DEFINITION--Bruising of the skin and underlying tissues of the elbow due to a direct blow. Contusions cause bleeding from ruptured small capillaries that allow blood to infiltrate muscles, tendons or other soft tissue. Because skin is so close to bone in this area, contusion of the elbow is a common injury to athletes.
BODY PARTS INVOLVEDElbow tissues, including blood vessels, muscles, tendons, nerves, olecranon bursa, connective tissue and covering to bone (periosteum). Periosteum injury is particularly common in elbow contusions.
SIGNS & SYMPTOMS
Swelling in the elbow--either superficial or deep.
Pain and tenderness over the elbow.
Feeling of firmness when pressure is exerted at the injury site.
Discoloration under the skin, beginning with redness and progressing to the characteristic "black and blue" bruise.
Restricted elbow activity proportional to the extent of injury.
Direct blow to the elbow, usually from a blunt object.
Falling on the elbow.
RISK INCREASES WITH
Contact sports such as football, hockey, basketball or soccer, especially if the elbows 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 appropriate protective gear and equipment, such as elbow pads, during competition or other athletic activity if there is risk of an elbow contusion.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's care unless the contusion is quite small.
Self-care for minor contusions, or for serious contusions during rehabilitation.
Physical therapy for serious elbow contusions.
Your own observation of symptoms.
Medical history and physical exam by a doctor for all except minor injuries.
X-rays of the elbow, wrist and shoulder 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.
Excessive bleeding leading to disability. Infiltrative-type bleeding can (rarely) lead to calcification and impaired function of injured muscle.
Prolonged healing time if usual activities are resumed too soon.
Infection if skin over the contusion is broken.
PROBABLE OUTCOMEComplete healing without complications. Most elbow contusions will heal in 6 to 10 days.
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.
Wrap an elasticized bandage over a felt pad on the injured area. Keep the area compressed for about 72 hours.
Immobilize the arm in a sling.
Use ice soaks 3 or 4 times a day. Fill a bucket with ice water, and soak 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 from wrist toward shoulder to provide comfort and decrease swelling.
For minor discomfort, you may use:
Acetaminophen or ibuprofen.
Topical liniments and ointments.
Your doctor may prescribe stronger medicine.
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.
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 an elbow 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.