Can Bruises Cause Serious Blood Clots?

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This survival-medicine website provides general information, not individual advice. Most scenarios assume the victim cannot get expert medical help. Please see the disclaimer.

Can a Bruise Cause a Serious Blood Clot?

Bruised legby James Hubbard, M.D., M.P.H.

I see this fairly often. Someone comes in with a whopper of a bruise, maybe with a lump, and they’re afraid it’s a blood clot. In a disaster situation, you’re likely to get some bruises, but you won’t be able to come see me. Should you worry?

In short, probably not. You do have clotted blood, but there are blood clots and there “blood clots.” In fact, if your blood doesn’t clot, you could bleed to death.

Bruise-related clotting happens in tissue outside the blood vessels. That’s where the bleeding occurred. What you’re really worried about is a deep-vein thrombosis (DVT)—a clot that forms inside a deep-in-the-tissue vein and can break off and travel to the lungs. DVTs are different, serious, and sometimes lethal.

So a bruise isn’t a serious blood clot. However, can a bruise cause a serious blood clot? No, but the hit that caused the bruise can—though that’s rare.

If the trauma that caused the bruise injures a large and deep-seated vein’s wall, it could make conditions right for a deep-vein clot to form. These veins are deep in the tissue and have to be hit just right. Compared with the number of bad bruises people get, this is rare as hen’s teeth and has to do with the injury to the vein’s inner wall. The bruise to the soft tissue is incidental.


How Can You Tell Whether You Have a DVT?

Even doctors can have a tough time telling whether you have a DVT. Sometimes one forms with very few outside signs. But suspect it if your arm or leg swells and becomes painful—trauma or no trauma.

Since DVTs often form in the calves, one test is the Homans’ sign. Simplified: You lie down, toes up. The doctor takes hold of your relaxed foot’s sole and quickly flexes your foot, pushing your forefoot back. Significant pain in the calf points toward a deep-venous blood clot. But positive Homans’ sign or not, If the doctor is suspicious, he or she will order a special type of ultrasound test that looks inside the veins to find out for sure. If you have DVT, you’ll be started on a blood thinner.

If you can’t get medical help, your best bet for a swollen, red extremity is to keep it immobile, elevate it at heart level or above, and apply a moderate amount of heat to the area. Get to a doctor as soon as you can.


So What If You Have a Bad Bruise That’s Bothering You?

For a bad bruise, treat it with RICE. That’s

  • Rest
  • Ice. Use a commercial type, a frozen bag of vegetables, or ice in a zip-close bag. Put a cloth between the ice and skin. Use it for something like ten minutes on, ten minutes off, repeat.
  • Compression with an elastic bandage—firm, but not to tight. Loosen as needed.
  • Elevation at heart level or above.

Unlike with DVT, using the extremity poses no threat if you just have a bruise.


What If Only the Bruise Is Swollen?

Sometimes, the area bleeds enough for blood to pool in the soft tissue. If this happens, a localized area will be swollen, even baggy. This is called a hematoma. Other than the RICE, leave it alone. It may even shrink to a smaller, firm spot—a blood clot. But it’s outside the blood vessels. To try to drain it outside of a medical facility is to risk infection.

Don’t be surprised if a large area of discoloration shows up days later. It may even travel with gravity down to areas not bruised. That’s a good thing. The blood from the hematoma is spreading out and will be absorbed.


Bottom Line?

Bruise or no bruise, if your extremity swells or hurts, see a health-care professional. You never know. But don’t get too concerned with some marble-sized knot after a fall.

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Photo by Matt Gibson.

  • Gorgia

    Got a lump on my inner forearm a while ago, shocking me because I didn’t realize that trying persistently to no good end to start a weed-whacker could cause such trauma, I didn’t notice I had done it till I saw the bigger than a golf ball sized lump on my inner arm later. Even later the lump dissipated and bruised something just as big looking but in a shape like a German Shepherd face. Also the meaty part of my thumb was bluer than usual. Now the bruise is much less, just where the ears of the “face” was… but my upper arm and bicep and arm muscle in general is achy as all be especially after flexing my muscle in the slightest to do things. I was worried this meant a blood clot could be travelling up toward my brain or somewhere, as the pain had reached the inner part of my bicep arm-area. That’s a ridiculous worry right? Guess time will tell. Thanks for mentioning the “rare as hens teeth” idiom.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Gorgia, probably you strained your biceps muscle as well. Sometimes people rupture the biceps tendon, which causes a “popeye” type, noticeable bulge in the muscle when you flex it.

