For a Friend: Bike Get-Off and Bruising, with pics (WARNING)
I'm posting this for a 51yo female friend who had a hard low speed, nearly stopped fall on Tuesday, on her side, with a very solid whack to her hip pointer area. She was able to continue riding, it was understandably very bruised later that evening, but was worse the next day. Since then the bruised area has spread, I imagine as the trauma area leaks fluid, etc.
She's experiencing swelling and hardness at the impact area, as well as some skin numbness in that area. Has a limp (naturally) and an internal burning sensation which I've experienced when I've done damage to tendons vs muscle.
Progression of the bruise:
Wed AM
Wed late afternoon
Thurs afternoon
Same time, showing the swelling.
She's icing, trying to stay off of it, taking ibuprophen and will see a doctor tomorrow.
As many of us here have had / will have our share of falls and bruises, can the docs here give us any insight as to what's going on, recovery protocols, etc?
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Comments
Rich,
While it's hard to know the extent of any DEEP injury (muscle,tendon,bone) the picture you show simply reflects the absorption process of a subcutaneous bleed (hematoma). It's very unlikely there is any active bleeding currently and the area will look angry (bruised) for 3-6 more weeks. Really there is no big danger. However if the pain is getting worse instead of slowly getting better would get an X-ray. With a low speed impact mechanism odds favor a more superficial process and hence it's easier to see and appears more dramatic.
I had almost the exact same injury a few months ago but happily have no pictures to show
.
It looks much worse than it is and time will heal without residual effect.
Dave
Dave,
Thanks for the detail! Any recommendations on when to return to cycling while it heals? Also, does activity (walking, cycling, etc) and increasing blood flow help the bruising go away?
What's the mechanism by which bruising goes away? Simple absorption?
Thanks. Seeing a doc today and I'll pass on the aspirin comment.
Rich,
The ecchymosis (bruising) in the picture is in the fatty plane below the skin and above the muscle. Resolution occurs by reabsorption by capillaries and lymphatics to a lesser extent -really nothing you can do to speed up the process however activity (if she is not sore) is a good thing.
I would be careful about aspirin- there in NO data ever published that shows it can prophylax against "clots" (deep vein thrombosis) and to the contrary in this instance may promote bleeding (however it is very unlikely she is actively bleeding now).
A heating pad may help the absorption by dilating adjacent capillaries but the process will still take a few weeks. I think compression shorts/hose will be beneficial.
Hope this helps.
Dave
Dave,
Thanks again for the information, bruising is coming down well. Our recent addition of Normatec as a sponsor got me thinking of whether or not the compression boots would be recommended to aid in healing bruising or other leg injuries?
Thanks! Any comments / insights on using the compression boots for stuff like this?
Sorry for the late reply.
Compression boots (Normatec) WILL help with reducing extremity edema (augments lymphatic and venous flow- reducing "venous hypertension") but it won't have any important impact in speeding up the absorption of the old blood stuck in the fatty plane (bruising)- that occurs by the body's own ability to break down the blood products (lysis) and absorb and process the products.
The good news is that by now your friend should be seeing a significant reduction in the bruising.
Dave