Bruises and Hard Lumps After a Fall: What to Expect

Ecchymosis

Dear Doctor: I had a car accident and fell, resulting in bruising and a lump in the muscle above my thigh near the knee.
The bruise is starting to fade, but why is the lump still there? What should I do? Will the lump never go away?

Xiao Min, 20~29 year old female. Ask Date: 2003/06/20

Dr. Liu Jinyong reply Family Medicine

Due to a car accident, there was an impact on the thigh above the knee, resulting in muscle contusions and a hard lump in that area.
The cause is attributed to the rupture of blood vessels surrounding the thigh above the knee due to the impact, leading to a hematoma.
The presence of the hematoma is what causes the hard lump.
For the first three days, ice towels were applied to the contusion, and from days four to seven, warm towels were used along with gentle massage of the area.
If the patient's PT (Prothrombin Time) and APTT (Activated Partial Thromboplastin Time) are within normal limits, the hematoma should gradually resolve.
If the hematoma does not resolve, it may lead to compromised blood circulation in the lower limb, resulting in cold skin temperature.
In severe cases, surgical intervention may be necessary.
Please visit a nearby public hospital for further examination and treatment.

Reply Date: 2003/06/20

More Info

When you experience bruising and hard lumps after a fall, such as in your case from a car accident, it’s important to understand the underlying processes that occur in your body. Bruises, or contusions, happen when small blood vessels are damaged, leading to bleeding under the skin. This results in the characteristic discoloration, which can range from red to purple and eventually fades to yellow or green as the body reabsorbs the blood.

The hard lump you are feeling is likely a hematoma, which is a localized collection of blood outside of blood vessels, often caused by trauma. When the blood leaks out into the surrounding tissues, it can create a firm mass that may feel tender or painful. As the bruise heals, the body works to break down and reabsorb the blood, which can take time, depending on the size of the hematoma and the individual’s healing capacity.

In your case, it sounds like the bruise is beginning to resolve, but the hard lump remains. This is not uncommon. Hematomas can take several weeks to months to fully resolve, and in some cases, they may remain palpable for an extended period even after the discoloration has faded. Factors such as the size of the hematoma, the location, and individual healing responses can all influence how long it takes for the lump to disappear.

Here are some steps you can take to manage the situation:
1. Rest and Protect the Area: Avoid activities that might aggravate the injury. Protecting the area from further trauma is crucial for healing.

2. Ice Therapy: If the lump is still painful or swollen, applying ice wrapped in a cloth for 15-20 minutes several times a day can help reduce swelling and discomfort.

3. Compression: Using a compression bandage can help minimize swelling and provide support to the area.

4. Elevation: Keeping the affected leg elevated can help reduce swelling.

5. Pain Management: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain and inflammation.

6. Monitoring: Keep an eye on the lump. If it becomes increasingly painful, grows in size, or shows signs of infection (such as redness, warmth, or discharge), it’s important to seek medical attention.

7. Consult a Healthcare Provider: If the hard lump persists for an extended period or if you have concerns about it, it’s advisable to consult a healthcare provider. They may recommend imaging studies, such as an ultrasound, to evaluate the lump further and rule out any complications.

In terms of whether the hard lump will disappear, it is likely that it will gradually resolve over time, but the duration can vary. Some hematomas may take weeks to months to fully resolve, while others may leave a residual lump that can persist for a longer time. In rare cases, if a hematoma becomes organized or forms scar tissue, it may not fully resolve without intervention.

In summary, while it is normal for a hard lump to remain after a bruise has faded, monitoring the area and taking appropriate care can help facilitate healing. If you have any concerns or if the lump does not improve, seeking medical advice is the best course of action.

Similar Q&A

Managing Facial Bruises and Hard Lumps in Children After Falls

Hello Dr. Huang: My child fell while walking and hit their face against a table, resulting in a large bruise (but no broken skin). After one to two weeks of applying warm compresses, most of the bruise has faded, but a small portion of the bruise and a soft, hard lump underneath ...

Dr. Huang Junxiong reply Surgery
Hello: According to your description, this mass may be a localized hematoma or seroma, or it could be localized fibrosis. It is recommended to visit a surgical outpatient clinic for diagnosis and management. Dr. Huang Jun-Hsiung.

Understanding Hard Lumps After Bruises: When to Seek Medical Attention

On December 20, 2019, I was involved in a car accident where the inner side of my right thigh struck a stone pillar, but there was no bone injury, only minor abrasions. Afterward, I developed large bruises, and the scab from the abrasion eventually fell off on its own. By January...

Dr. Peng Xianwen reply Surgery
It's difficult to make a judgment based solely on this description; it's best to visit the clinic in person for a more accurate assessment.

Understanding a Lump in the Abdomen After a Fall: Causes and Concerns

Hello Doctor: Four days ago, I fell down the stairs, and when I got home, I noticed a large bruise on the left side of my waist near the front (about the size of a palm). Later, I discovered that there was a circle without bruising in the middle (about the size of a fifty-cent co...

Dr. Ke Fangxu reply Surgery
It should be a subcutaneous hematoma. If it is not continuously enlarging or causing severe pain, it is not a concern. However, you may want to have a physician examine it to check for any other injuries.

Understanding a Hard Lump After a Month of Bruising on the Arm

After a month of bruising from an arm impact, there is a flat, approximately 1 cm long hard lump at the site of the impact. What could this be?

Dr. Chen Ronghong reply Surgery
Hello Mr. Huang, first please recall if there was a possibility of a foreign object penetrating when your arm was injured. If there is any suspicion, you should seek medical attention for removal. If the skin has remained intact, then the lump you described is more likely a subcu...