BRUISES

Introduction

Oh man, does that hurt! You're flying along on your bike, gliding through the park on your in-line skates, or chasing down a loose ball on the soccer field. Life couldn't be better! Suddenly, it all comes to a screeching halt. You've taken that hill too quickly on your bike, lost your balance on your blades, or someone on the other soccer team has missed the ball completely and kicked you right in the shin. The pain is bad enough, but the bruise left behind is pretty ugly. It's nothing new; you've had a bruise or two before. But what exactly is a bruise?
What Is a Bruise?
A bruise, also called a contusion or an ecchymosis (pronounced: eh-ky-moe-sis), happens when a part of the body is struck and the muscle fibers and connective tissue underneath are crushed but the skin doesn't break. When this occurs, blood from the ruptured capillaries (small blood vessels) near the skin's surface escapes by leaking out under the skin. With no place to go, the blood gets trapped, forming a red or purplish mark that's tender when you touch it - a bruise. Bruises can happen for a lot of reasons, but are mostly the result of bumping and banging into things - or having things bump and bang into you. Fortunately, as anyone who's ever sported a shiner knows, the mark isn't permanent.
How Long Do Bruises Last?
You know how a bruise changes color over time? That's your body fixing the bruise by breaking down and reabsorbing the blood, which causes the bruise to go through many colors of the rainbow before it eventually disappears. You can pretty much guess the age of a bruise just by looking at its color:

• When you first get a bruise, it's kind of reddish as the blood appears under the skin.
• Within 1 or 2 days, the hemoglobin (an iron-containing substance that carries oxygen) in the blood changes and your bruise turns bluish-purple or even blackish.
• After 5 to 10 days, the bruise turns greenish or yellowish.
• Then, after 10 or 14 days, it turns yellowish-brown or light brown.

Finally, after about 2 weeks, your bruise fades away.
Who Gets Bruises?
Anyone can get a bruise. Some people bruise easily, whereas others don't. Why? Bruising depends on several things, such as how tough a person's skin tissue is, whether a person has certain diseases or conditions, or whether a person's taking certain medications. Also, blood vessels tend to become fragile as people get older, which is why elderly people tend to bruise more easily.
What Can I Do to Help Myself Feel Better?
It's hard to prevent bruises, but you can help speed the healing process. When you get a bruise, you can use stuff you find right in your freezer to help the bruise go away faster. Applying cold when you first get a bruise helps reduce its size by slowing down the blood that's flowing to the area, which decreases the amount of blood that ends up leaking into the tissues. It also keeps the inflammation and swelling down. All you have to do is apply cold to the bruise for half an hour to an hour at a time for a day or two after the bruise appears.
You don't need to buy a special cold pack, although they're great to keep on hand in the freezer. Just get some ice, put it in a plastic bag, and wrap the bag in a cloth or a towel and place it on the bruise (it isn't such a good idea to apply the ice directly to the skin). Another cool trick is to use a bag of frozen vegetables. It doesn't matter what kind - carrots, peas, lima beans, whatever - as long as they're frozen. A bag of frozen vegetables is easy to apply to the bruise because it can form to the shape of the injured area. Also, like a cold pack, it can be used and refrozen again and again (just pick your least favorite vegetables as it's not a good idea to keep thawing and freezing veggies that you plan to eat!).
Another way to help heal your bruise is to elevate the bruised area above the level of your heart. In other words, if the bruise is on your shin, lie down on a couch or bed and prop up your leg. This will slow the flow of the red blood cells to the bruise because more of the blood in your leg will flow back toward the rest of your body instead of leaking out into the tissues of your leg. If you keep standing, more blood will flow to your bruised shin and the bruise will grow faster.
Minor bruises are easily treated, but it's probably best to talk to a doctor if:

• A bruise doesn't go away after 2 weeks.
• You bruise often and you haven't been bumping into things.
• Bruises seem to develop for no known reasons.
• A bruise is getting more painful.
• Your bruise is swelling.
• You can't move a joint.
• The bruise is near your eye.

Can Bruises Be Prevented?
Bruises are kind of hard to avoid completely, but if you're playing sports, riding your bike, in-line skating, or doing anything where you might bump, bang, crash, or smash into something - or something might bump, bang, crash, or smash into you - it's a good idea to wear protective gear like pads, shin guards, and helmets. Taking just a few extra seconds to put on that gear might save you from a couple of weeks of aches and pains (not to mention save your life if the accident's really serious)!

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Reviewed by: Steven Dowshen, MD
Date reviewed: September 2006