A contusion, commonly referred to as a bruise, occurs when small blood vessels beneath the skin are damaged or broken, resulting in localized bleeding and discoloration of the skin. Contusions can range in severity from mild to severe, depending on the force of the impact and the extent of tissue damage. While most contusions heal naturally with conservative measures and self-care, severe or recurrent bruising may require medical evaluation and intervention.

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Causes of Contusions

Injuries are the most common cause of bruises.

Blunt Trauma

Blunt trauma or impact to the body is the most common cause of contusions. This can occur due to falls, collisions, sports injuries, or physical altercations. The force of the impact causes blood vessels beneath the skin to rupture, leading to the formation of a bruise.

Repetitive Stress

Repetitive stress to a specific area of the body, such as during sports activities or occupational tasks, can also contribute to the development of contusions over time. Continuous pressure or friction on the skin and underlying tissues may result in bruising and discomfort.

Medical Procedures

Certain medical procedures, such as injections, intravenous (IV) catheter placements, or surgical interventions, can cause contusions at the site of the procedure due to tissue trauma and needle punctures.

Health Conditions

Conditions that impact the amount of platelets (clotting agents) in your blood can make you more prone to bruising. Examples include autoimmune diseases, leukemia, and hemophilia.

Characteristics of Bruising


The hallmark symptom of a contusion is discoloration of the skin, which ranges from red or purple to blue or black, depending on the severity of the injury and the depth of bleeding beneath the skin. Over time, the bruise may change color as the body breaks down and reabsorbs the trapped blood.

Pain and Tenderness

Contusions often cause pain, tenderness, and localized discomfort at the site of the injury. The affected area may feel tender to the touch and may be sensitive to pressure or movement.


Swelling and inflammation may accompany contusions, especially in the hours following the injury. Swelling occurs as the body’s natural response to tissue damage and bleeding, leading to fluid accumulation in the affected area.

Stiffness and Limited Range of Motion

Contusions can cause stiffness and limited range of motion in nearby joints or muscles, particularly if the injury affects mobility or function in the area. Stiffness may worsen with movement or activity and may improve with rest and conservative measures.

Injury Treatment

R.I.C.E. Protocol

The R.I.C.E. protocol (Rest, Ice, Compression, Elevation) is commonly used to manage contusions and promote healing.

  • Rest: Rest the injured area to prevent further trauma and allow tissues to recover.
  • Ice: Apply ice packs or cold therapy to the bruised area for 15-20 minutes every few hours to reduce pain, swelling, and inflammation.
  • Compression: Use compression bandages or wraps to apply gentle pressure to the bruised area, which helps limit swelling and support injured tissues.
  • Elevation: Elevate the injured limb or area above the level of the heart whenever possible to reduce swelling and promote fluid drainage.

Pain Management

Over-the-counter pain relievers, such as acetaminophen or ibuprofen, may be used to alleviate pain and discomfort associated with contusions. Topical analgesic creams or gels containing ingredients like lidocaine or menthol may also provide temporary relief from bruise-related pain.

Protection and Support

Protecting the injured area from further trauma and providing adequate support can aid in the healing process. Using splints, braces, or supportive garments may be beneficial for stabilizing injured joints or muscles and preventing aggravation of the contusion.

Gentle Mobilization and Rehabilitation

Gentle mobilization exercises and range-of-motion activities may be introduced once acute symptoms begin to subside. Physical therapy or rehabilitation programs may help restore strength, flexibility, and function to the injured area and prevent stiffness or weakness after a serious injury.

Medical Evaluation

Severe or persistent contusions, especially those associated with significant pain, swelling, or functional impairment, may require medical evaluation and imaging studies to rule out underlying fractures or soft tissue injuries. In some cases, drainage of large hematomas or surgical intervention may be necessary for the management of complicated contusions.


Contusions are common injuries characterized by localized bleeding and discoloration of the skin following blunt trauma or impact to the body. While most contusions resolve spontaneously with conservative measures and self-care, severe or recurrent bruising may require medical evaluation and intervention.


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