Contusion (Muscle Bruise)

Athletes in all contact sports have many opportunities to get a muscle contusion (bruise). Contusions are second only to strains as a leading cause of sports injuries.

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Muscle Contusion (Bruise)

Most contusions are minor and heal quickly, without taking the athlete needing to be removed from the game. But, severe contusions can cause deep tissue damage and can lead to complications and/or keep the athlete out of sports for months.

Contusions occur when a direct blow or repeated blows from a blunt object strike part of the body, crushing underlying muscle fibers and connective tissue without breaking the skin. A contusion can result from falling or jamming the body against a hard surface.

Although contusions can occur anywhere around the body, the following is a list of most common contusion sites:

  • Quadriceps/Hamstrings
  • Gluteal maximus/medius
  • Deltoid/Bicep
  • Calf/Peroneals

Getting prompt medical treatment and following your Sports Chiropractor’s advice about rehabilitation can help you avoid serious medical complications that occasionally result from deep muscle contusions. Two complications include compartment syndrome and myositis ossificans.

Symptoms of Contusion

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. For some injuries, your Sports Chiropractor may also need to check for nerve injury.

A physical examination will determine the exact location and extent of injury.

Diagnostic imaging tools may be used to better visualize inside the injured area of your body. These tools include ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT) scans.

Treatment for Contusion

Contusions cause swelling and pain and limit joint range of motion near the injury. Torn blood vessels may cause bluish discolouration. The injured muscle may feel weak and stiff.

To control pain, bleeding, and inflammation, keep the muscle in a gentle stretch position and use the RICE formula:

  • Rest: Protect the injured area from further harm by stopping play. You may also use a protective device (i.e., crutches, sling).
  • Ice: Apply ice wrapped in a clean cloth. (Remove ice after 15 minutes.)
  • Compression: Lightly wrap the injured area in a soft bandage or ace wrap.
  • Elevation: Raise it to a level above the heart.

Most athletes with contusions get better quickly without surgery. Your doctor may give you nonsteroidal anti-inflammatory drugs (NSAIDs) or other medications for pain relief. Do not massage the injured area.

During the first 24 to 48 hours after injury (acute phase), you will probably need to continue using rest, ice, compression bandages, and elevation of the injured area to control bleeding, swelling, and pain. While the injured part heals, be sure to keep exercising the uninjured parts of your body to maintain your overall level of fitness.

If there is a large hematoma that does not go away within several days, assessment from a Health Care practitioner is advisable.


After a few days, inflammation should start to go down and the injury may feel a little better. At this time, the Chiropractor or Physio may tell you to apply gentle heat to the injury and start the rehabilitation process. Remember to increase your activity level gradually.

Depending upon the extent of your injuries, returning to your normal sports activity may take several weeks or longer. If you put too much stress on the injured area before it has healed enough, excessive scar tissue may develop and cause more problems.

In the first phase of rehabilitation, your practitioner may prescribe gentle stretching exercises that begin to restore range of motion to the injured area. Later, when the range of motion has improved enough, he or she may prescribe weight bearing and strengthening exercises.

You may return to non-contact sports when you have normal, pain-free range of motion and able to return to contact sports when you get back your full strength, motion, and endurance. A protective device to prevent further injury to the area that had a contusion may be recommended.