Blunt Force Trauma

Blunt force trauma happens when you sustain an injury after an impact or forceful movements injure you. Those injuries can range from slight skin redness or a minor bruise to broken bones and internal injuries. Blunt force trauma is extremely common. It’s the most common cause of traumatic injuries and deaths worldwide.

Your body has internal defenses to protect you from blunt force trauma or at least limit its severity. Some examples of these defenses include your:

• Bones: Bones like your skull, rib cage and spine are like armor. Other bones, like those in your limbs, provide structure and limit movements that could injure soft tissues.
• Connective and soft tissues: Connective tissues absorb and dissipate impact forces. Your soft tissues can also stretch, bend and absorb blunt forces.
• Internal spaces: Your thoracic and abdominal cavities, among others, allow room for your internal organs to shift and jostle. It’s similar to how earthquake-resistant structures sway so ground movement doesn’t snap or break them.
• Membrane layers: Examples include the pericardium around your heart and the meninges around your brain and spinal cord. Some layers also hold fluid that provides additional cushioning.
• Senses: Your vision, hearing and sense of balance all help you avoid or minimize blunt force trauma from falls or impacts.
• Reflexes: Many of your motor (movement) reflexes exist to protect you from injuries, including blunt force trauma. And your nervous system links your reflexes and senses to speed up reaction times.
• Pain: When you feel pain, that’s your body telling you something’s wrong. That helps you avoid some injuries or keeps you from making injuries worse.

Blunt trauma is different from penetrating trauma, which involves injuries that pierce your body. But blunt trauma can still split or tear your skin. An example of that would be a split lip from something hitting you in the face.

What are some specific conditions that happen from blunt force trauma?

Blunt force trauma can take many forms, including (but not limited to) the following:

• Bone fractures
• Concussions and traumatic brain injuries (TBIs)
• Bumps (contusions) and bruises (ecchymosis), including to your internal organs and even your bones
• Eye injuries, including open globe injuries
• Facial injuries like a fractured jaw, broken nose or orbital fractures
• Flail chest
• Internal organ injuries that are more severe, like a ruptured spleen or collapsed lung (pneumothorax)
• Joint dislocations
• Ruptured testicle
• Shaken baby syndrome
• Skin tears (lacerations)
• Spinal cord injuries, including ones that cause paraplegia or quadriplegia
• Strain injuries like whiplash or a hyperextended knee

What are the symptoms of blunt force trauma?

Some symptoms of blunt force trauma are the same no matter which part of your body the injury affects. These include:

• Pain
• Bruising or redness
• Swelling
• Bleeding (when the force is enough to tear or split skin)

But some symptoms are very specific to the affected body part. Examples include:

• Head trauma: Confusion, feeling dizzy or lightheaded, or coma
• Chest trauma: Trouble breathing, heart rhythm irregularities, or blue fingernails or lips (cyanosis)
• Abdominal trauma: Nausea and vomiting or rebound pain (this happens when you press on your abdomen and the pain starts when you stop pressing)

What causes blunt force trauma?

Motor vehicle crashes are the top cause of blunt force trauma worldwide. Other common causes of blunt force trauma include:

• Falls
• Sports injuries
• Violent incidents (abuse, assault, war, etc.)

What are the risk factors for blunt force trauma?

Some risk factors for blunt force trauma are very specific to your life and circumstances. Others are more general. Some examples of risk factors include:

• Driving automobiles or frequent encounters with them
• Not using safety items like seat belts or protective gear like helmets for sports, bicycling, etc.
• Age, especially with decreased balance, strength or flexibility that happens naturally over time
• Jobs or activities that put you at risk, like working around machinery, large or massive items, etc.

How blunt force trauma causes injuries

There are four specific ways that blunt force trauma can damage your body:

• Strain (pull): This happens when forces pull body parts in opposite directions, like with a joint dislocation.
• Shear (twist or bend): This can happen when forces push different sections of your body or a body part in different (but not opposite) directions. That’s what happens with injuries like whiplash.
• Compression (crush): This happens when forces press on or crush body parts, like with cauliflower ear. It can also happen with internal swelling. That can cause dangerous conditions like compartment syndrome or brain swelling.
• Overpressure (crush and break or burst): This is when there’s too much pressure on a body part and the part breaks, bursts or splits. That’s how skin lacerations from blunt trauma happen. It can also damage organs and other parts inside your body.

