# Are there any long term effects of bruises?



## brownieinSC (Apr 19, 2004)

I am generally coated from the knee down on my legs with bruises. Are there any long term medical problems that bruises can cause, like say vein / circulation damage? I have some shin pads but they are so HOT I would rather have the bruises and enjoy my ride. I have just gone clipless so I am hoping that will help cut down on the bruises as well. Thanks


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## formica (Jul 4, 2004)

brownieinSC said:


> I am generally coated from the knee down on my legs with bruises. Are there any long term medical problems that bruises can cause, like say vein / circulation damage? I have some shin pads but they are so HOT I would rather have the bruises and enjoy my ride. I have just gone clipless so I am hoping that will help cut down on the bruises as well. Thanks


not from surface bruises.

I don't want to scare you, but REALLY DEEP BRUISES can leave damage if not treated properly. Not the little blue dots we mountain bikers have all over. ;-)

http://forums.mtbr.com/showthread.php?t=41619


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## Lucky (Jan 12, 2004)

formica said:


> I don't want to scare you, but REALLY DEEP BRUISES can leave damage if not treated properly.http://forums.mtbr.com/showthread.php?t=41619


I got a really deep bruise on my thigh from falling across a log while orienteering over 20 years ago. It left a permanent nickel-sized cluster of spider veins. I don't remember if I did anything for it, and I ran the next day. I don't think I got any calcifications, or if I did, I have no symptoms. Just a small knot of big blue veins. My sister, who is a doctor, suggested I have them injected with saline to make them go away if they bother me. After two surgeries for the wrist, I don't want to see the inside of a doctor's office for anything. :^P They can just stay there.

Kathy


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## brownieinSC (Apr 19, 2004)

*Thanks for the link*

I have only had a one or two really bad bruises so far. That means I can keep riding with no worries!


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## connie (Mar 16, 2004)

Lucky said:


> I got a really deep bruise on my thigh from falling across a log while orienteering over 20 years ago. It left a permanent nickel-sized cluster of spider veins. I don't remember if I did anything for it, and I ran the next day. I don't think I got any calcifications, or if I did, I have no symptoms. Just a small knot of big blue veins. My sister, who is a doctor, suggested I have them injected with saline to make them go away if they bother me. After two surgeries for the wrist, I don't want to see the inside of a doctor's office for anything. :^P They can just stay there.
> 
> Kathy


I'm like you - I only go to the doctor when it's a real crisis. I've had a number of MAJOR bruises (like dinner-plate sized). My usual treatment is ice, stretch, elevate if possible and go on with whatever I was doing. I'm typically riding the next day. I had one in the middle of my left quad that left a dent about 1/2" deep - it's been there for several years now - but other than appearance there's no long term damage, even from that.


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## papajohn (Feb 1, 2004)

brownieinSC said:


> I am generally coated from the knee down on my legs with bruises. Are there any long term medical problems that bruises can cause, like say vein / circulation damage? I have some shin pads but they are so HOT I would rather have the bruises and enjoy my ride. I have just gone clipless so I am hoping that will help cut down on the bruises as well. Thanks


There are a number of possible long-term consequences from deep bruising that are noticeable, but not always problematic.

Depending on the severity of the blow, you can have damage to the fat layer underneath the skin/muscle (over hips or lateral thighs for example), and the fat can chip off into little hard knots that can be felt under the skin.

The muscle tissue in a major muscle like quads or calf can get crushed to the point that a portion of muscle tissue dies, leaving a permanent dent or depression in the mass of the muscle.

A deep bruise can result in a pocket of blood (hematoma) forming in or under the muscle tissue. It usually spreads out and reabsorbs over time, leaving that progression of purple/brown/yellow discoloration over several weeks. However, in some instances a membrane can form around the hematoma, leaving a pocket of fluid (seroma) that may not reabsorb for a very long time, or may be prone to bleed again if it is re-traumatized.

Finally, deep bruises can indeed cause calcification to occur where the muscle was damaged so that a hard nodule or lump may form and may be there permanently.

The result of a deep bruise can be much worse if you are a heavy user of aspirin or other drugs that tend to be "blood thinners", so that the initial bleeding into the tissue is more pronounced.

As I said, the long-term consequence of most of these is generally cosmetic, and is more annoying than debilitating, but they can take a long time to completely heal.

Maybe more than you wanted to know but, oh well.

John W. (MD)


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## formica (Jul 4, 2004)

papajohn said:


> .
> 
> Maybe more than you wanted to know but, oh well.
> 
> John W. (MD)


S' ok, all that information is in the other bruise thread anyway, but education is a good thing. When I first heard about the calcification thing it scared the crap out of me.

formica


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## papajohn (Feb 1, 2004)

formica said:


> S' ok, all that information is in the other bruise thread anyway, but education is a good thing. When I first heard about the calcification thing it scared the crap out of me.
> 
> formica


Sorry, my bad.

