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Bruising, or muscle contusions, are a common injury in contact sports, caused by a direct blow or repeated blows by a blunt object. This crushes the muscle fibres and connective tissue, causing bleeding beneath the skin that does not escape, leading to bruising. Bruising can cause muscle weakness and stiffness, and in severe cases, deep tissue damage. This can lead to serious complications such as compartment syndrome and myositis ossificans, which can cause loss of limb. Bruising can also cause swelling, which may limit joint range of motion, potentially impacting muscle contraction.
| Characteristics | Values |
|---|---|
| Bruising cause | Direct blow or repeated blows by a blunt object |
| Muscle contraction loss cause | Muscle strain or "pulled muscle" |
| Muscle contusion treatment | RICE protocol: Rest, Ice, Compression, Elevation |
| Muscle strain treatment | NSAIDs, physical therapy |
| Muscle contusion complications | Compartment syndrome, myositis ossificans |
| Muscle strain complications | Prone to future injury, permanent shortening of muscles |
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What You'll Learn
Muscle contusion causes
A muscle contusion, or bruised muscle, is an injury to the muscle fibres and connective tissues. It is caused by a direct, blunt blow to the muscle, which crushes the muscle fibres and connective tissue without breaking the skin. This can be caused by colliding with a hard object or another person, or falling onto a hard surface.
Muscle contusions are common in contact sports, especially American football, where the thigh muscles are a common site of injury. They can also occur due to traumatic events like car accidents.
Other factors that can increase the risk of a muscle contusion include age, malnutrition, and bleeding disorders. People over 65 are more likely to fall and sustain a muscle contusion. Poor nutrition can cause weakness and dizziness, increasing the risk of falling. Bleeding disorders, such as haemophilia, can make it more likely that blood vessels will break after an impact, resulting in a muscle contusion. Smoking is another risk factor, as it constricts blood flow and slows healing.
The severity of a muscle contusion can vary. Mild contusions may produce little to no pain and swelling, while severe contusions can be very painful and cause noticeable swelling and bruising.
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Compartment syndrome
There are two types of compartment syndrome: acute and chronic. Acute compartment syndrome happens suddenly, usually after a severe injury or as a surgery complication. It can also occur after blood flow returns following a period of poor circulation. It is characterised by intense pain, swollen muscles, visibly bulging muscles, decreased blood flow, decreased movement, numbness, and a pale limb. It can lead to permanent muscle damage, paralysis, or even death if not treated immediately.
Chronic compartment syndrome, also known as exertional compartment syndrome, typically builds up slowly over time, especially after intense or excessive physical activity or exercise. It is most commonly caused by athletic exertion and is reversible with rest. It causes pain with exercise, which fades after the activity stops. It usually does not cause permanent damage and is not considered a medical emergency.
The symptoms of acute compartment syndrome include severe pain, decreased blood flow, decreased pulses, numbness, and a pale limb. The pain is often described as being greater than what would be expected from the injury and may not be relieved by rest or even strong painkillers.
The symptoms of chronic compartment syndrome include pain, tightness, cramps, weakness, and numbness. The pain typically lasts for months or even years but can be relieved with rest. This type of compartment syndrome is more likely to occur in people who engage in activities with repetitive motions, such as running or marching.
In summary, compartment syndrome is a serious condition that can lead to permanent muscle damage or other severe complications if left untreated. It is important to recognise the symptoms of both acute and chronic compartment syndrome and seek medical attention as needed.
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Myositis ossificans
The condition usually affects large muscles, with 80% of cases occurring in the extremities, particularly the elbow, thigh, or upper arm. In children and young adults, the quadriceps muscle in the thigh is a common site for myositis ossificans. Paraplegics are another group that is prone to developing myositis ossificans, often around the knees and hips, even without evidence of trauma.
The presence of myositis ossificans can be challenging to diagnose as it may mimic more aggressive conditions such as osteosarcoma. A thorough examination by a physiotherapist can help predict the likelihood of myositis ossificans, and an X-ray approximately three weeks after the injury is typically used to confirm the diagnosis. Treatment options are limited once myositis ossificans is established, and prevention is the best strategy. Management focuses on resting from aggravating activities and gentle pain-free range-of-motion exercises. Surgical resection is usually curative and reserved for symptomatic lesions.
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Muscle strain
A muscle strain, also known as a pulled muscle, is a common but painful injury. They are one of the most common soft tissue injuries and can be caused by pulling a muscle too hard, using it too much, or twisting it. This weakens the muscle fibres, stretching them beyond their limit and causing them to tear apart.
However, severe tears may require medical care or even surgery. It is important to seek medical attention if symptoms do not improve within a few days, as this could indicate a more serious injury. In these cases, a doctor may recommend physical therapy or other treatments to increase mobility and aid recovery.
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Treatment and recovery
Bruised muscles, or muscle contusions, are typically caused by trauma or blunt force to a body part. This crushes the muscle fibres, causing bleeding into the affected muscle, but does not break the skin. Bruised muscles are often the result of direct contact sports, hard falls, or collisions with hard surfaces or other people.
The treatment and recovery process for a bruised muscle depends on the severity of the injury. Mild muscle injuries can begin to heal within a few days, while moderate to severe muscle contusions may take four to six weeks to heal. Here are some treatment and recovery methods for bruised muscles:
- Rest: Protect the injured muscle from further damage by stopping unnecessary physical activity. Resting the muscle is crucial during the initial acute phase of healing, which typically lasts 24 to 48 hours after the injury.
- Ice: Apply ice to the injury to help reduce pain, swelling, and bleeding. Ensure that you do not apply ice directly to the skin but wrap it in a damp cloth or towel to avoid ice burns.
- Compression: Use compression bandages to provide support and reduce swelling.
- Elevation: Keep the injured area elevated to control bleeding and swelling.
- Medication: Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be prescribed by a doctor or purchased over the counter to reduce inflammation, swelling, and pain.
- Gentle Heat: After a few days, when inflammation and swelling begin to decrease, your doctor may advise applying gentle heat to the injury to promote healing.
- Physical Therapy: Moderate to severe muscle contusions may require physical therapy to reduce pain and promote healing. This may include exercises, massage, and electrotherapy.
- Surgery: In rare cases, severe complications such as compartment syndrome or myositis ossificans may require surgery.
It is important to seek medical attention if your symptoms do not improve within a few days, as severe muscle injuries may require further treatment and management.
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Frequently asked questions
A muscle contusion is a bruise in the muscle, caused by a direct blow or blunt force trauma. This crushes the muscle fibres and connective tissue, causing bleeding beneath the skin and bruising.
Muscle contusions are almost always painful. They can also cause swelling, skin bruising, weakness or stiffness in the injured muscle, and difficulty using the joints near the injury.
Mild muscle contusions can be treated at home using the RICE protocol: Rest, Ice, Compression, and Elevation. More severe contusions may require medical care, including physical therapy to increase mobility and prevent permanent damage.
While bruising can cause stiffness and loss of range of motion in the affected muscle, there is no evidence to suggest that it causes a complete loss of muscle contraction. However, severe bruising can lead to serious tissue damage and complications such as compartment syndrome and myositis ossificans.