How is blunt force trauma diagnosed?

Healthcare providers can diagnose blunt force trauma using a combination of the following:

• Imaging tests: Imaging tests are incredibly valuable for diagnosing and treating blunt force trauma. These tests can include X-rays and CT scans for most injuries. In some cases, ultrasound or magnetic resonance imaging (MRI) may be better (especially with soft tissue injuries).
• A physical exam: Providers will examine your body and the injury, looking and feeling with their hands or listening with a stethoscope. They do that to search for signs of blunt force trauma and determine its effects.
• A neurological exam: When there’s a chance of brain, spinal cord or nerve injury, providers will do a neurological exam.
• Lab tests: Blood and urine tests may reveal hidden damage to your internal organs from blunt force trauma.
• Your symptoms: If you’re conscious, your healthcare provider will ask about your symptoms. But if you’re not, the other exams will give them the information they need.

How is blunt force trauma treated?

The severity of the injury and the affected body part(s) are key factors in treating blunt force trauma. Some examples include:

• Rest, ice, compression, elevation (RICE): Minor injuries like bruises may only need simple treatments.
• Skin closure: Lacerations may need bandaging or closure with stitches or staples.
• Immobilization: Broken bones may need a splint, cast or another way to keep the affected body part from moving.
• Medications: Pain relievers, either over the counter or prescribed, are common for lingering symptoms of blunt force trauma.
• Surgery: Internal injuries may need surgery to repair or treat. Severe fractures may need internal fixation with metal hardware like rods, pins screws or plates.
• Hospital care: More severe injuries may need a hospital stay, especially when you have injuries that affect your brain, heart, lungs or other vital organs.

Other treatments are possible depending on the situation and circumstances. Because treatments can vary so widely, your healthcare provider is the best person to tell you about the options for your specific case.

Can blunt force trauma be prevented?

There are several things you can do to prevent blunt force trauma or lower your odds of having it.

To prevent blunt force trauma when driving or riding in motor vehicles, remember the following:

• Wear your seatbelt in moving vehicles, like automobiles, industrial vehicles, airplanes, etc.
• Use other automobile safety measures properly. Examples include positioning your seat (so airbags can deploy safely) and headrests (so they can protect you from whiplash).
• If you’re driving, follow speed laws, slow down when road conditions aren’t ideal and avoid distracted driving.
• Make sure children in your care know how to use safety gear like seatbelts and helmets correctly.
• Don’t let children drive vehicles intended for adults, like all-terrain vehicles (ATVs), motorbikes and golf carts.

Here are some ways you can try to prevent blunt force trauma from everyday activities:

• Limit tripping hazards and clutter in your home.
• Follow manufacturer instructions when using ladders and stepstools.
• Install grab bars and/or nonslip mats in bathrooms and showers.
• Wear grip-sole socks or shoes in or around the house if they’ll help.
• If you’re a pedestrian, use crosswalks and ALWAYS look before crossing (even if you’re sure you have the right of way).
• Wear the proper safety gear for any activity.
• Sit out from sports if you have an injury because it can make you vulnerable to even worse injuries.
• Be cautious about wearing headphones or earbuds during activities like walking or cycling. They might keep you from hearing sounds that would alert you to danger.

When should I go to the emergency room?

You should go to the emergency room or get emergency medical care if you experience a blunt force injury and then you:

• Lose consciousness, especially if the injury involved your head
• Start having trouble breathing or feel changes in your heart rate
• Have a bone that seems visibly broken
• Have symptoms of severe blood loss (hemorrhage), especially if you take blood thinners
• Have severe pain, especially if it feels much worse than what you’d expect from the visible effects of the injury
• Have an eye injury from blunt trauma, especially when it affects your vision
• Cough or vomit blood
• Notice a color change in your pee to pink
• Can’t move your body or a body part the usual way
• Are pregnant and are involved in a motor vehicle crash

Getting medical care quickly is absolutely vital with severe blunt force trauma injuries. That’s why experts call the first 60 minutes after an injury “the golden hour” for people with life-threatening injuries.

What questions should I ask my doctor?

Some questions you may want to ask your healthcare provider include:

• How severe is my injury?
• What’s the outlook for my case?
• Which treatment option(s) do you recommend?
• Are there any side effects or complications I should watch for, and what should I do if I notice them?