A bruised shoulder, known medically as a contusion, occurs when a direct impact damages small blood vessels and soft tissues beneath the skin without breaking the surface. This trauma causes blood to pool in the area, creating discoloration, localized pain, and swelling. The shoulder is a highly mobile, complex joint, and the extent of the injury—whether superficial or deep—greatly influences the time required for recovery.
The Typical Healing Timeline for a Bruised Shoulder
For a mild contusion, where the damage is mainly superficial, you can expect noticeable improvement within the first week or two. Significant pain and swelling typically subside during this initial period, allowing for a gradual return to light activities. Full recovery for a minor bruise, where the discoloration completely fades and full function is restored, often occurs around two to three weeks after the injury.
A moderate contusion, which involves deeper muscle tissue damage and a larger collection of pooled blood (a hematoma), requires a longer recovery period. These injuries may take approximately four to six weeks to heal fully, especially if they cause more significant limitation in the shoulder’s range of motion. Severe contusions, which may involve damage close to the bone or significant muscle tearing, can require six to eight weeks, or even longer, before the shoulder is completely pain-free and strengthened.
The visible stages of a bruise offer a natural timeline for the healing progress as the body metabolizes the trapped blood. Initially, the bruise appears red or dark purple because the pooled blood is fresh. Within one to two days, the bruise transitions to blue, purple, or black as the blood loses oxygen and begins to clot.
As the body breaks down the hemoglobin, the bruise changes color once more. Typically, between five and ten days, the area may turn green, followed by a yellow or yellowish-brown hue, indicating that the blood products are being reabsorbed and cleared. This color change is a positive sign, signaling that the skin is returning to its normal tone.
Immediate Steps for Managing Shoulder Pain
Managing the immediate symptoms of a bruised shoulder focuses on limiting the internal bleeding and controlling inflammation in the first 48 hours. The R.I.C.E. protocol provides a framework for initial self-care, starting with Rest to prevent further strain on the injured tissues. Avoiding activities that cause pain or require lifting is essential to protect the joint during the acute inflammatory phase.
Applying Ice to the injury site helps constrict the blood vessels, which reduces both swelling and pain. For the shoulder, ice should be applied for 15 to 20 minutes at a time, several times a day, for the first two days after the injury. Ensure a barrier, like a towel, is placed between the ice pack and the skin to prevent cold-related injury.
Compression can be applied carefully using a soft elastic bandage to help reduce swelling. Care must be taken not to wrap the shoulder too tightly, which could impede circulation. Sometimes, a simple sling is utilized to provide temporary support and remind the patient to limit arm movement.
Elevation is recommended to use gravity to help drain excess fluid and blood from the injured area. Since elevating the shoulder above the heart is impractical, this is best achieved by propping up the arm and shoulder with pillows while sitting or lying down. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can also be taken to help manage pain and reduce inflammation.
When to Seek Medical Attention
While most bruised shoulders resolve with home care, certain symptoms suggest the injury may be more serious than a simple contusion, requiring professional medical evaluation. You should seek immediate attention if you experience an inability to move the arm or shoulder joint at all, as this may indicate a fracture or a severe tendon tear.
Persistent, severe, or sharp pain that fails to improve after 48 hours of consistent home treatment should also prompt a medical visit. A visible deformity around the shoulder area, such as a noticeable bump or an unusual contour, is a warning sign that could suggest a joint dislocation or a broken bone.
Any sensation of numbness, persistent tingling, or coldness in the arm, hand, or fingers is a serious red flag, indicating possible compromise to the nerves or blood vessels. If the bruising spreads rapidly, or if you develop signs of infection like fever, increasing warmth, or spreading redness around the injury site, a doctor should be consulted immediately.