Bruises Contusions


contusionAthletes in all contact sports are at risk of sustaining a “corky” – otherwise known medically as a muscle contusion (bruise). Contusions are second only to strains as a leading cause of sports injuries.

The majority of contusions are minor and heal really quickly, without taking the athlete away from the game. But, severe contusions can cause deep muscle damage and can lead to complications that may keep the athlete out of sports for months.

What Causes A Contusion Injury?

Contusions occur when there is 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, such as an opposition player’s knee.

How Do I Know If I Have A Contusion?

Contusions cause pain and swelling as well as limited joint range of motion around the injury.  The direct blow causes blood vessel damage, with the torn blood vessels leaking out bluish discoloration. The injured muscle may feel weak and stiff.

Sometimes a pool of blood collects within damaged tissue, forming a painful lump in the area of the injury (hematoma).

How Do You Treat A Contusion?

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 20 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 with simple treatment measures.

During the first 24 to 48 hours after injury (acute phase), you will probably need to continue using the RICE principles to control bleeding, swelling, and pain.

While the injured muscle 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, your doctor may need to drain it surgically to speed healing – but this is a very rare occurrence.


After a few days, inflammation should start to go down and the injury may feel a little better.

At this time, your 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 range from a week to 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 physio may prescribe gentle stretching exercises that begin to restore range of motion to the injured area.

Once your range of motion has improved, your physio may prescribe weight-bearing and strengthening exercises.

When you have normal, pain-free range of motion, your physio may let you return to non-contact sports.

When Can I Play Again After A Contusion?

You may be able to return to contact sports when you get back your full strength, motion, and endurance.

When your physio says you are ready to return to play, he or she may want you to wear a specialised protective device to prevent further injury to the area that had a contusion.

Depending upon your sport, you may get special padding made of firm or semi-firm materials. The padding spreads out the force of impact when direct blows from blunt objects strike your body.

My “Corky” Is Not Improving – What’s Going On?

Getting prompt medical treatment and advice on rehabilitation following your injury can help you avoid some of the serious medical complications that occasionally result from deep muscle contusions.

Two of the more common complications are compartment syndrome and myositis ossificans.

Compartment Syndrome

In certain cases, rapid bleeding may cause extremely painful swelling within the muscle group of your arm, leg, foot, or buttock.

This can build up pressure in the muscle sheath – the piece of tissue that surrounds the muscle (similar to the skin of a sausage).

A build-up of pressure from fluids within the muscle sheath several hours after a contusion injury can disrupt blood flow and prevent nourishment from reaching the muscles.

Compartment syndrome can be very serious, and may require urgent surgery to drain the excess fluids. If in doubt, get it checked out.

Myositis Ossificans

Young athletes who try to rehabilitate a severe contusion too quickly sometimes develop myositis ossificans. This is a condition in which the bruised muscle grows bone instead of new muscle cells.

Symptoms may include mild to severe pain that does not go away and swelling at the injury site. Abnormal bone formations can also reduce your flexibility. We see the athlete stretchign to try and improve their range of motion, but vigorous stretching exercises may actually make the condition worse!

Rest, ice, compression, and elevation to reduce inflammation will usually help. Gentle stretching exercises may improve flexibility. Surgery is rarely required.

I Have A Contusion – What Do I Do Right Now?

If you have copped a contusion injury, then the first thing to do is the follow the RICE

Your next step is to have your contusion injury assessed by a Leading Edge Physiotherapist.  You can BOOK ONLINE now, or call one of our clinics on (08) 8364 6800 or (08) 8159 1300 to book an appointment.

If you are not sure if you need an assessment, you can ENTER YOUR DETAILS HERE and one of our physios will give you a call back to discuss your problem and work out the next step in your recovery.

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