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What is Bruising? Important facts about contusions.
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What is Bruising? Important facts about contusions.


Dr. Edward F.Group III, DC, Ph.D, ND, DACBN

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A bruise is also called a contusion. Contusions occur when a direct blow or repeated blows from a blunt object strike part of your body, crushing underlying muscle fibers and connective tissue without breaking the skin. You can also get a contusion by falling or jamming part of your body against a hard surface. Most contusions are minor and heal quickly without taking you out of the game. But severe contusions can cause deep tissue damage and lead to complications and/or keep you out of sports for months. When these tissues are injured, small veins and capillaries (the tiniest blood vessels) under the skin sometimes break. These blood vessels then leak out red blood cells.

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.

The red blood cells that collect under your skin are what cause that bluish, purplish, reddish, or blackish mark. That's where black-and-blue marks get their name - from their color on the skin.

Some people bruise easily whereas others may have tougher skin tissue. Despite the many ways you can get them, bruises pretty much go through the same colorful changes as the body begins to heal itself.

A bruise will turn nearly all the colors in the rainbow before it finally fades away. The color changes mean that your body is metabolizing, or breaking down, the blood cells in the skin. This is the chemical process that your body goes through to repair itself.

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 fractured bone, dislocated joint, sprain, torn muscle or other injuries. Contusions to the abdomen may damage internal organs.

Your body will go through the following phases:

  • First, you'll probably have a bump that will probably look red or purplish and tender. The bump might swell from the blood collecting under the tissue.
  • After a couple of days, the bruise will look blue (or even blackish).
  • After 5 to 10 days, it may look greenish or even yellow.
  • After 10 to 14 days, the bruise will most likely be a light brown, and then get lighter and lighter as it fades away.

Most bruises will disappear after 2 weeks, and some go away even sooner.

This is bruising in general. Despite the fact general bruising was mentioned, in reality there are three types of bruising that occurs on the body:

  1. Subcutaneous -- beneath the skin,
  2. Intramuscular -- within the belly of the underlying muscle
  3. Periosteal -- bone bruise

If you have a bruise anywhere on your body do not attempt to drain the bruise with a needle, or continue running, playing, or otherwise using the painful, bruised part of your body, and above all else do not ignore the pain or swelling.

Since bruises do result from an injury, the following safety steps are important to follow:

  • Teach children how to be safe.
  • Be mindful to avoid falls around the house
  • Wear seat belts in motor vehicles.
  • Wear proper sports equipment to pad those areas most frequently bruised

Typical skin bruises that talked about above, but there is a bruise that can occur deep within the body. This type of bruise is called Myocardial contusion. Myocardial contusion is a bruise of the heart muscle, often the result of a traumatic fall of some type including a motor vehicle accident, or cardio-pulmonary resuscitation (CPR). This can cause your heart to react and force it to become stunned in a way so that it reacts to it. This can cause harm to that affected area and create what is known as a bruise.

If this has happened to you, you may notice irregularies when getting an electrocardiogram (ECG), as (in order of frequency) sinus tachycardia, right bundle branch block, and ventricular dysrhythmia. Additionally, an echocardiogram may reveal abnormalities in the ability of the ventricle to contract (wall motion abnormalities).

Another bruise that affects people is a bone bruise. A bone bruise results from constant pressure applied on a part of the bone. The damaged area occurs in the medullary portion of the bone and can be accompanied by bleeding and swelling. Bruises are often caused by falls, sports injuries, car accidents, or blows received by other people or objects. Bruises can last from days to months, with the bone bruise being the most severe and painful.

Another type of bruise that no one may think about is a black eye. A black eye is caused by bleeding into the tissue around the eye. This most often follows trauma. The medical term for this type of bruising is ecchymosis. These types of bruises are not pleasant and can be misconstrued as domestic abuse, especially if the black eye is on a married woman. Or, if found on a man, it could mean he was in a fight of some kind, since a fight is what usually can cause this type of condition.

If you find you bruise easily from any type of hit to your skin or body, you may be suffering from Glanzmann’s disease. This is a rare congenital disorder of blood platelets manifested by easy bruising and nosebleeds.

Continue reading to find how to properly treat bruises.


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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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