Occasionally, the area of a bruise will become firm and may actually start increasing in size instead of going away. The bruise may also continue to be painful. There are two major causes for a bruise that gets worse. First, if a large collection of blood is formed under the skin or in the muscle, the body may wall the blood off causing what is called a hematoma. A hematoma is nothing more than a small pool of blood. Hematomas may need to be drained by a healthcare professional.
Getting prompt medical treatment and following a doctor's advice about rehabilitation can help an individual avoid serious medical complications that occasionally result from deep muscle contusions and bruises. These complications include compartment syndrome and myotosis ossificans.
Compartment syndrome: In certain cases, rapid bleeding may cause extremely painful swelling within the muscle group of the arm, leg, foot, or buttock. The build-up of pressure from fluids several hours after a contusion injury can disrupt blood flow and prevent nourishment from reaching the muscle group underneath the bruise. Compartment syndrome may require urgent surgery to drain the excess fluids.
Myositis ossificans: Myositis ossificans is a condition in which the bruised muscle grows bone instead of new muscle cells. Young athletes who try to rehabilitate a severe contusion too quickly sometimes develop this condition. Symptoms may include mild to severe pain that does not go away and swelling at the injury site. Abnormal bone formations can also reduce flexibility. Vigorous stretching exercises may make the condition worse. Rest, ice, compression, and elevation to reduce inflammation will usually help. Gentle stretching exercises may be used to improve flexibility. Surgery is rarely required.
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