DEFINITION--Bruising of skin and underlying tissues of the buttock caused by a direct blow. Contusions cause bleeding from ruptured small capillaries that allow blood to infiltrate muscles, tendons, nerves or other soft tissue.
BODY PARTS INVOLVED
Skin, subcutaneous tissue, tendons, ligaments, blood vessels (both large vessels and capillaries), periosteum (the outside lining of bone), muscles and connective tissue.
SIGNS & SYMPTOMS
Swelling and a hard lump in the injured buttock--either superficial or deep.
Pain and tenderness in the buttock.
Feeling of firmness when pressure is exerted on the buttock.
Discoloration under the skin, beginning with redness and progressing to the characteristic "black and blue" bruise.
CAUSESDirect blow to the buttock, usually by a blunt object.
RISK INCREASES WITH
Contact sports, especially football, ice hockey, basketball and baseball (sliding).
Sports that make falling from a height likely, such as high-jumping, pole-vaulting, skating or gymnastics.
Medical history of any bleeding disorder such as hemophilia.
Inadequate protection of exposed areas during contact sports.
HOW TO PREVENT
Wear protective equipment such as hip pads, when appropriate.
Build adequate muscle strength and achieve good coordination prior to exercise, athletic practice or competition.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's care for precise diagnosis unless the injury is quite small.
Self-care for minor contusions and during rehabilitation for serious contusions.
Physical therapy for serious contusions.
Your own observation of symptoms.
Physical exam and medical history by a doctor for all except minor injuries.
X-rays of the buttocks to assess total injury to soft tissue and to rule out the possibility of underlying fracture. The total extent of injury may not be apparent for 48 to 72 hours following injury.
Excessive bleeding into the buttock 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 injury site is broken.
Fracture of the underlying pelvic bone (frequent complication of buttock contusion).
Injury to the sciatic nerve.
PROBABLE OUTCOMEHealing time varies from 1 to 4 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 (if possible). See Appendix 1 for details.
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 firmly 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 48 hours, apply heat instead of ice if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments or ointments.
Take whirlpool treatments, if available.
Protect the injured area with pads or an elasticized bandage wrap between treatments.
Massage gently and often to provide comfort and decrease swelling.
For minor discomfort, you may use non-prescription medicines such as acetaminophen or ibuprofen (available under many different brand names). Do not use aspirin for injuries involving bleeding.
Your doctor may prescribe stronger medicine for pain, if needed.
ACTIVITYBegin activities slowly and stop exercise as soon as pain begins. Increase activity as healing progresses.
DIETEat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.
REHABILITATIONRehabilitation exercises must be individualized. Follow your doctor's or surgeon's directions.
CALL YOUR DOCTOR IF
A buttock contusion doesn't improve within a day or two.
Signs of infection (drainage from skin, headache, muscle aches, dizziness, fever or a general ill feeling) occur if skin was broken.