Muscle Contusion

What is a muscle contusion?

A muscle contusion is a bruise in your muscle. It’s a painful injury that happens when a direct hit by a blunt object crushes your muscle fibers and connective tissue without breaking your skin open. This breaks blood vessels that support your muscle, which leads to bleeding into the affected muscle.

Unlike a skin bruise, you can’t see a muscle bruise. But you can feel it — most muscle contusions are painful.

Muscle contusions can range from mild to severe. Most contusions heal with at-home treatment.

What are the symptoms of a muscle contusion?

Muscle contusions are almost always painful. You may have additional symptoms depending on the severity of the injury, including:

• Swelling (edema) in the affected area.
• Skin bruising.
• Weakness or stiffness in the injured muscle.
• Difficulty using your joint(s) near the injury.

Depending on the intensity of the trauma, you may have additional injuries, including:

• Muscle hematoma (a buildup of blood in your muscle tissue).
• Sprain (stretching or tearing of ligaments in a joint).
• Dislocated joint.
• Muscle strain.
• Broken bone.
• Damage to your internal organs if the hit was to your abdomen.

What causes a muscle contusion?

A direct, blunt hit to one of your muscles usually causes a muscle contusion (bruise). This commonly happens to athletes during contact or extreme sports. But any direct blow could cause a contusion, like falling onto or running into a blunt object.

For example, a quadriceps (thigh muscle) contusion is one of the most common injuries in contact sports, especially American football. Your thigh muscles are some of the largest muscles in your body, making them an easy target. Strong forces like tackling or falling on top of someone can lead to bruises on these muscles.

What are the risk factors for a muscle contusion?

Muscle contusions are more common in people who play contact or extreme sports. But they can also happen due to falls or traumatic events like car accidents.

Other factors that can increase your risk of a muscle contusion include:

• Age: People over 65 are more likely to develop injuries from falling.
• Malnutrition: Poor nutrition can cause weakness and dizziness. These symptoms increase your risk of falling and getting a muscle contusion.
• Bleeding disorders: Having a bleeding disorder (like hemophilia) can make it more likely that your blood vessels will break after an impact, resulting in a muscle contusion.
• Smoking: Smoking constricts blood flow and slows healing. It could worsen muscle contusions.

What are the possible complications of a muscle contusion?

Possible complications of moderate to severe muscle contusions include:

• Compartment syndrome: This happens when pressure rises in and around your muscle. With a muscle contusion, rapid bleeding can cause pressure. This syndrome is very painful and can be dangerous. Compartment syndrome can limit the flow of blood, oxygen and nutrients to muscles and nerves. It can cause serious damage and may require urgent surgery. If you experience numbness and weakness or rapidly increasing swelling in the injured area, go to the hospital as soon as possible.
• Myositis ossificans: This happens when bone forms inside your muscle after a traumatic injury. It sometimes develops after a severe muscle contusion if you try to rehabilitate the muscle too quickly. It can take two to four weeks after the injury before myositis ossificans is noticeable.

How is a muscle contusion diagnosed?

Your healthcare provider will physically examine the injury to diagnose a muscle contusion. They’ll ask about your symptoms and how the injury happened.

They may apply slight pressure to different parts of your injured muscle and test the range of motion of nearby joints.

Your provider may also use imaging tests to view your soft tissues, like:

• Magnetic resonance imaging (MRI).
• Ultrasound.

You may have other imaging tests, like CT scans or X-rays, if your provider thinks you have a bone bruise, fracture or myositis ossificans.

How can I heal a bruised muscle?

Most people heal from a muscle contusion with rest and over-the-counter (OTC) medication. You shouldn’t exercise for at least five to seven days after the injury to allow it time to heal. Depending on the injury severity, your healthcare provider may recommend:

• Using the RICE (rest, ice, compression, elevation) method: The RICE method involves resting your injured muscle, icing it, wearing an elastic bandage around it (compression) and elevating the affected area while you’re resting. The RICE method helps reduce pain and swelling.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter medicines can help relieve pain and decrease inflammation while the contusion heals. You shouldn’t use NSAIDs for more than a few days to a week.
• Physical therapy: Moderate to severe muscle contusions may require physical therapy. Physical therapy typically involves a set of exercises that you complete during in-office visits and at home between appointments. Your physical therapist may also massage the affected muscle or stimulate your tissues with small electrical currents (electrotherapy). These treatments can reduce pain and promote healing.

In rare cases, you may need surgery if you have compartment syndrome or myositis ossificans.

How can I prevent a muscle contusion?

Just like how not all accidents are preventable, not all muscle contusions are preventable. But there are some steps you can take to lower your risk of getting a muscle contusion:

• Train and exercise properly to prevent overworking your muscles.
• Do warm-up and cooldown exercises before and after sports.
• Wear protective equipment during contact sports and extreme activities.
• Clear your living space of clutter and other tripping hazards to prevent falls.
• If you’re at increased risk of falling, consider using a walking aid, like a cane or a walker.
• If you have a bleeding disorder, consider avoiding activities that can lead to injuries.

How long does it take a muscle contusion to heal?

The time it takes for a muscle contusion to heal varies based on its severity and what you do to care for it. Moderate to severe muscle contusions may take four to six weeks to heal. Mild muscle contusions take much less time — usually five to seven days. If you use the muscle too much or overstretch it after the injury, it could take longer to heal.

Your healthcare provider will give you the best idea of what to expect. Be sure to follow their instructions for care so you don’t prolong the healing time.

When should I see my healthcare provider?

You may not need to see a healthcare provider for a mild muscle contusion. But you should see a provider if you experience symptoms of a moderate to severe contusion or possible complications, including:

• Weakness or numbness in the affected area.
• Difficulty using your joints in the affected area.
• Rapid, severe swelling.

A note from Cleveland Clinic

Injuries are a big bummer. But the good news is that at-home rest is enough to treat most muscle contusions. While it can be difficult to take a break from your usual activities, it’s important to do so. Getting back to physical activities too soon after the injury can worsen it and prolong healing time. If you have severe symptoms after injuring your muscle, like rapid swelling, weakness and numbness, get medical care as soon as possible.