Sprains and Bruises

What Is a Bruise?

A bruise is the discoloration of the skin caused due to an injury. Because of an injury, blood vessels get damaged, and blood from the damaged vessels gets collected near the surface of the skin. The different types of bruises are:

• Subcutaneous - Bruising under the skin.

• Intramuscular - Bruising under the muscles.

• Periosteal - Bruising around the bone.

What Is a Sprain?

A sprain is caused by stretching or tearing of ligaments, which are fibrous tissues that connect bones together in a joint like the ankle. A sprain is usually accompanied by bruising, as the injury also damages the blood vessels near the joint causing bluish discoloration of the skin. An ankle sprain is the most common sports injury. The grades for sprains are:

• Grade 1 - Mild tenderness, swelling, and bruising because of stretching or tearing of the ligament.

• Grade 2 - Moderate pain, swelling, and bruising because of incomplete tear of the ligament.

• Grade 3 - Severe swelling and bruise because of a complete tear of the ligament.

It is often difficult to differentiate a sprain from a strain. As the symptoms are the same for both, the only difference is a strain is caused by injury to the muscles or fibrous tissue that connects a muscle to the bone (tendons).

What Are the Causes of a Bruise and Sprain?

Usually, the sprained joint will have some bruising around it. The causes of a sprain are:

1. Sports injuries.

2. Walking on an uneven surface.

3. Landing the wrong way after a jump.

4. Vigorous exercise.

5. Fall.

6. Poor flexibility.

7. Overexertion.

8. Lifting heavy objects.

9. Poor posture.

Apart from these causes, bruising is also seen in patients with bleeding or clotting disorders, leukemia, deep vein thrombosis (DVT), concussions, varicose veins, and people on blood thinners (Heparin and Warfarin).

What Are the Symptoms of a Bruise and Sprain?

The symptoms associated with bruising depend on the cause. Pain and bluish discoloration of the skin are the symptoms seen. As the bruise heals, it can change into the following colors:

• Red - A bruise is red initially due to the collection of oxygen-rich blood underneath the skin.

• Blue or purple or black - After a couple of days, it changes to blue or blackish as the blood loses oxygen.

• Yellow or green - After 5 to 10 days, as hemoglobin is broken down and bilirubin and biliverdin are produced, it turns yellowish green.

• Yellowish-brown - After a couple of weeks, it will turn light brown in color.

Some of the common symptoms of a sprain are:

• Pain.

• Inflammation.

• Bruising.

• Stiffness.

• Weakness.

• Restricted movement of the affected joint.

What Are the Risk Factors for Bruises and Sprains?

Bruises and sprains can result from various risk factors, including:

• Trauma: Direct impact or force on the body, such as a fall, collision, or twisting motion, can lead to bruises or sprains.

• Sports or Physical Activities: Engaging in sports or activities that involve rapid movements, jumping, or sudden changes in direction increases the risk of sprains and bruises.

• Age: Older adults may be more prone to bruises and sprains due to changes in skin elasticity, muscle strength, and bone density.

• Poor Flexibility and Conditioning: Inadequate warm-up, stretching, and conditioning exercises can make muscles and joints more vulnerable to injuries like sprains.

• Weak Muscles or Ligaments: Weakness in muscles or ligaments can contribute to instability in joints, making them more susceptible to sprains.

• Previous Injuries: Having a history of previous sprains or bruises can weaken the affected area and increase the risk of re-injury.

• Certain Medical Conditions: Conditions such as osteoporosis, arthritis, or bleeding disorders can predispose individuals to bruising and may also affect the strength and stability of joints.

• Medications: Some medications, such as blood thinners or certain steroids, can increase the risk of bruising due to their effects on blood clotting or tissue integrity.

• Environmental Factors: Slippery or uneven surfaces, poor lighting, and other environmental factors can contribute to falls and subsequent bruising or sprains.

• Improper Footwear or Equipment: Wearing inadequate footwear or using faulty equipment during physical activities can increase the risk of foot, ankle, or leg injuries leading to bruises or sprains.

How Are Bruises and Sprain Treated at Home?

First aid for muscle sprain and bruise is done with rest, ice, compression, and elevation (RICE).

• Rest - Avoid using the joint or body part that is injured for some time, but too much rest can make the muscle week and can prolong healing.

• Ice - Immediately after an injury, apply ice. Wrap the ice in a towel and place it on the area for 20 minutes, and keep repeating this every hour. This will bring down the swelling.

• Compression - To reduce the swelling further, cover the area loosely with a bandage. Do not tie it very tight, as it might stop the blood circulation to the area.

• Elevation - Keep the injured area raised above the level of your heart.

Other measures include:

• Use pain medicine after consulting your doctor.

• Apply cold packs to the area to reduce swelling. Heat may help to reduce pain in later stages.

• Always stretch and warm up before sports to prevent injury.

When to Seek Medical Attention?

As bruises are a surface injury, they do not need medical attention. But sometimes it can be due to some serious underlying condition. Consult the doctor immediately in the following situations:

• Numbness in the injured arms or legs.

• Loss of function of the joint, limb, or muscle.

• If the discoloration keeps growing in size.

• If it lasts for more than 2 weeks.

• If it recurs in the same place.

• If it was caused due to head or neck injury.

• If the vision is affected.

Home treatments may be used for mild to moderate sprain, but in the following cases, get immediate medical attention:

• If the area is still in pain after a week.

• If the area is numb.

• If one cannot use the injured joint.

• If there is bleeding from the injury.

How to Prevent Bruises and Sprains?

• Wear protective gears while playing contact sports.

• Avoid slippery surface.

• Keep floors uncluttered.

• Wear well-fitting shoes.

• If one is on blood thinners, consult the doctor to adjust the medications to prevent bruising.

• To prevent sprain, maintain proper posture, stretch properly before playing, and avoid lifting heavy objects.

Mild sprains and bruises may get better with the help of home remedies in about a couple of weeks. If the symptoms are getting worse, or if one sees spontaneous bruising without any injury, consult doctor immediately.

Conclusion

Bruises and sprains are common injuries caused by trauma, sports activities, and age-related factors. Proper preventive measures such as warm-ups, protective gear, and safe practices during physical activities can help reduce the risk of these injuries. Early intervention and proper management aid in faster recovery and prevent complications.