On Saturday’s float down the river with Damsel’s I was extra careful in everything I did. I did not want any mishaps, broken bones or any bad ju ju that can occur from time to time….especially as prone to being a clutz as I am.
At one point I had to do the squat and go to the bathroom in the deep recesses of the woods. On my way back, I was in a bit of a hurry as I didn’t want to delay the boat any further. Somehow I bumped my leg on a log along the way back. I didn’t recall much until I got in the boat and I felt a sharp pain. I also didn’t really think about it until that evening after my shower I was laying on my bed and my leg was thumping…. the bump had turned into a nasty bruise. I decided to look up the definition….eeek.
WIKIPEDIA SAYS: bruise, also called a contusion, is a type of relatively minor hematoma of tissue in which capillaries and sometimes venules are damaged by trauma, allowing blood to seep into the surrounding interstitial tissues. Bruises can involve capillaries at the level of skin, subcutaneous tissue, muscle, or bone. A bruise may be named by the length of its diameter as an petechia (less than 3 mm), purpura (3 mm to 1 cm) or ecchymosis (1 to 3 cm), although these terms can also refer to internal bleedingnot caused by trauma.
As a type of hematoma, a bruise is always caused by internal bleeding into the interstitial tissues, usually initiated by blunt trauma, which causes damage through physical compression and deceleration forces. Trauma sufficient to cause bruising can occur from a wide variety of situations including accidents, falls, and surgeries. Disease states such as insufficient or malfunctioning platelets, other coagulation deficiencies, or vascular disorders, such as venous blockage associated with severe allergies can lead to the formation of bruises in situations in which they would not normally occur and with only minimal trauma. If the trauma is sufficient to break the skin and allow blood to escape the interstitial tissues, the injury is not a bruise but instead a different variety of hemorrhage called bleeding, although such injuries may be accompanied by bruising elsewhere.
Bruises often induce pain, but small bruises are not normally dangerous alone. Sometimes bruises can be serious, leading to other more life-threatening forms of hematoma, such as when associated with serious injuries, including fractures and more severe internal bleeding. The likelihood and severity of bruising depends on many factors, including type and healthiness of affected tissues. Minor bruises may be easily recognized in people with light skin color by characteristic blue or purple appearance (idiomatically described as “black and blue”) in the days following the injury.
Increased distress to tissue causes capillaries to break under the skin, allowing blood to escape and build up. As time progresses, blood seeps into the surrounding tissues, causing the bruise to darken and spread. Nerve endings within the affected tissue detect the increased pressure, which, depending on severity and location, may be perceived as pain or pressure or be asymptomatic. The damaged capillary endothelium releases endothelin, a hormone that causes narrowing of the blood vessel to minimize bleeding. As the endothelium is destroyed, the underlying von Willebrand factor is exposed and initiates coagulation, which creates a temporary clot to plug the wound and eventually leads to restoration of normal tissue.
During this time, larger bruises may change color due to the breakdown of hemoglobin from within escaped red blood cells in the extracellular space. The striking colors of a bruise are caused by the phagocytosis and sequential degradation of hemoglobin to biliverdin to bilirubin to hemosiderin, with hemoglobin itself producing a red-blue color, biliverdin producing a green color, bilirubin producing a yellow color, and hemosiderin producing a golden-brown color. As these products are cleared from the area, the bruise disappears. Often the underlying tissue damage has been repaired long before this process is complete.
Well all this medical mumbo jumbo, makes some sense, but I also know it hurts…and you should be mindful of where you are walking on a trail to use the bathroom. 🙂
Severity of bruises
Bruises can be scored on a scale from 0-5 to categorize the severity and danger of the injury.
|Harm score||Severity level||Notes|
|0||Light bruise||No damage|
|1||Less than Moderate bruise||Little damage|
|2||Moderate bruise||Some damage|
|4||Extremely serious bruise||Dangerous|
|5||Critical bruise||Risk of death|
The harm score is determined by the extent and severity of the fractures to the organs and tissues causing the bruising, in turn depending on multiple factors. For example, a contracted muscle will bruise more severely, as will tissues crushed against underlying bone. Capillaries vary in strength, stiffness and toughness, which can also vary by age and medical conditions.