A simple bump or fall often results in a bruise, a common injury that prompts questions about treatment. Many people instinctively rub the affected area, hoping to soothe the discomfort. However, this action may not be helpful and can potentially worsen discoloration and swelling. Effective, evidence-based care begins with understanding what a bruise is and how it heals. Immediate management should focus on controlling internal bleeding and inflammation.
What Exactly Is a Bruise?
A bruise, medically termed a contusion, results from blunt force trauma to the body. The impact causes small blood vessels, specifically capillaries, beneath the skin’s surface to rupture and leak blood into the surrounding tissues. Since the skin is not broken, the blood pools, creating a visible mark.
This collection of blood beneath the skin is known as a hematoma. The discoloration, which ranges from red to blue, purple, and eventually green and yellow, is caused by the body’s natural process of breaking down and reabsorbing the leaked hemoglobin. A minor bruise typically takes around two weeks to clear this pooled blood.
Why Rubbing Can Worsen a Bruise
The urge to rub a fresh injury is often due to the gate control theory of pain, where the sensation of touch temporarily distracts the brain from pain signals. However, manipulating the bruised area immediately after injury works against the body’s initial healing response. The trauma has already ruptured capillaries, and the body is actively trying to stop internal bleeding through clotting.
Vigorous rubbing or massaging can disrupt the fragile clotting process attempting to seal the damaged blood vessels. This action can also mechanically spread the leaked blood, potentially increasing the size or darkness of the resulting bruise. Rubbing can exacerbate inflammation and lead to a more noticeable, longer-lasting discoloration.
Proper Immediate Care for Bruises
Effective immediate care for a bruise focuses on minimizing leaked blood and controlling the resulting swelling. The most widely recommended approach for soft tissue injuries, including bruises, is the R.I.C.E. method: Rest, Ice, Compression, and Elevation. This protocol should be applied as soon as possible after the injury and continued for the first 24 to 48 hours.
Resting the injured area prevents further trauma and allows the body to focus on repair. Immediate application of cold, or ice, causes blood vessels to constrict, which helps limit internal bleeding, swelling, and pain. The ice pack should be wrapped in a thin towel to prevent skin damage and applied for short intervals, typically 10 to 20 minutes at a time.
Compression, usually achieved with a snug elastic bandage, provides support and limits the space available for fluid and blood accumulation. This pressure helps manage swelling without cutting off circulation. Elevating the bruised limb above the level of the heart uses gravity to help drain excess fluid away from the injury site, further reducing swelling. After the initial 48 hours, applying gentle heat may increase blood flow and help speed up the reabsorption of pooled blood.
When Bruises Require Medical Attention
Most bruises are minor and resolve completely within two weeks. However, certain signs suggest the injury may be more serious or point to an underlying health issue. Seek medical attention if a bruise is accompanied by severe swelling, intense pain lasting more than a few days, or an inability to move a nearby joint. Bruises that do not fade after two weeks also warrant a doctor’s visit.
A lump developing in the bruised area could indicate a more significant hematoma. Unexplained bruising, especially frequent, large bruises occurring without a known injury, may be a sign of a bleeding disorder or an adverse reaction to medication. Bruising on the head, abdomen, or near the eye with vision changes requires immediate professional evaluation.