Deep Muscle Bruises: What Are The Causes And Effects?

Deep muscle bruises, or muscle contusions, are a common injury, especially for athletes in contact sports. They occur when a direct blow or blunt force crushes the muscle fibres and connective tissue without breaking the skin. This causes bleeding into the muscle, resulting in pain, swelling, and limited range of motion in the affected joint. While most contusions are minor, severe cases can cause deep tissue damage and lead to serious complications, such as compartment syndrome and myositis ossificans, which may require surgery. Treatment for muscle contusions typically involves rest, ice, compression, and elevation (RICE), along with anti-inflammatory medication to reduce swelling and speed up recovery.

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Compartment syndrome

Acute compartment syndrome is a medical emergency that typically occurs within a few hours of a severe injury or trauma, such as a car accident or a broken bone, and can lead to permanent disability or tissue death if not treated promptly. It can also develop after surgery or as a result of treatment such as casting. Chronic compartment syndrome, on the other hand, develops over time with repeated stress or vigorous exercise, causing swelling and bleeding inside the muscle compartment. While it is extremely painful, it is usually not considered a medical emergency and can be treated by adjusting your workout routine or with rest, ice, compression, and elevation of the affected limb.

The symptoms of acute compartment syndrome include intense pain, swollen muscles, visibly bulging muscles, numbness, pins and needles, or electricity-like pain in the affected limb. The pain may feel like a burning sensation or a deep ache and may be greater than expected for the severity of the injury. It can also cause weakness or loss of sensation, pale skin in the affected area, and foot drop if it occurs in the leg. Chronic compartment syndrome symptoms include aching or cramping in the affected muscle that gets worse within 30 minutes after starting exercise but usually goes away with rest.

The treatment for acute compartment syndrome is surgery, called a fasciotomy, to relieve the pressure in the muscle. During a fasciotomy, the surgeon makes cuts around the muscle to relieve the pressure. There are also clinical trials investigating the use of ultrafiltration to treat compartment syndrome. Chronic compartment syndrome can often be treated by adjusting your workout routine or with rest, ice, compression, and elevation of the affected limb.

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Myositis ossificans

The exact cause of myositis ossificans is not completely understood. However, it is believed that it may develop if a contusion is caused to re-bleed during recovery. This can happen if someone returns to activity too soon, or through over-vigorous massage or stretching of the quadriceps muscle. It is also believed that myositis ossificans occurs when, instead of making muscle cells (fibroblasts), the body creates new bone cells.

The most common sign of myositis ossificans is a large, painful, tender lump beneath the skin. As the lump gets bigger, it may reduce your range of motion. Other symptoms include swelling, muscle weakness, and increased pain in the morning.

There is no guaranteed way to prevent myositis ossificans. However, you can reduce your risk by treating injuries properly, especially if you have a severe bruise or swelling. Immediately after injury, use the RICE method: rest, ice, compression, and elevation.

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Tissue damage

A deep muscle bruise, or muscle contusion, is a painful injury that occurs when a direct blow or blunt force crushes the underlying muscle fibres and connective tissue without breaking the skin. This can lead to bleeding into the muscle, causing a pool of blood to collect within the damaged tissue, known as a hematoma. Hematomas can form lumps over the injury site and are typically accompanied by pain, swelling, and skin discolouration.

While most muscle contusions are minor and heal quickly with at-home treatments, severe contusions can cause deep tissue damage and lead to serious medical complications. In some cases, rapid bleeding and swelling within the muscle can result in compartment syndrome, a life-threatening condition that requires urgent surgery to drain excess fluids and relieve the extreme build-up of pressure.

Additionally, extensive tissue damage from a deep muscle bruise may result in broken bones, dislocated joints, sprains, torn muscles, or other injuries. Contusions to the abdomen or chest may also damage vital internal organs, such as the heart, lungs, liver, kidneys, pancreas, and spleen. These types of injuries require immediate medical attention and may necessitate diagnostic imaging tools such as X-rays, ultrasounds, MRIs, or CT scans to determine the exact location and extent of the damage.

