A bruise, or contusion, forms when small blood vessels beneath the skin are damaged, causing blood to leak into surrounding tissues and resulting in discoloration. A common question is whether massaging a bruise can help it heal.
Immediate Care for a Bruise
Massaging a bruise immediately after an injury is not recommended. This can force more blood from damaged vessels, increasing internal bleeding and inflammation, and potentially extending healing time. Instead, the standard first-aid approach for a fresh bruise involves the RICE method: Rest, Ice, Compression, and Elevation.
Resting the injured area prevents further damage and allows the body to begin repair. Applying ice, wrapped in a cloth, for 15-20 minutes helps constrict blood vessels, reducing blood flow to the site and minimizing swelling and pain. Compression with an elastic bandage helps control swelling. Elevating the bruised area above heart level uses gravity to reduce blood pooling. These steps are most effective within the first 24 to 48 hours.
Later Stage Bruise Care
After 48 to 72 hours, once swelling has subsided and the bruise begins to change color, a very gentle massage might be considered. At this stage, damaged blood vessels have sealed, and gentle manipulation around the bruise can stimulate blood flow and lymphatic drainage. This increased circulation helps the body clear away trapped blood.
Use light pressure and circular motions, starting around the bruise before moving closer to the discolored area. The goal is to encourage blood flow and assist natural reabsorption. If any discomfort beyond mild pressure occurs, stop immediately. Heat application, such as a warm compress, can also be introduced after 48 hours to improve circulation and aid in the dissipation of pooled blood.
The Science of Bruise Healing
Bruises form when trauma causes capillaries, tiny blood vessels beneath the skin, to rupture. This leads to blood leaking into surrounding tissues, creating visible discoloration. The changing colors reflect the body’s process of breaking down and reabsorbing leaked blood.
Initially, a bruise may appear red due to fresh, oxygen-rich blood. Within one to two days, as blood loses oxygen and hemoglobin (the iron-rich protein in red blood cells) breaks down, the bruise typically turns blue, purple, or black. By five to ten days, it often shifts to green or yellow hues as hemoglobin is further broken down into compounds like biliverdin and bilirubin. Finally, as these blood products are reabsorbed, the bruise fades to yellowish-brown or light brown before disappearing, usually within two weeks.
When to Consult a Doctor
While most bruises are harmless and resolve on their own, certain signs warrant medical attention. Consult a healthcare provider if a bruise appears without clear reason, or if you experience frequent, large, or unusually painful bruising. A lump forming under the bruise (a hematoma), or persistent pain lasting more than a few days, indicates a need for professional evaluation.
Seek medical advice if a bruise does not show signs of healing or disappear within two weeks, if there are signs of infection (increasing redness, pus, or fever), or if it is accompanied by numbness, weakness, or loss of function in a limb or joint. Bruises on the head or neck, especially with vision problems or confusion, require immediate assessment. Individuals taking blood-thinning medications or those with bleeding disorders may bruise more easily and should discuss concerns with their doctor.