  • Guest

    photo

  • Guest

    heres a photo

  • Jill Fleetwood

    I went wakeboarding this weekend, for the first time in years. Afterwards, I saw this large bruise below the back of my knee. I’m not sure when this happened. It’s impossible for the board to hit me right there, and I didn’t have a hard fall. I literally asked the driver to stop and slowly let go into the water. It is swollen (bumped out) and about 2″ across and 2″ tall. Could this be a blood clot as in deep vein thrombosis? I’m going to schedule a doctor’s appointment, but am a little worried. It is very tender to the touch and a little painful just sitting there.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Jill, I can’t diagnose you specifically, but in general something like that is more like I describe in the post.

  • Dean

    Hey,

    i had a haemotema diagnosed a couple of weeks back

    Playing soccer I got a kick which swelled something rotten initially and was very ore and stiff.

    Now the swelling has subsided somewhat, however I’m left with a very painful tennis ball shaped thing on my leg which throbs constantly and severely hurts when I walk. Could this be a clot?

    • Dean

      Sorry for the double post, thought I’d deleted the guest one

  • Dean

    Hey,

    I took a kick to the thigh around 11 days ago playing football (soccer).

    Initially it swelled up something rotten,….(see first pic)

    I had this diagnosed as a haemotoma and was told the bruising would ease up along with the pain over time, and that the pain shouldn’t last too long, and just to take ibuprofen for the pain.

    Although the bruising had subsided somewhat, I’m now left with a thick, solid tennis ball shaped thing on my leg which is VERY painful, constantly throbbing (the pain with the swelling was more related to stiffness than throbbing). Is this normal? Would this be a sign of a clot? (see 2nd pic)

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      See the post part about what if the bruise is swollen. But since the swelling is so large and painful, I’d see a doctor to have it checked out.

  • Becky

    Hi there…. I had a vein randomly swell and then rupture. They told me it was a vericose vein rupture even though I never had a vericose vein there that I was aware of. It’s on the inside of my left knee. Anyway, in a matter of minutes it swelled (the vein) then ruptured. I experienced itching first then saw the swelling of the vein and bruising. I now have a very large bruise but no knot. This just weirded me out a bit because the doctors couldn’t tell me why a vein would rupture like that. My thought process was that maybe a clot was blocking the vein and caused it to suddenly swell then rupture. Anyway… I’ve been looked at by two different docs neither of which are concerned about a clot. My leg is slightly achey in general but they are telling me it’s normal…. It doesn’t seem normal but I guess I’ve not had a vein rupture before. I spent many hours in a car the precious week driving from Florida to Illinois and back for a trip to disney world. Even with that my doctors are not concerned with a clot. Should I insist on some kind of further check or just accept this?

    • Synthia Fagen

      Becky, I had this EXACT same thing happen to me in the exact same place, yesterday. Can you write an update here? Any other findings? Has it happened since? Thank you!

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Becky, I can’t tell you specifically in your case but, in general, sometimes a vein just leaks for no apparent reason. Maybe the wall got a little weak or was defective. Also, a varicose vein has to start at some point in time. In other words, one day there’s nothing, the next day there’s a swelling or bulge in a vein. If you’re really worried something’s wrong, you could insist on a duplex ultrasound of the area however, without much in the way of symptoms, insurance may or may not pay for it.

  • Andrew Cooper

    Got a knock at a football game on Saturday this is what it was like Sunday morning, I don`t feel any discomfort and have full movement of my arm, the blood has spread a little over the next couple of days but seems to be dissipating now. Not been to a GP yet as i feel no hard pain, just a aching where the impact was.Is this OK

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      I can’t make a specific diagnosis without a direct exam. All I can do is give you general information like what’s in the post (see What If The Bruise is Swollen). If you have concerns you should check with your doctor.

  • Brav0holic

    Hi, I did this 10 days ago. I barely bumped it on something and it caused an instant ‘goose egg’ I know the photo doesn’t look too bad, but what concerns me is the continual aching, radiating pain. Also, there is yellowish bruising behind the calf?.And a few months ago, the Dr said I was anemic. I was tested again and it was back to normal. Should I be concerned about this hard bump that wont stop hurting? Like I said I barely hit it.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      If the area is painful and not getting better, you should see a doctor. If it is just inflamed, heat and ibuprofen should help. However, there’s no way I could diagnose one way or the other without an exam.

      • Brav0holic

        Thanks so much. I’ll give them a call. Im due for an appt anyways.

  • Brav0holic

    I knocked my shin on something I cant recall what, but I know it wasn’t that hard as I kept on moving. This was