Muscle Bruises and Contusions
Treatment and massage tips to speed up recovery and get rid of bruises fast.
by Brad Walker | First Published February 28, 2006 | Updated March 21, 2019
What is a bruise and how do they occur?
Muscle bruises are the result of your body colliding with a solid object, (or a solid object colliding with your body). When this occurs, the soft tissues under your skin (muscle fibers and connective tissue) are crushed but the skin does not break or rupture. When these soft tissues are damaged, blood from the ruptured capillaries leaks out under the skin and pools, causing the area to swell and form a red or purplish mark that can be sore and tender to touch. The symptoms associated with bruises are pain, swelling and restricted movement.
Types of Bruises
Like muscle strains, bruised muscles are graded into three categories and these are referred to as: first; second; or third degree depending on their severity.
- A first degree bruise is the least severe. It is the result of a minor rupture of the capillaries and is accompanied by mild pain, some swelling and stiffness. There is usually very little loss of function as a result of a first degree bruise.
- A second degree bruise is the result of a moderate rupture of the capillaries and increased bleeding. There is also increased swelling and pain associated with a second degree bruise and a moderate loss of movement at the injury site.
- A third degree bruise is the most severe of the three. A third degree bruise is the result of a major rupture of the capillaries and will result in massive swelling, severe pain and instability around the injury site.
Anyone can get a bruised muscle, although people involved in contact sports are most at risk. But why do some people bruise more easily than others? The severity of a bruise can depend on a number of things, including:
- How tough a person’s skin tissue is;
- The general health of the underlying muscles and soft tissue;
- Medications you may be on; or
- Your age. Age can be a major contributor because as we get older our blood vessels become more fragile.
How to Treat Bruises
Most first degree bruises will require very little treatment, however second and third degree muscle bruises should be treated initially with the R.I.C.E.R. regimen. This involves the application of (R) rest, (I) ice, (C) compression, (E) elevation and obtaining a (R) referral for appropriate medical treatment.
- R: (rest) It is important that the bruised area be kept as still as possible. This will help to slow down blood flow to the injury and prevent any further damage.
- I: (ice) By far the most important part. The application of ice will have the greatest effect on reducing bleeding, swelling and pain. Apply ice as soon as possible after the bruise has occurred.
- C: (compression) Compression achieves two things. Firstly, it helps to reduce both the bleeding and swelling around the bruise, and secondly, it provides support for the bruised area. Use a wide, firm, elastic, compression bandage to cover the entire injury site.
- E: (elevation) Simply raise the bruised area above the level of the heart at all possible times. This will further help to reduce the bleeding and swelling.
- R: (referral) If the bruise is severe enough, it is important that you consult a professional physical therapist or a qualified sports doctor for an accurate diagnosis. They will be able to tell you the full extent of the injury.
Before moving onto the next stage of treatment, there are a few things that you must avoid during the first 72 hours. Be sure to avoid any form of heat on the bruise, including heat lamps, heat creams, spas, Jacuzzi’s and saunas. Avoid all movement and massage of the bruised area. Also avoid excessive alcohol. All these things will increase the bleeding, swelling and pain of your bruise.
After the first 48 to 72 hours
Most of the swelling will have subsided after the first 48 to 72 hours and you are now ready to start some gentle treatments to speed up recovery and get rid of that bruise.
- Firstly, light activity is important for two reasons; it will promote blood circulation and activate the lymphatic system. The lymphatic system is vital in clearing the body of toxins and waste products, which can accumulate in the body following a bruised muscle. Activity is the only way to activate the lymphatic system.
- Next, use heat in the form of a heat pack, ray lamp or hot water bottle. Heat is very effective in stimulating blood flow to the bruised muscle tissues.
- And lastly, start to massage the bruise and connecting muscles. While light activity and heat will help the injured area, they will not remove the scar tissue and other damaged tissue. Only massaging the bruise will do that. Initially, the injured area may be quite tender, so start with light strokes and gradually increase the pressure until you’re able to use firm strokes. Concentrate your effort at the direct point of the bruise and use your thumbs to get in as deep as possible to break down the scar tissue.
Warning! Never do any activity that hurts the bruised area. Of course you may feel some discomfort, but NEVER, NEVER push yourself to the point where you’re feeling pain. Listen to your body. Don’t over-do-it at this early stage of the recovery.
What else can you do to get rid of bruises?
- Be sure to drink plenty of fluid during your injury rehabilitation. The extra fluid will help to flush a lot of the waste products from your body.
- Also, I recommend you purchase a special ointment to use for your massage called Rub-on-Relief. This special ointment is extremely effective in treating soft tissue injuries, like sprains, strains and tears. It includes all-natural ingredients, has zero side effects and best of all, it’s quite cheap. You can purchase this ointment from the link above.
- Gentle stretching should also be included as part of your heat and massage treatment. This will help to regain your range of motion and re-align the bruised muscle fibers. While working on increasing the flexibility of the injured area, it’s also important to increase the flexibility of the muscle groups around the bruise.
- Once your flexibility and range of motion has returned to normal and movement of the injured area is pain free, you can start to implement some more active rehabilitation techniques like strength work, balance drills and sport specific training.
While the recommendations on this page are a good starting point, you'll get a lot more benefit when you add the right stretches to your training program. With the Ultimate Guide to Stretching & Flexibility (Handbook, DVD & CD-ROM) you'll...
You'll get 135 clear photographs and 44 video demonstrations of unique stretches for every major muscle groups in your body. Plus, the DVD includes 3 customized sets of stretches (8 minutes each) for the Upper Body; the Lower Body; and the Neck, Back & Core. And the Handbook will show you, step-by-step, how to perform each stretch correctly and safely. Plus, you'll also learn the 7 critical rules for safe stretching; the benefits of flexibility; and how to stretch properly.
If you want to improve your flexibility so you can to train harder, race faster, recover quicker and move better, check out the Ultimate Guide to Stretching & Flexibility for yourself.
Research and References
- Walker, B. (2018). The Anatomy of Sports Injuries, 2nd Edition (ISBN: 978-1623172831)
- Bahr, R. Maehlum, S. (2004) Clinical Guide to Sports Injuries, 1st Edition (ISBN: 978-0736041171)
- Wikipedia contributors. (2019, February 12). Bruise, In Wikipedia, The Free Encyclopedia.
- Larson, C. Almekinders, L. Karas, S. Garrett, W. (2002). Evaluating and managing muscle contusions and myositis ossificans. The Physician and Sportsmedicine, 30(2), 41-50.
- Trojian, T. (2013). Muscle Contusion (thigh). Clinics in Sports Medicine, 32(2), 317-324.
- Diaz, J. Fischer, D. Rettig, A. Davis, T. Shelbourne, K. (2003). Severe quadriceps muscle contusions in athletes: a report of three cases. The American Journal of Sports Medicine, 31(2), 289-293.
About the Author: Brad Walker is often referred to as the "Stretch Coach" and has even been called the Stretching Guru. Magazines such as Runners World, Bicycling, Triathlete, Swimming & Fitness, and Triathlon Sports have all featured his work. Amazon (author page) has listed his books on five Best-Seller lists. Google cites over 100,000 references to him and his work on the internet. And satisfied customers from 122 countries have sent 1,000's of verified customer reviews. If you want to know about stretching, flexibility or sports injury management, Brad Walker is the go-to-guy.
Disclaimer: The health and fitness information presented on this website is intended as an educational resource and is not intended as a substitute for proper medical advice. Please consult your physician or physical therapist before performing any of the exercises described on this website, particularly if you are pregnant, elderly or have any chronic or recurring muscle or joint pain.