So What's The Deal With Bruises?

[GETMETOCA]

I always have my share of bruises, but lately, I 've had some really bad ones.  They are different in that the tissue beneath is hard as a rock and very painful.  The areas of bruise are large, and in the current ones I have they are a foot in diameter (left hip/thigh) and the one on my tricep goes all the way around the arm from mid-tricep to the wrist.  All due to an unplanned get-off last Saturday.

I never used to worry about blood clots, but everyone who see's the bruise on my arm makes an effort to warn me about blood clots.  So what happens when you have a blood clot?  I have heard some people (massage therapists) say that massaging the area will facilitate breaking up of the clot to proceed with healing, while others say it can cut something loose, travel to the brain and POW!  Anuerism.  I'm thinking that bruises are the result of broken vessels or veins, and the purple color is the result of all this loose blood that just pools around until it somehow moves out of the system like waste.  How long does it take for a clot to move a foot?  What's the difference between a clot to the brain vs a clot to the heart?  How do doctors tell if you have a clot anyway and what would one feel like?

And what's this hard tissue all about?  What does the hard/knotty tissue have to do with the bruise, are they tied together somehow, other than from the impact of the crash?  Is it part of the bruised tissue or do these knots have something to do witht he nearby bones?  Also, the bruised and knotty area is very warm to the touch, like it has a fever.

So what's the scoop on bruises, anyone?

 

 

 

[bbbom]

Wow, great questions Natalie! And just in time for bruise season to start for us here. I'm curious to see what we find out.

 

[Philip]

Natalie what are ya'll doing over there? That sounds like maybe you should get a doctor to check that out. As far as the knots are concerned my dad had one in his thigh that turned out to be a bleeding artery. It just kept pooling in his leg and drying under the skin causing a large bruise and a hard knot. Not trying to scare you just offering some info. Let us know. If you need I can send Dr. Boudreaux over but I'm not sure what kind of diagnosis you'll get. ;)
Take care.

 

[SPD]

Can you say OLD AGE :flame:

 

[BillyWho]

Originally posted by SPD
Can you say OLD AGE :flame:

Not if you were smart LOL!

 

[GETMETOCA]

Originally posted by SPD
Can you say OLD AGE :flame:

Its a good thing you live a few states away...:think: :)

 

[vetwfo'er]

I crashed last year around August. It was a hard crash that slammed me on my left side and my thigh swelled up (size of half a softball) and turned purple almost immediatly. Then a couple of days later I was black and blue from my crotch to my foot. I figured I better let the doc look at it and they told me it would go away..... eventually. The color took about a month to go away ans the lump is still there. It has shrunk quite a bit but, is still there.

vetwfo'er

 

[altagirl]

I've had a couple of bruises like that (that big too, unfortunately). One last fall actually left a dent in my thigh (slammed my leg straight into my mountain bike handlebars at full speed), and I have one in my arm that looks normal on the surface but there's still some hard tissue underneath.

Usually I start massaging the tissue once it's turning colors and healing to help clear it up faster, but it would be interesting to get a medical perspective on that.

 

[TheGrinch]

Where's Nephron? He might be able to shed some light on the subject.

 

[nephron]

Natalie--sorry so late.

Doesn't sound too bad to me. The soft tissue bruising you're having seems reasonably appropriate for a middle aged female getting off a bike at high speed. Females tend to bruise easier anyway, due to hormonal influences on soft tissue construction (capillary wall integrity, collagen production, tissue elastin etc..). I wouldn't worry about it. You may have been taking some aspirin or other NSAIDS that can affect platelet function as well.

As far as the localized 'hard' or 'indurated' areas of 'fever' or 'calor', with 'redness' or 'rubor', it's possible that some of the superficial veins have thrombosed--also called superficial thrombophlebitis. You can apply some warm compresses every few hours, and take about 650mg of aspirin a day to help alleviate that. It's less likely to be a true cellulitis (or skin infection), but still possible.

As far as emboli, FORGET about it. The embolisms everyone's talking about are from large distal central veins, not superficial ones. It's a long story, but to cut it short, when you hear of someone dieing suddenly from 'blood clots', it's a pulmonary embolism, where the deep iliac and/or femoral veins have clotted from stasis/inactivity/coagulopathy, etc....the clots are about the size of a finger or two in breadth, break loose, travel up the inferior vena cave, into the right atrium, right ventricle and then the Pulmonary artery, where they either get stuck in the right or left main branches of the pulmonary artery, or across the 'saddle'--called a 'saddle embolus'. Sudden death occurs due to acute right heart failure. I've successfully coded only one, and it was because I was thinking about it and started thrombolytics during the code (which lasted 45 minutes)--something you don't see on ER. ;)

A clot like that CANNOT go to the brain unless there's a right to left shunt (persistent foramen ovale or patent atrial septal defect) with secondary pulmonary hypertension. This is because there is a complete separation of the RIGHT (VENOUS) and LEFT (ARTERIAL) system, the transition of which occurs across the pulmonary capillary bed where oxygenation occurs. Strokes are due typically to de novo intracerebral artery thrombosis or carotid disease, less commonly due to left heart emboli or hemorrhage.

So if the therapist massages the clot, it will not embolize, because it is a superficial vein, and the clots will not make it in large size into the central venous circulation. It won't help much, but it won't hurt. You'd be better off just exercising and using some aspirin/compresses as above.

Hope that helped.

 

[KiwiBird]

Dang! Doctors can get away with soooo much more than ordinary lay folks.

Natalie - I would have never called you "middle aged". :eek:

 

[dirt bike dave]

Who says he is going to get away with it? ;)

Natalie is much younger than all the middle aged people I know!

 

[GETMETOCA]

Thanks Kiwi and DBD, for knowing where to stand on that finely drawn line...;) Its nice to know you two can flatter old ladies with the best of them.

I'm giong to have to give Nephron a 'get out of jail free' card this time, since he was so attentive to my bruise needs.  Besides, we all know that if I'm going to live to 100, fifty is considered "middle aged".  I've got 13 more years to go! :confused:

 

[yzrider_69]

thats hardly old shes in her prime and this is coming from a 16 year old.

 

[JTT]

Along this same lines, I have a question. I have experienced similar bruising lately, but is also comes with a large localized swelling. I wacked my shin on my footpeg the other day and thought little of it, but when I go home, I noticed a large bump protruding, about the size of half an orange. A week later the bump is only golfball size, but the swelling and bruising has migrated to my ankle making it slightly stiff. As I have only started to experience these things in the last 4-5 years, I assumed it was the dreaded "old age" thing too. Is this normal?

 

[altagirl]

I run into the same thing (I'm 29). The bruising and swelling eventually goes away, but when a large bruise starts to dissolve, the color and fluid seem to succumb to gravity and drifts down towards my ankle or foot, which then becomes a little stiff with the extra fluid. It helps to elevate your leg as much as possible to counteract this, but it's tough to do when you're working and the injury wasn't all that serious in the first place. In addition, if i hit my shin bone just right, I sometimes end up with a permanent lump on the bone. Doesn't hurt or anything, but I can feel a little raised spot where it used to be smooth.

Not medical advice, but I always find it reassuring to hear that other people have similar symptoms during the healing process.

 

[JTT]

Originally posted by altagirl
Not medical advice, but I always find it reassuring to hear that other people have similar symptoms during the healing process.

Definitely true :thumb:

ps. I have the lumps on my shins too! I'm 38 though :(