KNEE CONTUSION |
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General Information
DEFINITION--Bruising of the skin and underlying tissues of the knee due to a direct blow. Contusions cause bleeding from ruptured small capillaries that allow blood to infiltrate muscles, tendons or other soft tissue. The knee is highly vulnerable to contusions.
BODY PARTS INVOLVEDKnee, including blood vessels, muscles, tendons, nerves, covering to bone (periosteum) and connective tissue.
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SIGNS & SYMPTOMS
Swelling--either superficial or deep.
Pain and tenderness over the knee.
Feeling of firmness when pressure is exerted on the knee.
Discoloration under the skin, beginning with redness and progressing to the characteristic "black and blue" bruise.
Restricted knee activity proportional to the extent of injury.
Break in skin over the contusion (frequent in knee injuries).
CAUSESDirect blow to the front or side of the knee.
RISK INCREASES WITH
Contact, running or riding sports, especially if the knees are not adequately protected.
Medical history of any bleeding disorder such as hemophilia.
Poor nutrition, including vitamin deficiency.
Use of anticoagulants or aspirin.
HOW TO PREVENTWear protective knee pads during competition or other athletic activity if there is risk of a knee contusion.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's care unless the injury is quite small.
Self-care for minor contusions, and 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 knee to assess total injury to soft tissue and to rule out the possibility of underlying fractures. 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 sometimes lead to calcification and impaired function of injured muscles, ligaments or tendons.
Prolonged healing time if usual activities are resumed too soon.
Infection if skin over the contusion is broken.
PROBABLE OUTCOMEHealing time varies from 2 to 6 weeks, depending on the extent of injury.
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 an elasticized bandage over a felt pad on the knee. Keep the area compressed for about 72 hours.
Use an ice pack 3 or 4 times a day. Wrap ice chips or cubes in a plastic bag, and wrap the bag in a moist towel. Place it over the injured area for 20 minutes at a time.
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.
Use ice massage for 10 minutes before and after workouts. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball.
See section on rehabilitation exercises.
CALL YOUR DOCTOR IF
You have a knee 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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