Everything you need to know about a hip bruise after a fall or blow

Any injury is dangerous due to its consequences.

A hip contusion is damage to the muscles and connective tissue from external influences. At the same time, the skin maintains its integrity.

Depending on the force of the blow, a bruise will form at the site of the injury, that is, an accumulation of blood under the skin. Although such a place is rarely injured, the consequences here can be the most severe. The thing is that the hip joint is one of the largest and most important joints in the body.

Risk factors

A hip joint bruise is a closed injury to tissue: subcutaneous tissue, blood vessels, muscles. In young people, the pathology occurs as a result of an accident, work injury or during active sports. Older people are more vulnerable. There are age-related problems that are risk factors:

• unsteady gait due to diseases of the joints and bones;
• frequent dizziness due to pressure changes;
• poor vision, which does not allow you to notice an obstacle: door frame, furniture.

A bruise resulting from a fall is the most likely cause of injury, especially in winter.

Prevention[edit | edit code]

Bruises inevitably accompany sports, especially such hard sports as American football, hockey or rugby. It is unlikely that they can be completely prevented, but some of them can be avoided with the help of protective equipment. Hockey players, for example, wear special protective shorts that protect the pelvis and hips from injury; American football players also wear similar shorts with built-in protective shields. Other pieces of protective equipment, such as shoulder pads, reduce the likelihood of another player bruising his pelvis and hip when colliding with him. The surface of the playing field may also be an important factor. Thus, there is an opinion (not supported, however, by research data) that when playing on grass, fewer bruises occur than when playing on artificial turf.

Causes

Injuries to the hip joints are possible both at home and as a result of professional activities associated with increased physical activity. Most often, damage occurs due to external influences, for example, a strong impact on a foreign object. It is also possible to injure the hip joint when falling from a height.

It should also be noted that external damage to the joint by people suffering from various types of diseases of cartilage and bone tissue is possible even when the tissue is subjected to a minor impact. As a rule, these types of injuries are especially difficult to treat and require a long period of rehabilitation.

Physiotherapy

Treatment of bruises during the rehabilitation period should not only be effective, but also as safe as possible, without unpleasant consequences and side effects. This therapeutic course excludes the use of chemicals and drugs. After receiving a hip bruise from a fall, treatment often uses physiotherapeutic procedures, the purpose of which is to treat with the help of physical factors affecting the patient's body.

Such manipulations include the following procedures:

1. Magnetotherapy . The procedure is based on the effect of a low-frequency alternating magnetic field on the injured part of the body. Its purpose is to relieve pain and activate the process of regeneration of damaged tissue. After a course of therapy, the patient’s swelling and inflammation decrease, the tone of blood and lymphatic vessels normalizes, and blood and lymph flow in the bruise area improves. Additionally, the victim’s emotional state and sleep are stabilized. The procedure is not prescribed during pregnancy, the presence of a pacemaker, or pathologies accompanied by increased bleeding.
2. Ultrasound . The procedure is based on the use of variable acoustic pressure, causing microvibration. Ultrasound therapy has a pronounced analgesic, antispasmodic, anti-inflammatory and general tonic effect. Manipulations help improve tissue nutrition and stimulate recovery processes. Ultrasound may be used for hip bruises due to falls in the treatment of elderly patients.
3. Inductothermy . The essence of the procedure is the use of a high-frequency alternating magnetic field. After manipulation, blood vessels dilate, blood flow accelerates and coronary circulation improves. All this gives anti-inflammatory and absorbable effects. The procedure will be especially effective for hip hematoma after injury. Inductothermy is contraindicated in acute purulent processes.

The advantage of physiotherapy is its high efficiency combined with safety of use. But in case of a hip bruise, the treatment method and the appropriate physiotherapeutic procedure are chosen by the attending physician. Such therapy can be started within a week after injury.

