) scans.
For some injuries, your doctor may also need to check for nerve injury.
To control pain, bleeding, and inflammation, keep the muscle in a gentle stretch position and use the RICE formula:
- Rest. Protect the injured area from further harm by stopping play. You may also use a protective device (i.e., crutches, sling).
- Ice. Apply ice wrapped in a clean cloth. (Remove ice after 20 minutes.)
- Compression. Lightly wrap the injured area in a soft bandage or ace wrap.
- Elevation. Raise it to a level above the heart.
Most athletes with contusions get better quickly with simple treatment measures. Your doctor may give you nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, or other medications for pain relief. Do not massage the injured area.
During the first 24 to 48 hours after injury (acute phase), you will probably need to continue using rest, ice, compression bandages, and elevation of the injured area to control bleeding, swelling, and pain. While the injured part heals, be sure to keep exercising the uninjured parts of your body to maintain your overall level of fitness.
If there is a large hematoma that does not go away within several days, your doctor may drain it surgically to speed healing.