John W.


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## formica (Jul 4, 2004)

papajohn said:


> Sorry, my bad.
> 
> John W.


nono, not bad, if you ask me... I'd rather have an MD chiming in on these things anytime. Espcially one that understands mountain biking. Besides, isn't it the nature of a board like this that every thing has been discussed before at some point in time anyway...? Didn't mean to scare you off..

Or do you mean, bad as in the calcification thing being scary...?

eep, now I am confused, what else is new...

What I would like to hear about is treating nasty bruises that swell and get tender. Everyone says massive doses of Ibuprofen but I know that' is not always a good thing. I went with a compression wrap and ice massage last time around.

formica


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## papajohn (Feb 1, 2004)

formica said:


> nono, not bad, if you ask me... I'd rather have an MD chiming in on these things anytime. Espcially one that understands mountain biking. Besides, isn't it the nature of a board like this that every thing has been discussed before at some point in time anyway...? Didn't mean to scare you off..
> 
> Or do you mean, bad as in the calcification thing being scary...?
> 
> ...


LOL! No, I meant bad as in I had commited a party-foul for failing to read the old thread, but then so had the original poster too, so I was mostly responding to her as if neither of us knew of the other thread.

I did not take offense


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## formica (Jul 4, 2004)

well jeez now that you are here, what are the right things to do? heat, no heat, ice, no ice, massage, no massage, drugs or what? 

;-)

formica


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## alaskarider (Aug 31, 2004)

*serious effects of mountain bike crashes*

I am fairly new to MTBR, but have been reading various posts lately in search of a new bike. In any case, I have read a couple of threads now about the possible effects of bruising and thought I'd share my experience, since I haven't seen anybody else mention anything like it.

While riding down a rather loose trail in 2001, I failed to get my foot out of the toe clip (I've since switched to clipless, which I find much easier to escape from), fell to the side, and bruised up my shin. However, the apparent surface bruise, which wasn't even that impressive, turned out to be the least of my worries.

Within the next few weeks, I began to notice myself getting out of breath much more easily than normal. Being stubborn, I refused to see the doctor for quite a while until I awoke one morning with severe pain in my side whenever I breathed. My boyfriend dragged me to the emergency room, where I was diagnosed with a pulmonary embolism: a blood clot in my lung. If that sounds scary, it is. I was in the hospital for 5 days on an IV (blood thinner) and spent another 6 months taking another blood thinner. I was only 23.

While we'll never know for sure whether it was the mountain bike accident that caused the clot, my doctor thinks the likely sequence is that I developed Deep Vein Thrombosis (DVT), a blood clot in my leg, as a result of the swelling from the accident. Not long afterwords, that clot likely broke off and lodged itself in my lung, which is when I began to feel shortness of breath. Over time, my body was unable to dissolve the clot in my lung, which grew enough that I could feel it in the lining of my lung (which is when I felt the pain). I am still riding, but am much more cautious than I used to be.

I'm not trying to panic anybody out there. My doctor assured me that surface bruises would not cause DVT. However, if you happen to have a crash that causes significant swelling in your legs that lasts for a while, you may want to consult with your doctor about getting an ultrasound to make sure you don't have DVT. It's definitely worth avoiding the hospital stay and 6 months without getting to do any sort of fun riding afterwards.


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## papajohn (Feb 1, 2004)

formica said:


> well jeez now that you are here, what are the right things to do? heat, no heat, ice, no ice, massage, no massage, drugs or what?
> 
> ;-)
> 
> formica


As with any body insult, the two priorities are, if possible a) limit the injury and b) promote healing/recovery.

Talking about deep, significant bruises here, there is no question that ice for the first 48 to even 72 hours can help to limit the bleeding and tissue swelling, and ice is a good pain killer. Limiting use of the muscle or affected area for the same length of time helps for the same reason.

After about 72 hours, periodic application of mild heat, and resuming exercise can be helpful, because both promote bloodflow to the area which helps to reabsorb the hemorrhage, and help healing of the damaged tissue.

Personally I would avoid massage for the first 72 hours at least, to avoid the possibility of causing new bleeding, and because it might be too painful.

I really don't know of any medication that is proven to help the process, but others may have some good ideas.

But in the end I ain't no web MD. Don't forget to consult your family physician. 

Regarding the pulmonary embolism, while I certainly understand her fright and concern (that is a very serious situation), it is rarer than hens teeth in this circumstance, so it is not something I would expect to ever hear of again.

John W.


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