Contusions: Overview, Types, and Treatment

What is a Contusion?

A contusion is the medical term for what is otherwise known as a bruise. Though the word bruise conjures images of the purplish or “black and blue” marks you might see after banging a body part on a hard object, it can actually happen anywhere in the body. Contusions develop as a result of trauma, which includes any kind of injury inflicted on the body from an outside source. In addition to visible skin tissue bruises, internal organs, muscles, and even bones can all also develop contusions when subject to trauma.

When trauma happens—absentmindedly banging your leg into the coffee table, for instance—small blood vessels called capillaries are ruptured. As a result of these ruptures, localized bleeding begins to seep out into the surrounding dermal tissues; depending on the severity of the impact and amount of bleed, a small mound may form in the injured area. In the kinds of minor contusions that we recognize as bruises, the trauma is limited to layers of tissue that lie just under the surface of the skin. The characteristic discoloration of bruises is due to the blood from those ruptured capillaries being actually visible through the skin.

Contusions are, of course, a very common part of life. Athletes who participate in contact sports or workers who have physically demanding jobs are naturally prone to get bruises through the normal course of daily life. The same is true for kids of all ages who inevitably get a little banged up when playing in groups or getting into mischief. Contusions are rarely a cause for concern, however; in some cases, if the trauma is particularly intense, more significant bleeding occurs and pools in the area and causes a hematoma to form, a kind of severe contusion that creates a much larger lump.

Contusion Types

As noted above, contusions can occur anywhere in the body where trauma can happen. Even besides the fact that some contusions aren’t visible, there are other factors that determine how they are categorized. Below are the three types of contusion:

• Subcutaneous: A subcutaneous contusion is the most common and most visibly apparent type of contusion because it happens directly under the surface of the skin. This is the type that most people associate with a bruise, and they generally go away on their own without treatment.
• Intramuscular: Also known as a muscle contusion, this type occurs when a traumatic injury results in a direct blow to muscle tissue. Such a trauma may cause a visible subcutaneous contusion, but the deep tissue damage associated with this kind of injury causes blood vessels within the muscle fibers to similarly rupture and bleed. This bleeding can cause the affected muscle to swell and reduce mobility, and it may also create a tightening of the fibers that leads to a muscle knot.
• Periosteal: This type of contusion refers to the periosteum, a membrane that covers the outer surface of all bones. In some trauma—such as a hard hit to the primarily skin-and-bone shin—the actual bone itself can become bruised. Blood vessels in the periosteum rupture, and the blood seeps into surrounding soft tissue; in this case, however, the blood can pool under the periosteum or even into the bone itself if the trauma has also led to a broken bone.

Though bruises are known for causing discoloration on the skin, they aren’t the only conditions that have that symptom. Ecchymosis, for instance, refers to the same kind of discoloration that results from blood leaking into the top layer of skin; the main difference, though, is that ecchymosis doesn’t necessarily happen because of trauma. Another example is purpura, a discoloration that comes about because of bleeding related to various blood or platelet disorders; this also doesn’t require trauma to occur.

How to Treat or Manage a Contusion

The vast majority of bruises you get in your life will heal on their own and won’t need medical treatment, but that doesn’t mean that you shouldn’t welcome relief from any pain or discomfort. One of the best ways to speed the healing process along is through a classic method known by the acronym R.I.C.E. Short for Rest, Ice, Compression, and Elevation, this method aims to reduce comfort and make it easier to get back to normal activities. For a bruised arm, as an example, you would want to rest the arm and avoid moving it and then apply a cold pack for 15-20 minutes of each hour. Then, by wrapping the arm (compression) and elevating it, you can further reduce swelling.

The R.I.C.E. first aid method is meant to be used during the first 24 to 48 hours after the injury in order to reduce swelling and pain. After the first two days, a warm compress or heating pad applied regularly throughout the day can further reduce pain and stiffness. In addition to these physical treatments, you can also use over-the-counter pain relief medication like acetaminophen or ibuprofen that will additionally bring down inflammation.

When Should I Seek Medical Care?

Most bruises are a minor nuisance that don’t even require treatment. Outside of some light pain or stiffness in the area, you probably are barely aware of its presence. The more severe the trauma, however, the more seriously to take the injury. If you’re unsure of how to gauge the severity, below are some symptoms that would be a signal to seek medical attention:

• vision problems (from a black eye or another head trauma)
• swelling that is especially painful
• sharp pain that lingers days after the injury
• bruises that remain longer than 2-3 weeks
• a large lump (hematoma) in the affected area
• unexplained or frequent bruising in the same location
• other kinds of bleeding (bloody nose, blood in urine, etc.)

TrustCare: Healthcare Professionals You Can Trust

Bruises can be painful nuisances, but they’re thankfully almost always a minor concern. Yet sometimes in life traumatic injuries happen, and you’re not totally sure if the injury is serious. TrustCare’s urgent care facilities are there for just this kind of eventuality; if you’ve got a contusion and you’re not sure what to do about it, drop by one of our many convenient locations. Our highly trained staff is dedicated to providing the highest quality health care and medical advice.