Brief overview
- Treatment: Treatment depends on the type and severity of the contusion. First aid measures include cooling and elevation. In the case of severe injuries, a puncture may be advisable.
- Course of disease and prognosis: The healing period for mild bruises is a few days to weeks. For a severe contusion (bruise), it takes four weeks or longer.
- Symptoms: Depending on the severity of the contusion, possible symptoms include pain, swelling and restricted movement. Other symptoms occur depending on the localization.
- Causes and risk factors: A contusion is caused, for example, by a blow, fall or impact. Such injuries frequently occur in certain sports such as soccer or ice hockey.
- Diagnosis: The diagnosis is made by a medical examination. This may also include an X-ray examination, computer tomography (CT) or magnetic resonance imaging (MRI).
What is a contusion?
A bruise is a direct injury caused by compression. It is closed – so there is no visible skin injury and no broken bone. The tissue at the bruised site (for example, skin, fatty tissue, fascia, muscle, tendons, tissue capsule, et cetera) is bruised.
Depending on the type and location of the contusion, one speaks of a bone contusion, muscle contusion, eyeball contusion, lung contusion, brain contusion, thigh contusion (“horse kiss”), rib contusion, knee contusion or shoulder contusion. A contusion also occurs on other parts of the body, such as the foot or wrist.
Rib contusion
Learn more about the cause, symptoms and treatment of bruised ribs in the article Rib Contusion.
Knee bruise
Learn more about the cause, symptoms, and treatment of a bruised knee in the Knee Bruise article.
Shoulder contusion
Contusion and bruise
The medical term for contusion is contusion (contusio). In practice, however, a distinction is often made between the two terms: a contusion is defined as a trivial tissue damage associated with pain and without long-term significance. It is not accompanied by bleeding or swelling.
A contusion, on the other hand, is a severe bruise that is also accompanied by swelling and hemorrhage (hematoma). If, after a contusion, a lump is felt under the skin that turns out to be a swelling, it can be assumed to be a severe contusion. If tissue has also been destroyed, doctors refer to this as a contusion.
How is a contusion treated?
First aid for a contusion
The aim of first aid measures for a contusion is to reduce the escape of blood and lymph into the surrounding tissue as far as possible. To do this, follow the PECH rule:
- Ice: Cool the affected area for about 15 to 20 minutes. To do this, use ice packs or compresses with cold water. The cold causes the blood vessels to contract and less blood to escape. Caution: Because of the risk of local frostbite, never apply ice directly to the skin!
- Compression: External pressure may prevent the tissue from swelling and even more blood from injured vessels from leaking into the surrounding tissue. Therefore, apply a compression bandage to the injured area if possible.
- Elevate: If possible, elevate the injured area. This also reduces blood flow to the injured area.
For eye bruises, apply cool washcloth!
For bruises of the abdomen, it relieves pain if the affected person lies down with knees drawn up.
Herbal remedies for bruises
Some patients also rely on home remedies for bruises, such as curd compresses or clay packs. However, whether a particular home remedy really helps against a bruise is often not scientifically proven.
Home remedies have their limits. If the symptoms persist over a longer period of time, do not get better or even get worse, you should always consult a doctor.
When to see a doctor?
Sometimes it is not easy to distinguish between a serious injury and a minor injury.
A simple bruise generally does not require a doctor’s visit. If the discomfort is severe or persistent (for example, if the bruise or swelling does not go down), going to the doctor is necessary. The same applies if, in the case of a bruise that initially appears trivial, the symptoms quickly worsen.
If in doubt, always consult a doctor. Especially if the head, abdomen or eye are affected. For example, in the case of an eyeball contusion, it may be necessary to administer medication to reduce the elevated intraocular pressure. If the contusion has led to a retinal detachment, the doctor will operate.
In the case of very severe contusions with large bruises, especially in the joint, a puncture may be useful. In this procedure, the doctor uses a needle to aspirate the fluid that has accumulated in the tissue. Sometimes the doctor also surgically removes an existing bruise.
As a complication of a severe muscle contusion, there may be an increase in pressure in the muscle, the so-called compartment syndrome. This means that the muscle is no longer supplied with blood (and thus oxygen) and may die. Therefore, surgical relief must be provided quickly.
In the case of a brain contusion, the doctor usually refers the patient to a hospital.
A contusion generally heals on its own and without consequences. The same normally applies to a severe contusion. Only exceptionally do scarring changes develop in the area of the hemorrhage in the latter case.
Contusion: Duration
The healing period for a trivial contusion is usually two to three weeks, in mild cases only a few days. In the case of a contusion that is accompanied by scarring changes, healing may take four weeks or longer.
Contusion: Symptoms
A contusion is painful, especially when the injured area is moved or strained. However, there is no bleeding or significant swelling. Such symptoms do not occur until a severe contusion (bruise) occurs.
Often a contusion is accompanied by restricted movement, for example in the case of a muscle contusion in the area of the thigh (thigh contusion).
In case of a brain contusion (contusio cerebri), unconsciousness and neurological symptoms (such as epileptic seizures, loss of smell = anosmia, speech, visual disturbances et cetera) occur.
Causes and risk factors
A contusion is caused by direct blunt force from the outside. For example, it is a blow, fall, impact, falling objects or entrapment.
Bruises very often occur during sports, especially contact sports such as soccer or ice hockey. But it is also possible to get such an injury in sports where you do not have direct contact with teammates. This happens, for example, when a tennis ball flies into your eye (eyeball contusion).
Examination and diagnosis
The doctor will first inquire about the symptoms and their origin. Possible questions are:
- How did the injury occur? For example, did you fall or did you receive a blow?
- Do you have any other complaints?
Then follows the physical examination. The doctor examines the injured area and palpates it carefully. In doing so, he looks for swelling, painful pressure and restricted movement, for example.
If the contusion affects a joint, an effusion may form, i.e. increased fluid is secreted into the joint cavity. If blood vessels have been destroyed, blood collects in the joint cavity (hematoma).
By means of an ultrasound examination, the doctor detects the extent of the injury. Sometimes he performs X-ray examinations to rule out additional bony injury.
Imaging procedures
A bone contusion occurs especially on parts of the body where a bone is only covered by a thin layer of skin. This is the case, for example, on the head, ribs and shin.
For a more accurate diagnosis (such as to rule out ligament injuries or in the case of a brain contusion), the doctor will order a computed tomography (CT) scan or magnetic resonance imaging (MRI).
Prevention
Special protective clothing can reduce the risk of a contusion and other more serious (sports) injuries. For example, it is recommended to wear a helmet when cycling, skiing and inline skating, and shin guards when playing field hockey or soccer. Back protectors are recommended for snowboarders and mountain bikers.