Degree of injury and characteristic symptoms

Human body tissues have varying resistance to mechanical damage. When struck with a blunt object or a fall, soft tissues are damaged, but strong bones and elastic skin remain intact. A bruise is accompanied by severe pain even with minor harm to health. To distinguish it from a more severe injury - a crack or fracture, you need to know the main symptoms:

Hematoma in the hip joint one day after injury

• Sharp pain at the moment of impact, over time only felt when moving or touching.
• Clear swelling of the affected area, descending below the joint due to gravity.
• Formation of a hematoma as a result of rupture of blood vessels. A symptom of a severe contusion of the hip joint is a bruise covering a large area.
• Due to severe pain when supporting a limb, lameness appears.
• The ability to perform passive movements is preserved.
• In the first hours, the color of the skin at the site of injury is purple-red; the next day it becomes blue-purple. The greenish-yellow tint lasts 5-6 days.

According to severity, bruises are divided into 4 groups:

• 1st degree - minor damage that goes away on its own after 2-3 days;
• 2nd degree - characterized by the formation of edema and hematoma, accompanied by sharp pain on palpation;
• 3rd degree - there is damage to the muscles and tendons due to a strong blow, the injury can cause complications, mobility is limited;
• Grade 4 - severe injury that threatens human health; immediate medical attention is required.

What happens during a bruise?

The most characteristic changes in muscle bruises occur in the blood vessels and nerve endings. The severity of the changes depends on the force of the impact and the degree of compression of the muscle between the femur and the object that caused the injury.

With a minor bruise, local microcirculation disorders develop. A reflex spasm of the vessels occurs, their subsequent expansion, stagnation of blood inside the vessels and saturation of the surrounding tissues with serous fluid (the liquid component of blood). That is, traumatic swelling is observed.

When the damage is more severe , multiple ruptures of small vessels occur, followed by hemorrhage. However, if the vascular rupture occurs inside the muscle and the muscle membrane is not damaged, blood penetration into the surrounding tissues will be minimal. Therefore, the main symptoms are likely to be pain and decreased function.

If damage to the muscle membrane occurs, the spilled blood penetrates into the intermuscular and fascial spaces. The surrounding tissues (skin, subcutaneous tissue) are saturated with blood. Blood can separate tissues and accumulate in the form of a hematoma, which is visualized as a bruise.

Sometimes large hematomas do not resolve. Connective tissue grows around them, which forms a cavity filled with fluid. One of the frequent complications in this case is the development of a traumatic cyst, its suppuration, petrification (deposition of calcium salts).

In addition to rupture of blood vessels, strong impacts can lead to crushing of muscle tissue and traumatic necrosis (death of tissue and cellular structures). In this case, reactive inflammatory edema is added to the described symptoms.

MRI image on the right shows a contusion of the vastus intermedius muscle with a large intramuscular hematoma (arrows) containing clotted blood

How does a doctor act in case of injury?

For a doctor, diagnosing a bruise is not difficult. To avoid unforeseen complications, the doctor has the right to do an additional examination. First of all, the doctor examines the area of ​​the bruise, touches the skin, making sure that the bones are intact, and feeling the size of the hematoma that has formed. Then he asks the patient to lift his leg, bend it, and walk. Using the actions performed, he will look at the activity during movements. To make sure there is no fracture or crack in the bone, you will be sent for an x-ray.

If the patient complains of severe pain, makes limited movements, but the hip bruise is minimal, the doctor will send the person for an MRI. The phenomenon sometimes accompanies rupture of ligaments, muscles, and skin detachment. Hematomas located inside the muscle are excluded. The doctor sends me for an MRI, but the x-ray does not show such abnormalities.

Preventive actions

To prevent hip bruising, traumatologists advise adhering to general principles:

1. Exercise extreme caution in the workplace, while exercising or moving during the cold season. Patients should use protective equipment during competitions, choose shoes with non-slip soles, and remember to follow safety rules.
2. Reducing injuries is achieved by constant training: walking, training in sports clubs. Control of body weight plays an important role - excess weight creates additional stress on the lower limbs.

Hip bruise is a common injury among patients of all age groups. Immediately after the injury, the patient should visit the trauma center in order to determine the extent of the injury and exclude a possible fracture. Ignoring the symptoms of the pathology can cause the development of serious complications.

