Muscle Contusion

Medically Reviewed By William C. Lloyd III, MD, FACS

What is a muscle contusion?

A muscle contusion is a type of soft tissue injury. Another name for this injury is a bruise. Muscle contusions are very common. In fact, they are the second-leading sports-related muscle injury after strains. Bruises are usually minor and heal quickly without requiring any changes in your activity level. In rare cases, muscle contusions can be severe enough to cause deep tissue damage. Recovery from such a severe contusion can take several weeks.

Muscle contusions are usually the result of a direct blow to the body. However, some people bruise easily and may get bruises from relatively minor bumps or bangs. They may notice skin discoloration or have tenderness without remembering an injury.

A muscle contusion is rarely a medical emergency. But, you should seek emergency medical care (or call 911) any time someone sustains severe trauma.

For a muscle bruise alone, see your doctor right away or seek prompt medical care if you notice any of the following:

  • Abnormal bleeding, such as bleeding gums, frequent nose bleeds, or blood in the urine or stool

  • Frequent, very large, or very painful bruises

  • Lump under the bruise

  • Pain with the bruise that lasts for more than three days

  • Severe pain or swelling in the area or further down the forearm

  • Numbness or weakness anywhere in the injured limb

  • Unexplained bruising or random bruising

What are symptoms of a muscle contusion?

The main symptoms of a muscle contusion are pain, minor swelling, and skin discoloration. The changes in skin color are due to trapped blood under the skin. Over time, your body breaks down the blood and gets rid of it. As a result, you will see shifts in the discoloration. It often starts as a red or purplish mark that may have darker colored dots. The bruise may then turn blue or blackish after a couple of days. Within 5 to 10 days, the color changes to a green or yellow bruise. Finally, the bruise will fade to brown after about two weeks. It will continue to fade until it is gone completely.

See your doctor if you have a bruise that persists or worsens. You should also see your doctor if you have a muscle contusion that limits your ability to use a body part.

What causes a muscle contusion?

The cause of a muscle contusion is blunt force. This can occur as the result of a fall or from a direct blow. The force on the muscle crushes small blood vessels without breaking the skin. Blood leaks out of these small vessels and pools in the surrounding tissues and under the skin. If the force is strong enough, it can also crush muscle fibers and connective tissue.

What are the risk factors for a muscle contusion?

Playing sports and participating in recreational activities increases the risk of getting bruised. This is especially true for contact sports. There are other factors that increase the risk of easy bruising including:

  • Being 50 years of age or older

  • Having a bleeding disorder from liver disease, vitamin K deficiency, or a genetic disorder

  • Having blood vessel defects

  • Having a platelet disorder including too few platelets or platelets that do not work properly

  • Taking anticoagulant or antiplatelet drugs

Reducing your risk of a muscle contusion

It’s hard to prevent bruises because they are usually the result of sudden blows or bumping into something. If you have risk factors for easy bruising, take care to avoid falls and other accidents.

How is a muscle contusion treated?

There is no mystery about how to get rid of bruises. Most of them will fade away on their own over time. If you sustain a bump or blow that could result in a bruise, you can help speed healing by using ‘RICE’:

  • Rest

  • Ice the area with cold packs for 10 minutes at a time

  • Compression by using an elastic wrap on the area

  • Elevation by propping the area so it is above the level of the heart

Taking over-the-counter pain relievers for painful bruises can improve your comfort. Your doctor may recommend draining accumulated fluid from very large or severe muscle contusions. Major muscle damage may require physical therapy and rehabilitation with strength and flexibility exercises.

What are the potential complications of a muscle contusion?

Deep tissue damage from a severe muscle contusion can lead to complications without proper medical treatment. This includes:

  • Compartment syndrome, which results from a buildup of pressure from excess fluids. This causes severe pain and can prevent adequate blood flow to the muscle. Compartment syndrome is a medical emergency.

  • Myositis ossificans, which occurs when bones grow abnormally in the damaged muscle. It can happen when you rush your recovery. The condition causes pain, swelling, and loss of flexibility.

The best way to prevent these complications is to carefully follow your treatment and rehabilitation program for severe contusions.

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  1. Bruise: First Aid. Mayo Foundation for Medical Education and Research. http://www.mayoclinic.org/first-aid/first-aid-bruise/basics/art-20056663
  2. Bruising and Bleeding. Merck Manual Consumer Version. http://www.merckmanuals.com/home/blood-disorders/blood-clotting-process/bruising-and-bleeding
  3. Easy Bruising: Why Does It Happen? Mayo Foundation for Medical Education and Research. http://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/easy-bruising/art-20045762?pg=1
  4. Muscle Contusion (Bruise). American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/muscle-contusion-bruise/
  5. Sprains, Strains, and Other Soft Tissue Injuries. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/sprains-strains-and-other-soft-tissue-injuries/
  6. What’s a Bruise? Nemours Foundation. http://kidshealth.org/kid/talk/qa/bruise.html
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 25
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