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I do combat sports, and in these sports there are a lot of hits that can cause bruising.
I've found that, over time, physical conditioning can reduce and/or eliminate the bruising to the point where even after hard impacts, there is no residual bruising.
However, I was under the impression that it is not possible to "condition" for reduced bruising since bruising is the result of ruptured capillaries, and you can't condition to not rupture blood vessels.
Can someone offer an explanation to why, with conditioning, it is possible to reduce/eliminate bruising?
Bruises are a type of hematoma of tissue in which capillaries and sometimes venules are damaged by trauma, allowing blood to seep, hemorrhage, or extravasate into the surrounding interstitial tissues (reference). From what I read there seems to be two reasons why you notice a reduction in bruising.
The first would be because there is a deadening of nerve cells where they get used to the pain and eventually less sensitive. There could also be the development of some scar tissue from the bruising which has irregularly developed nerve endings leading to lesser stimulation. (reference 1 and reference 2)
The second reason could be because you yourself get stronger. The Wolff's law states that:
Bone in a healthy person or animal will adapt to the loads under which it is placed.1 If loading on a particular bone increases, the bone will remodel itself over time to become stronger to resist that sort of loading.2 The internal architecture of the trabeculae undergoes adaptive changes, followed by secondary changes to the external cortical portion of the bone,3 perhaps becoming thicker as a result (reference).
So, repeated stress on the bones of your face/hands should be make them stronger. I don't think your body can adapt to heal faster in an area from repeated bruising as most likely scar tissue will develop from repeated stress on the skin. You can however improve your nutrition and diet to help your body heal better (reference).
Do you bruise more easily now than you did when you were younger? Totally normal. As you age, your skin gets thinner and loses the protective layer of fat that acts as a cushion when you bump into something. Also, your blood vessels get more fragile. Both of these things mean you get more bruises.
If you take aspirin or a blood thinner, don't be surprised by the occasional black-and-blue mark. Some supplements, like fish oil and ginkgo, can do it too.
Steroids like prednisone can also cause easy bruising, because they thin the skin. If you notice this happening, don't stop taking your medication, but do talk to your doctor about it.
What causes hemosiderin staining?
Hemosiderin staining can essentially be regarded as a very severe form of bruising. Staining happens in areas where a significant amount of bruising has occurred as a result of severe injuries, hemorrhages or, in certain cases, after a particularly invasive surgery.
When damage occurs, the surrounding tissue is flooded with blood and a bruise forms. The more severe the trauma, the more blood that leaks into surrounding tissues, signifying a greater presence of hemosiderin.
It is difficult for the body to access the iron in hemosiderin. This, combined with the fact that iron is responsible for the coloration of hemosiderin, results in prolonged staining that is visible on the surface of the skin.
Other than trauma, staining can also be a by-product of serious life-threatening conditions such as high blood pressure and heart disease.
“When vein valves fail, regurgitated blood forces red blood cells out of capillaries,” explains Dr. Alex Roher of San Diego Botox. One of the more common reasons for valves leaking is chronic venous insufficiency (CVI), a condition where malfunctioning leg valves make blood flow difficult in an area. This creates pools of blood that result in hemosiderin staining.
Because bruises are usually the direct result of an injury, the following are important safety recommendations:
- Teach children how to be safe.
- Be mindful to avoid falls around the house. For example, be careful when climbing on ladders or other objects. Avoid standing or kneeling on counter tops.
- Wear seat belts in motor vehicles.
- Wear proper sports equipment to pad those areas most frequently bruised, such as thigh pads, hip guards, and elbow pads in football and hockey. Wear shin guards and knee pads in soccer and basketball.
Other Causes of Unexplained Bruising
There are some serious advanced medical conditions that can also cause unexplained bruising on your body. Usually, these diseases are accompanied by other symptoms and random bruising occurs in the later stages of the disease.
Serious liver disease can cause easy bruising because the liver can’t produce enough blood clotting factors.
Dr. Dennis Lee on MedicineNet says that along with random bruises, liver disease can turn the skin yellow and cause all over body itching. Liver disease may also make legs swell and cause intestinal bleeding. 18
Easy bruising is sometimes a symptom of the late stages of chronic kidney disease.
Dr. Charles Silberberg, says that a person with advanced kidney disease may also have drowsiness, numbness in hands and feet, breath odor, blood in the stool, and/or vomiting in the mornings. 19
Some cancer treatments can affect blood platelets causing easy bruising and bleeding that is difficult to stop. The National Cancer Institute says that chemotherapy can cause random bruising, as well as tiny purple or red spots on your skin. 20
An unexplained bruise on your breast that doesn’t go away could be a sign of inflammatory breast cancer. Other symptoms of inflammatory breast cancer are painful breasts that suddenly swell, itching, and nipple changes or discharge. 21
Another type of cancer that can cause easy bruising is leukemia. The American Cancer Society says that leukemia can cause a number of symptoms including weight loss, constant tiredness, recurrent infections, and unexplained bleeding. 22
Although in rare cases random bruising can be a sign of a serious condition, the bruising will be accompanied by many other symptoms. It’s good to remember that in most cases the cause of unexplained bruising is nothing to worry about.
