Persistent Bruising After Injury: When to Seek Medical Help

Q: Persistent Bruising After Injury: When to Seek Medical Help

Hello： Your ongoing bruising situation raises concerns about the possibility of fractures, ligament tears, or tendon ruptures. <br>However, if you are still able to walk normally, the likelihood of a fracture is relatively low. <br>It is more probable that you may have a ligament

Stasis of blood?

Hello doctor, I was in a car accident at the end of September, and my left calf was crushed by a motorcycle, resulting in bruising.
The bruising has improved but is not fully healed, and there is still a large area of light-colored bruising on my leg.
When I use a heating pad, it causes redness and swelling.
A massage therapist mentioned that because I previously had a ligament injury in my left ankle that never fully healed (which has caused a shift in my walking balance and residual effects), there may be blockages in the meridians, making it difficult for the bruising to resolve.
Given that it has been over two months, which specialty should I see for treatment? Will the persistent bruising have any long-term effects? Thank you.

An, 40~49 year old female. Ask Date: 2022/11/29

Dr. Lin Zhebin reply Family Medicine

Hello: Your ongoing bruising situation raises concerns about the possibility of fractures, ligament tears, or tendon ruptures.
However, if you are still able to walk normally, the likelihood of a fracture is relatively low.
It is more probable that you may have a ligament or tendon tear.
It is advisable to consult an orthopedic specialist for an examination.

Reply Date: 2022/11/29

More Info

It sounds like you have been dealing with a persistent bruise on your left calf since your motorcycle accident in late September. Bruising, or contusions, can occur when small blood vessels are damaged, leading to bleeding under the skin. In most cases, bruises heal on their own within a few weeks. However, when bruising persists for an extended period, as in your case, it may warrant further investigation.

Given that you mentioned the bruise has not fully resolved after more than two months, and you are experiencing symptoms like redness and swelling when applying heat, it is advisable to seek medical attention. Persistent bruising can sometimes indicate underlying issues, such as:
1. Hematoma: A collection of blood outside of blood vessels that can form after an injury. If a hematoma does not resolve, it may require drainage or further treatment.

2. Infection: If the area becomes increasingly red, warm, or swollen, or if you develop a fever, it could indicate an infection that needs to be addressed.

3. Vascular Issues: If there are underlying vascular problems, such as venous insufficiency, it could lead to prolonged bruising and swelling.

4. Soft Tissue Injury: As you mentioned, if you have a history of ankle ligament injuries, it is possible that there is ongoing soft tissue damage that has not healed properly, leading to complications.

5. Blood Disorders: In rare cases, persistent bruising can be a sign of a bleeding disorder or other systemic issues.
In terms of which specialist to see, I recommend starting with a visit to an orthopedic doctor or a sports medicine physician. They can evaluate your injury, assess the bruising, and determine if there are any underlying issues that need to be addressed. If necessary, they may refer you to a vascular specialist or a hematologist for further evaluation.

In the meantime, here are some general care tips for bruising:
- Rest: Avoid activities that may aggravate the injury.

- Ice: Applying ice packs can help reduce swelling and pain, especially in the first few days after the injury.

- Compression: Using a compression bandage can help minimize swelling.

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

As for the concern about the bruise not resolving, while it may not pose an immediate threat, it is essential to address it to prevent any long-term complications. If the bruise continues to persist or worsen, or if you experience increased pain, it is crucial to seek medical help promptly.

In summary, persistent bruising after an injury should not be ignored, especially when accompanied by other symptoms. A thorough evaluation by a medical professional will help determine the appropriate course of action and ensure that any underlying issues are addressed.

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