Is rehabilitation necessary?

Recovery after a bruise of the hip joint begins on the third day, if the pathology is without complications.

If hemarthrosis occurs along with a bruise of the hip joint, then exercises can be started after removing the fixation bandages. It is important to develop the hip joint. Before this, it is recommended to do only static exercises, in which the thigh muscles tense but do not move. You can strain them daily, 2-3 approaches. This will help improve blood flow in the affected area and prevent stagnation.

The exercises can be found in this article.

Exercise videos

Check out the exercises you can do after a hip injury to avoid chronic pain.

Elderly people and athletes often suffer from bruises of varying severity. The injury is accompanied by bruising and swelling. The sharp pain at the time of injury is replaced by dull and aching pain. Ignoring a bruise and not treating it can lead to complications. Timely diagnosis will help determine the condition of the bones and exclude cracks and fractures. Adequate treatment will speed up recovery time after injury.

Diagnosis and treatment

If an elderly person has difficulty moving, complains of severe pain, or there is extensive bruising, he must be sent to a traumatologist. The doctor conducts an external examination and determines the circumstances of the injury. To clarify the diagnosis, an instrumental study is prescribed:

• radiography - the image allows you to assess the condition of the bones of an elderly person, exclude dislocations and fractures;
• Magnetic resonance imaging is performed to assess tissue damage:
• Computed tomography is prescribed for severe bruises; the diagnostic method gives a complete picture of the condition of the bones.

Having determined the degree of damage from the bruise, the doctor chooses the appropriate therapy.

Conservative treatment

Local remedies for bruises

The main treatment method for hip joint contusion in elderly people is conservative. Patients are prescribed rest for 2-3 days. If the damage is significant, a splint is applied. Further movement with support from crutches or a cane is recommended. The patient is prescribed anti-inflammatory drugs "Voltaren", "Xefocam", as well as drugs that reduce pain. Cold compresses are replaced with warm ones, the patient receives electrophoresis with novocaine, which accelerates the resorption of the hematoma. Ointments “Diklak”, “Dolobene”, “Troxevasin” are applied to the injured area.

Treatment aimed at restoring joint mobility and muscle stretching begins on days 2-3; in severe cases, physical activity begins on days 10-12. Therapeutic exercise begins with passive movements of the limb - flexion-extension, rotation. Exercises like “Scissors” and “Bicycle” are shown.

Surgical intervention

Surgical intervention is required in isolated cases, with an extensive inflamed hematoma. Blood clots are removed, drainage is installed, and antibiotics are prescribed.

Surgery is resorted to in case of soft tissue detachment. The cavity filled with liquid is drained. The incision is sutured. In case of significant swelling, dissection of the fascia is performed to relieve intramuscular pressure.

ethnoscience

To treat a bruised hip joint at home, simple and effective traditional medicine recipes are suitable. The following will help alleviate the patient’s condition:

• Compresses made from raw potatoes. The peeled tuber is grated and part of the resulting juice is drained. The potato mass is wrapped in several layers of gauze and applied to the affected area.
• A mixture of aloe and honey. The leaves of the medicinal plant are washed and cleared of hard skin. Then crush and add liquid honey.
• A cabbage leaf, cut until the juice is released, is used to reduce swelling.

All folk remedies are used only with the permission of a doctor to avoid allergic reactions and complications.

Treatment[edit | edit code]

Conservative treatment[edit | edit code]

The goal of treatment is to restore full range and strength of movement in the injured leg as quickly as possible. Treatment begins with conservative measures to combat pain and swelling. These include rest, cold compresses, and NSAIDs. If standing or walking causes pain, you can use crutches. After 1-2 days, they begin to restore leg mobility with exercises for passive muscle stretching. You can immediately begin treatment by stretching the affected muscles, for which the leg is immobilized in the appropriate position - for example, if the upper part of the quadriceps muscle is bruised, the knee joint is often fixed in a bent position. Along with stretching the affected muscles, exercises are prescribed to strengthen the surrounding muscles. Gradually, the strength and mobility of the leg is restored, and the victim returns to sports.

