ARM CONTUSION, UPPER ARM |
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General Information
DEFINITION--Bruising of the skin, muscle and underlying tissues of the upper arm due to a direct blow. Contusions cause bleeding from ruptured small capillaries, allowing blood to infiltrate muscles, tendons or other soft tissue. Muscle tissue is damaged most by a contusion in this area.
BODY PARTS INVOLVED
Upper arm, particularly the biceps and triceps muscles.
Other soft tissues, including blood vessels, tendons, nerves, covering to bone (periosteum) and connective tissue.
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SIGNS & SYMPTOMS
Local swelling--either superficial or deep.
Pain and tenderness over the bruised area.
Feeling of firmness when pressure is exerted on the injured area.
Discoloration under the skin, beginning with redness and progressing to the characteristic "black and blue" bruise.
Restricted arm activity proportional to the extent of injury.
CAUSESDirect blow to the upper arm, usually from a blunt object.
RISK INCREASES WITH
Violent contact sports such as football or hockey, especially when the upper arm is not protected adequately.
Medical history of any bleeding disorder such as hemophilia.
Poor nutrition, including vitamin deficiency.
Use of anticoagulants or aspirin.
HOW TO PREVENTWear appropriate protective gear and equipment, such as foam-rubber or felt pads, during competition or other athletic activity if there is risk of an upper-arm contusion.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's care unless the injury is quite small.
Self-care for minor contusions, or for serious contusions during rehabilitation.
Physical therapy for serious contusions.
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and physical exam by a doctor for all except minor injuries.
X-rays of the arm, shoulder and elbow to assess total injury to soft tissue and to rule out the possibility of underlying fracture. The total extent of injury may not be apparent for 48 to 72 hours.
POSSIBLE COMPLICATIONS
Excessive bleeding leading to disability. Infiltrative-type bleeding can occasionally lead to calcification and impaired function of injured muscle.
Prolonged healing time if usual activity is resumed too soon.
Infection if skin over the contusion is broken.
PROBABLE OUTCOMEHealing time varies with the extent of injury, but all but the most serious upper-arm contusions should heal in 1 to 2 weeks.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AIDUse instructions for R.I.C.E., the first letters of REST, ICE, COMPRESSION and ELEVATION. See Appendix 1 for details.
CONTINUING CARE
Wrap felt or sheet wadding over the injured area. Then wrap the arm with an elasticized bandage from armpit to fingertips. Keep the area compressed for about 72 hours.
Continue ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage gently over the injured area in a circle about the size of a softball. Do this for 15 minutes at a time, 3 or 4 times a day, and before workouts or competition.
After 72 hours, apply heat instead of ice if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, heat liniments or ointments, or whirlpool treatments.
Massage gently and often to provide comfort and decrease swelling.
MEDICATION
For minor discomfort, you may use:
Acetaminophen or ibuprofen.
Topical liniments and ointments.
Your doctor may prescribe stronger medicine for pain.
ACTIVITYBegin activities slowly and stop exercise as soon as pain begins. Increase activity as healing progresses.
DIETDuring recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Your doctor may prescribe vitamin and mineral supplements to promote healing.
REHABILITATION
Begin daily rehabilitation exercises when supportive wrapping is no longer needed.
See section on rehabilitation exercises.
CALL YOUR DOCTOR IF
You have an upper-arm contusion that doesn't improve in 1 or 2 days.
Skin is broken and signs of infection (drainage, increasing pain, fever, headache, muscle aches, dizziness or a general ill feeling) occur.
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