To treat a deep muscle bruise and prevent further tissue damage, it is essential to follow the RICE (Rest, Ice, Compression, Elevation) method. This involves resting the injured muscle, applying ice to reduce pain and swelling, using compression bandages for support, and elevating the affected area above heart level to improve circulation and reduce swelling. It is also crucial to protect the injured area from further harm by refraining from physical activity and, if necessary, using assistive devices such as crutches or a sling.

In the rehabilitation phase, medical professionals may prescribe gentle stretching exercises to improve flexibility and range of motion. Once range of motion has improved, weight-bearing and strengthening exercises may be introduced. Returning to sports or physical activities too quickly can lead to excessive scar tissue development, causing further complications. Therefore, it is important to follow the advice of a healthcare professional to ensure a safe and gradual return to normal activities.

Pain and swelling

A deep muscle bruise, or muscle contusion, is an injury to the muscle fibres and connective tissues. It is caused by a direct blow from an object that strikes the body, damaging the underlying muscle fibres and connective tissues without breaking the skin.

Deep muscle bruises almost always cause pain and swelling. The injured muscle may feel weak and stiff, with limited range of motion in the joint near the injury. The severity of the injury will determine the level of pain and swelling, with mild bruises causing less pain and severe bruises causing more. Bruises can last from days to months, with bone bruises being the most severe and painful.

To treat the pain and swelling of a deep muscle bruise, it is recommended to use the RICE method: Rest, Ice, Compression, and Elevation. This helps to reduce pain and swelling and control bleeding. It is important to rest the injured muscle and not overwork it. Applying ice to the injury for 20 minutes every two hours during the first 24 to 48 hours can help to reduce swelling and pain. Compression bandages can provide additional support and prevent bleeding, further reducing swelling. Elevating the injury above the heart level when at rest increases circulation and reduces swelling.

Over-the-counter medications such as NSAIDs (ibuprofen or naproxen) can help relieve pain and decrease inflammation. However, these should not be used for more than a few days to a week due to the risk of increased bleeding. In some cases, natural substances like arnica cream, bromelain from pineapples, and aloe vera can help reduce the effects of a bruise and promote healing. Applying gentle heat to the injury after 48 hours can also boost blood flow and aid in clearing up the bruise.

Restricted movement

A deep muscle bruise, or muscle contusion, is an injury to the muscle fibres and connective tissues. It is often associated with the muscles in the upper leg. A deep muscle bruise can cause restricted movement due to the pain and swelling that accompanies the injury. The affected muscle may feel tender, making it difficult to use the muscle and limiting the range of motion of the joint near the injury.

The severity of a muscle bruise can vary, ranging from mild to severe. Most contusions heal with at-home treatment, such as the RICE protocol: Rest, Ice, Compression, and Elevation. It is important to keep the injured area in a gentle stretch position and avoid any massage or movement that causes pain. Immobilising the limb can help minimise the size of any hematoma that forms and improve flexibility.

For more severe bruises, medical care may be required. Bruises that do not show signs of improvement within a few days should be assessed by a doctor, who may recommend physical therapy to increase mobility. Severe contusions can cause deep tissue damage and lead to complications that may prevent athletes from returning to their sport for months.

Deep muscle bruises can be caused by a direct, blunt blow to the muscle, such as in contact sports, or by falls or car accidents. They are particularly common in sports such as American football, where strong forces like tackling or falling on top of someone can result in bruises to the large thigh muscles. People over 65 are also more likely to develop muscle bruises from falling due to increased fragility of blood vessels with age.

Complications from deep muscle bruises can include compartment syndrome, where internal bleeding and increased pressure cause tissue to swell, reducing blood flow to the muscle and nerve cells. This can be life-threatening and may require surgery. Another complication is myositis ossificans, where muscle tissues harden and form bone due to repeated trauma.

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