Surgical treatment[edit | edit code]

Surgical interventions for bruises are usually not required. Only in rare cases is it necessary to open a hematoma or perform a fasciotomy due to increased subfascial pressure.

Special methods[edit | edit code]

Severe swelling and failure of conservative treatment indicate a possible large hematoma, preventing the rapid healing of the bruise. In such cases, an MRI is performed and, based on its results, the issue of draining the hematoma is decided.

How to treat

There are two treatment methods - conservative and surgical. When choosing the first option, treatment includes: first aid and further following the doctor’s recommendations. If you follow your doctor's instructions, pain symptoms can be reduced quickly. During the first week, you cannot put any weight on the leg; the limb remains at maximum rest.

To reduce swelling, the leg should be kept in an elevated position. For example, at night you can put a pillow. The outflow of blood will increase, and swelling will not appear in the morning.

Pain distracts, interferes, brings discomfort to life, so the doctor prescribes painkillers. Now doctors are more inclined to drugs of non-steroidal origin: ibuprofen, Nise and others. They relieve pain, swelling, and reduce the inflammatory response. It is possible to use ointments: fastum, febrofid - they act directly on the lesion.

When these symptoms begin to decrease, the doctor writes a recommendation for physical therapy. This includes electrophoresis using potassium iodide, magnetic therapy, and UHF. After undergoing the procedures, blood flow improves and hematomas resolve.

Possible complications and consequences

A joint bruise is a minor injury, but without treatment complications arise:

• Formation of bone formations (ossifications) in damaged muscles. The problem area becomes swollen and dense. The pathology is treated conservatively or by surgical removal.
• The development of secondary arthrosis, provoked by the impact of a bruise. The cartilage tissue of the joint becomes thinner and exfoliates. There is limited mobility of the hip.
• Morel-Lavallee disease - the epidermis, together with subcutaneous adipose tissue, is sharply separated from the fascia. The resulting cavity is filled with blood or another type of fluid.
• Purulent infection of the hemorrhage area caused by pathogenic microorganisms. Symptoms of complications: increasing pain, fever, weakness.

Main signs

Accompanied by symptoms:

1. The bruised area is swollen;
2. There was an outpouring of blood under the skin;
3. The thigh is enlarged;
4. The bruised area hurts when touched;
5. The function of the knee joint is impaired.

Fall on the thigh Due to a severe bruise, the hemorrhage continues for about a day. The consequence is damage to internal organs located in close proximity to the impacted area.

Due to a serious injury, after a few hours the temperature rises and the lymph nodes become enlarged. Possible hardening of the muscle, pressing down on the swollen muscles by inelastic bones.

A doctor is competent to make a diagnosis of such an injury. It will be necessary to diagnose the patient, palpate the affected area and near it, and check the joints for movement. If, during the examination, the doctor suspects a serious injury, for example, a hip fracture, he has the right to prescribe an x-ray or MRI to examine the soft tissues.

First aid. Scheme of actions before examination by a doctor

Before the patient is taken to the emergency room, the following measures must be taken:

1. The victim should be in a position that is comfortable for him. Optimally - sitting or reclining, with the leg straightened.
2. In order to reduce blood flow, it is advisable to place the limb on a hill. A roller, rolled up towel, pillow, etc. will do.
3. Be sure to apply cold to the bruised area. Frozen fruit, butter, ice, and a bottle of water will do. Make sure that there is no direct contact of the cold with the skin: be sure to wrap it in a scarf or gauze. To avoid excessive hypothermia, you need to maintain certain time intervals between the procedure. For example, apply cold for 10 minutes every hour until the bleeding stops completely.
4. Treat external damage with an antiseptic. Hydrogen peroxide, iodine, brilliant green will do. If you don't have medications on hand, simply rinse with running water.
5. To relieve swelling, apply a tight bandage to the bruise site using an elastic bandage. If there is a change in the color of the limb, you need to loosen the bandage.

