Bruising of skin and underlying tissues of the forearm caused by a direct blow. Contusions cause bleeding from ruptured small capillaries, allowing blood to infiltrate muscles, tendons or other soft tissue.

BODY PARTS INVOLVED

Tissues of the forearm, including blood vessels, muscles, tendons, nerves, covering to bone (periosteum) and connective tissue.
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SIGNS & SYMPTOMS

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• Forearm swelling–either superficial or deep.
• Pain and tenderness in the forearm.
• 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 forearm activity proportional to the extent of injury.
  

  CAUSES

  Direct blow to the forearm, usually from a blunt object.

  RISK INCREASES WITH

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• Violent contact sports, especially when the forearm is not adequately protected.
• Medical history of any bleeding disorder such as hemophilia.
• Poor nutrition, including vitamin deficiency.
• Use of anticoagulants or aspirin.
  

  HOW TO PREVENT

  Wear appropriate protective gear and equipment during competition or other athletic activity if you have had a recent contusion or the activity makes a contusion likely.

  WHAT TO EXPECT

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  APPROPRIATE HEALTH CARE

• Doctor’s care, unless the contusion is quite small.
• Self-care for minor contusions and for serious contusions during rehabilitation.
• Physical therapy for serious contusions.
  

  DIAGNOSTIC MEASURES

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• Your own observation of symptoms.
• Medical history and physical exam by a doctor for all except minor injuries.
• X-rays of the injured area to assess total injury to soft tissue and to rule out the possibility of underlying fracture. Total extent of injury may not be apparent for 48 to 72 hours.
  

  POSSIBLE COMPLICATIONS

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• Excessive bleeding, leading to disability. Infiltrative-type bleeding can sometimes lead to calcification and impaired function of injured muscles and tendons.
• Decreased blood supply to forearm muscles, causing tissue death, loss of function and contraction of affected muscles.
• Prolonged healing time if usual activities are resumed too soon.
• Possible infection if skin is broken over the contusion.
  

  PROBABLE OUTCOME

  Healing time varies with the extent of injury, but average healing time for forearm contusions is 2 to 3 weeks.

  HOW TO TREAT

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  NOTE — Follow your doctor’s instructions. These instructions are supplemental.

  FIRST AID

  Use instructions for R.I.C.E., the first letters of REST, ICE, COMPRESSION and ELEVATION. See Appendix 1 for details.

  CONTINUING CARE

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• Use a sling to immobilize the arm.
• Wrap an elasticized bandage over a felt pad on the injured area. 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

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• For minor discomfort, you may use: Acetaminophen or ibuprofen. Topical liniments and ointments.
• Your doctor may prescribe stronger medicine for pain.
  

  ACTIVITY

  Begin activities slowly and stop exercise as soon as pain begins. Increase activity as healing progresses.

  DIET

  During 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

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• Begin daily rehabilitation exercises when supportive wrapping is no longer needed.
• See section on rehabilitation exercises.
  

  CALL YOUR DOCTOR IF

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• You have symptoms of a forearm contusion that doesn’t improve within a day or two.
• Skin is broken and signs of infection (drainage, increasing pain, fever, headache, muscle aches, dizziness or a general ill feeling) occur.