BUMPS and BRUISES

Boatyard time again and the season for bumps and bruises has arrived. Our body is constantly healing itself as we knock ourselves about every day and  after the initial “ouch”, we generally tend to ignore the resultant bruising. 

 

Direct trauma to our muscles, such as walking into a stanchion or falling off your bike can cause a bruise (or haematoma). This is a pool of blood which has formed from the damaged and now leaking tiny blood vessels (veins and capillaries). The blood in our vessels is constantly on the move and so it does not clot, however a bruise is contained within the soft tissues and is not flowing and so clotting occurs giving rise to a rainbow of colours as the blood coagulates. These colours change and lighten as our body takes away the damaged cells and pooled blood and replaces the tissues with new cells.

There is little doubt that there are numerous angles and pointy bits on yachts with which to experience a heamatoma but they are also frequently caused in other ways such as contact sports, falls and overstraining at the gym. Generally the blunter the point of impact, the wider the distribution of the bruise.

When a bruise has formed from a point of impact it will be medically termed as a contusion. Deeper contusions usually form in areas of high muscle density such as the quadraceps, hamstrings, calf muscle, biceps and triceps.

A mild contusion will not bother the range of movement of the limb too much. There will be some discolouration of the skin and some swelling. Normal activities can continue undisrupted and often the sufferer does not remember how it happened.

A moderate contusion produces a larger bruise with obvious swelling and there will be some restriction of movement and pain. The limb will stiffen up overnight and if movement continues to be restricted over the next few days the sufferer should now seek some help to hasten the recovery.

A severe contusion does not necessarily have to be an enormous widespread bruise as it may be very deep into the muscle bulk and so can be deceiving. The sufferer will certainly remember how they received the injury and will be incapacitated.

It is important to remember that everyone has a different response to bruising, for example if you are taking blood thinning medication such as aspirin or are diabetic, it would be a good idea to have the contusion assessed by a medical professional.

The physiotherapy treatments for haematomas / contusions will include ice treatment at the appropriate time post injury, compression, ultra-sound and graded stretching of the involved muscle groups (again at the correct time post injury) Ultra-sound (therapeutic not investigatory) is applied to the periphery of the contusion. Your physio will use ultra-sound to cause a tiny vibration at the edges of the contusion which helps to loosen the coagulating blood for it to be faster absorbed and reduce in size allowing the body to quickly replace the damaged cells.

WHY BOTHER TO SEEK MEDICAL ADVISE FOR A BRUISE ?

The bigger the bruise, the longer the healing time, the stiffer you will become is one answer.

 At the Physiotherapy Centre in Mallorca we have seen some very impressive contusions covering almost half a limb or buttock from bumps into cleats, companion ways, stanchions, winches, booms and hatch falls. Many more from rugby, football, jet skiing and martial arts.

In some cases of a deep contusion a complication can appear if left untreated called Myositis Ossificans. Usually seen in the thigh or gluteal (bottom) muscles it can also occur in the arm or lower leg when the pool of leaked blood has been stuck in the soft tissues for so long that it starts to calcify. This calcification causes gravel sized lumps to interfere with the extensibility and contractibility of the muscle and other soft tissues prolonging pain and swelling and decreasing function.

Myositis Ossificans can be diagnosed with an X-Ray and may result in a surgical procedure to remove the calcification which will then require further post-surgical rehab !

So if in doubt get it checked out !

 

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