Rehabilitation period

The recovery period after a hip joint injury depends on the degree of damage and the regenerative forces of the body. In older people, the rehabilitation process is slow. In the first days after injury, it is advisable to remain in bed. A set of physiotherapeutic procedures helps speed up the recovery process:

• limb massage;
• magnetotherpy;
• laser therapy;
• high frequency currents.

Exercise therapy will help restore mobility to the bone joint and strengthen muscle tone. A set of exercises is selected by the doctor. First they are performed lying on your back. Muscle activity allows you to avoid negative consequences in the form of myositis ossificans.

How to distinguish a femoral neck bruise from a fracture

It is very difficult to do this without hardware diagnostic tests, but certain signs will help determine the possible type of injury. In case of injury:

• Limb shortening is never recorded;
• there is no sign of a “stuck heel” - the person is able to raise the foot in a supine position;
• when palpating the bone structures there is no sharp, acute pain.

It is possible to accurately diagnose the type of damage only after X-rays and computed tomography of the hip.

The main distinguishing feature of a femoral neck bruise from a fracture is the sign that a fracture is characterized by shortening, the person will not be able to move the leg. An additional sign that distinguishes a femoral neck fracture from a bruise is the absence of pain when palpating the bone. The exact diagnostic result is visible with X-rays and CT scans of the hip. Hip bruises often occur in older people.

Specifics of injury in the hip joint

A fall on the side or buttocks in most cases results in injury - a bruise or fracture. A person cannot get up on his own or it is difficult for him to do so and is accompanied by severe pain. It is believed that a bruise should not be taken as a serious circumstance. Just rest for a couple of days and the pain will go away. But in practice, such bruises of the hip joint have complications that prevent the victim from leading an active lifestyle for another 1-3 months. For older people, a pelvic injury can be a reason for complete limitation of mobility and lack of independence until complete recovery.

When the pelvis is contused, depending on the force of the fall or impact, both soft tissue and bone are injured. A symptom of a bruise is acute pain and the formation of a hematoma at the site of impact.

If a pelvic contusion is not accompanied by the formation of a crack, displacement of articular elements or a fracture, then treatment requires following the doctor’s recommendations and staying at home in bed.

Athletes receive blows to the hip joints due to the specifics of their profession, and people involved in a traffic accident. Regardless of the cause of the injury, the degree of damage to the hip joint varies, as evidenced by the symptoms that the victim complains about.

Sources of development

Damage to the lower limb can occur anywhere: at home, at work, in a sports complex, on the street.

Common causes of hip bruises include:

1. Impacts to the problem area with blunt objects;
2. Car crashes;
3. Falls on a slippery surface - in the cold season, on wet linoleum, tiles;
4. Playing sports without the necessary equipment;
5. Neglect of workplace safety rules.

In childhood, most injuries occur due to playing in inappropriate places: construction sites, quarries, roofs of low buildings. Elderly people, due to poor coordination, are injured when falling on ice.

Lip tear

Acetabular lip

The lip of the acetabulum is the soft cartilage tissue that surrounds it; it is responsible for the production of synovial fluid, that is, for lubricating the joint and nourishing the cartilage. The lip is often injured because it is not strong enough, but it undergoes a lot of stress.

Such damage is typical for athletes, in particular, ballerinas and football players, but it can also be caused in everyday life by an unfortunate fall. The pathology is quite insidious, since often the pain from a labral tear is weak and the person does not see a doctor. But pieces of cartilage break off and move around the joint, causing its deformation and degenerative changes, as a result, arthrosis appears.

Symptoms

Symptoms of a labral tear can vary, depending on the severity of the injury. In some cases, the pain is mild, but you should still see a doctor to prevent destruction of the joint.

The following symptoms are typical for this injury:

• Dull, aching pain that appears with active movement, but goes away with rest;
• Possible impairment of motor activity of the joint;
• In some cases, clicking and crunching sounds appear when moving.

Symptoms can sharply intensify, then severe pain, swelling, redness of the skin appears, and movement in the joint is impaired. This indicates that the joint is being destroyed.