Contusion
Crush injury to soft tissue that could result in damaging mm fibres, capillary rupture, bleeding into subcutaneous tissue of skin, and edema. Skin remains intact.
Hematoma
Large area of local hemorrhage following a trauma
Causes of Contusion
- trauma, due to direct blow
- can get other injuries as well (strain, sprain, fracture, etc.)
First 24 hours post-injury
- most critical, primary goal is to control the bleeding
Factors that may increase bleeding
- exercising
- heat
- alcohol intake
- blood thinning meds
- vigorous massage
Contusion colours for stages
Acute = red/black/blue
Subacute = purple & black to brown, yellow or green discolouration
Tx Goals: Acute, Subacute, Chronic
Acute - no onsite work
Subacute - maintain proximal circul. and ROM
Chronic - increase ROM & Strength/function
Hydrotherapy for Contusions
Acute - ice to decrease inflammation/swelling
Subacute - contrast to help aid venous return
Chronic - heat to help increase pliability of adhesions
Contraindications for Contusions
- meds
- no manual therapy
- do not disturb clotting process
- no aggressive testing
- dont decrease protective mm spasm in acute
- no local work for myositis ossificans
- no heat or contrast hydro for moderate/severe in first 3-5 days (risk of re-bleeding
