When you experience an injury, your body often reacts by forming what is known as a hematoma, a collection of blood outside of blood vessels. Many people wonder if massaging this area can help it heal. Massaging a hematoma is not recommended and can even be harmful.
Understanding a Hematoma
A hematoma forms when blood leaks from a damaged blood vessel into the surrounding tissues, creating a localized pool of blood. It commonly results from physical trauma or injury, but can sometimes happen spontaneously. Unlike a bruise (contusion), which results from bleeding from smaller capillaries and appears as a flatter discoloration, a hematoma typically involves larger vessels, forming a raised, firm, and painful lump beneath the skin. They vary in size and location, appearing anywhere from just under the skin to deep within muscles or internal organs.
Why Massaging is Not Advised
Medical professionals advise against massaging a hematoma, particularly in its early stages. Massaging the affected area can disrupt the natural clotting process that the body initiates to stop the bleeding, potentially leading to increased bleeding or re-bleeding within the hematoma. This pressure can also heighten inflammation and swelling, prolonging discomfort and recovery.
Massage may cause more pain and delay healing by damaging fragile tissues. There is also a risk of infection if the skin is compromised, as manipulating the area could introduce bacteria. While some might believe massage helps “break up” the pooled blood, it can actually cause further damage rather than promote beneficial reabsorption. Case reports have documented instances where massage led to the formation or worsening of hematomas.
Recommended Care for Hematomas
Instead of massage, home care for a hematoma involves the R.I.C.E. method: Rest, Ice, Compression, and Elevation. Resting the injured area helps prevent further injury. Applying an ice pack or cold compress for 10 to 20 minutes at a time, several times a day during the first 24 to 48 hours, can reduce pain, swelling, and blood flow to the area. Always wrap ice in a cloth to prevent direct contact with the skin.
Gentle compression with an elastic bandage can help minimize swelling and prevent the hematoma from expanding, but ensure the bandage is not wrapped too tightly, which could restrict circulation. Elevating the injured body part above the level of the heart also reduces swelling by promoting fluid drainage. After the initial 48 hours, a warm compress may be applied to encourage the body to reabsorb the pooled blood. Over-the-counter pain relievers like acetaminophen can manage discomfort, but nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen should be avoided, as they can increase the risk of bleeding.
When to Consult a Doctor
While many hematomas resolve on their own, certain signs and symptoms warrant prompt medical attention. Seek medical attention if a hematoma is very large, rapidly growing, or causes extreme pain that does not improve. Hematomas on the head or neck, especially following head trauma, require immediate evaluation. Watch for symptoms such as confusion, persistent or worsening headache, uneven pupils, vomiting, changes in vision, or slurred speech, as these can indicate an intracranial hematoma.
Signs of infection, including increased pain, spreading redness, warmth around the area, pus, or a fever, also warrant medical attention. If you experience numbness, tingling, or weakness in the limb affected by the hematoma, it could indicate nerve compression. Medical attention is also warranted if a hematoma does not improve or worsens after several days, or if it appears without a clear injury, as this may indicate an underlying medical condition.