Thoracic Contusion

Brief Outline of Thoracic Contusion

A contusion is a closed wound to the body’s soft tissue, resulting from a blow to muscle, tendon, or ligament. Contusion injuries cause bruising and often, discolouration, due to blood pooling around the site of the trauma. Contusions of the back are possible in a variety of contact sports like football and hockey, due to violent force applied to the soft tissues, or as the result of a fall on the back.

Anatomy and physiology

Contusions involve trauma to subcutaneous tissue. Because the musculature is well vascularised and the regional blood flow is usually high at the moment of impact, bleeding occurs from torn blood vessels into the skin and subcutaneous tissues, forming a bruise or ecchymosis (discolouration of an area of the skin). Capillaries are damaged due to blunt force, resulting in a blood seeping into the surrounding tissue. While most contusions acquired in the course of sports activity are minior, some are symptomatic of serious injuries including fractures or internal bleeding.

Cause of Thoracic Contusion

Overloading or overstretching muscles through a blow to the back from another athlete during contact sports. Blow from sports equipment, especially hockey and lacrosse. Hard fall on the back.

Signs and symptoms

Pain at injury site. Tenderness to the touch. Blue, purple, orange or yellow discolouration of the skin. Painful spasms and knot-like contractions (which act as a protective mechanism).

Complications if left unattended

Contusions may indicate more serious underlying conditions, including fracture, haematoma (blood in muscle), or other internal bleeding, all of which should receive prompt medical attention. Minor contusions generally clear up in a matter of days without complication. More severe cases, however, may require 3 – 4 weeks to heal.

Treatment

  • Rest
  • Ice
  • Medication
  • Injection
  • Physiotherapy

Rehabilitation and prevention

Avoiding pressure or further trauma to the contusion site and application of ice are usually sufficient to speed recovery. As contusions result from blunt force accidents, they are generally not preventable, though proper conditioning and diet (including an abundance of vitamin C) may lessen the severity of contusion. Follow-up management may include application of superficial heat, ultrasound, massage, and appropriate stretching and resistance exercise.

Long-term prognosis

While contusions in the back can produce significant acute pain, they are faster to heal than muscle strains or ligament sprains. Severity of bruising depends on many factors, including muscle tension or relaxation at the time of injury. Pain will generally subside in hours or days and skin discolouration will abate as well. The athlete should enjoy a full return to activity, in more severe cases after about 4 weeks, without lasting deficit.

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