- Call the doctor if the bruise is accompanied by swelling and extreme pain, especially if you take a blood-thinning medication for a medical condition.
- Call the doctor if bruising occurs easily or for no apparent reason.
- Call the doctor if the bruise is painful and under a toenail or fingernail.
- Call the doctor if a bruise does not improve within two weeks or fails to completely clear after three or four weeks.
- Go to an emergency room if you think you have a broken bone along with the bruise.
- Some bruises, such as those on the head or the eye, can cause a lot of anxiety.
- If a bruise (sometimes called a "goose egg") occurs on the head, but the person did not black out and is able to remember the accident, it is unlikely that a serious head injury has resulted. On the other hand, if the person cannot remember what happened and you suspect the person may have a concussion, they should be taken to the nearest emergency room.
- If a bruise occurs just above the eye, you can expect the bruise to travel to the area just under the eye, possibly causing a black eye, because of the effects of gravity. As long as you are able to move the affected eye in all directions and do not have changes in your vision, it is unlikely to be a serious injury that requires a visit to the hospital.
If an injury is obviously a bruise and the doctor does not suspect any broken bones, the doctor will probably not perform any tests.
- If there is swelling or severe pain, the doctor may want to get an X-ray of the area to make sure there are no broken bones.
- If bruising occurs frequently and for no apparent reason, the doctor may have your blood tested to look for a bleeding disorder.
- Certain bruises, a pattern of bruises over time and in various stages of healing may alert a doctor to the possibility of physical abuse.
HELLP syndrome is a pregnancy complication that affects the blood and liver. It’s a medical emergency that needs quick treatment.
Signs and symptoms of HELLP include blurry vision, chest pain or pain in the upper right or middle part of the belly, swelling and throwing up.
If you have signs or symptoms of HELLP, call your health care provider or emergency services (911) or go to a hospital emergency room.
If you have HELLP, you may need to give birth as soon as possible because complications can get worse and harm you and your baby.
Go to all your prenatal care checkups, even if you’re feeling fine. They allow your provider to find and treat HELLP early.
What is HELLP syndrome?
HELLP syndrome is a serious pregnancy complication that affects the blood and liver. HELLP stands for these blood and liver problems:
- H--Hemolysis. This is the breakdown of red blood cells. Red blood cells carry oxygen from your lungs to the rest of your body.
- EL--Elevated liver enzymes. High levels of these chemicals in your blood can be a sign of liver problems.
- LP--Low platelet count. Platelets are little pieces of blood cells that help your blood clot. A low platelet count can lead to serious bleeding.
HELLP syndrome is rare. It happens in about 1 to 2 of 1,000 pregnancies. HELLP usually develops in the third trimester of pregnancy, but it sometimes develops in the week after a baby is born. If you have HELLP syndrome, the liver may bleed, causing pain in your chest or belly. It’s is a medical emergency that needs quick treatment. Without early treatment, 1 out of 4 women (25 percent) with HELLP has serious complications. Without any treatment, a small number of women die.
If you’ve had HELLP syndrome in a past pregnancy, tell your provider. Getting early and regular prenatal care can help reduce your risk of having HELLP again. Going to all your prenatal care checkups allows your health care provider to find and treat problems like HELLP early.
HELLP syndrome usually goes away after giving birth.
What causes HELLP syndrome?
We don’t know what causes HELLP syndrome. You’re at risk for HELLP if you have preeclampsia or eclampsia. About 1 to 2 in 10 pregnant women (10 to 20 percent) with preeclampsia or eclampsia develop HELLP. Preeclampsia is a serious blood pressure condition that can happen after the 20th week of pregnancy or after giving birth (called postpartum preeclampsia). It’s when a woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working normally. High blood pressure (also called hypertension) is when the force of blood against the walls of the blood vessels is too high. It can stress your heart and cause problems during pregnancy. Eclampsia is when preeclampsia is uncontrolled and causes seizures. Seizures are sudden, abnormal electrical activity in the brain that can cause changes in behavior, movement, feelings and consciousness.
What are signs and symptoms of HELLP syndrome?
Signs of a condition are things someone else can see or know about you, like you have a rash or you’re coughing. Symptoms are things you feel yourself that others can’t see, like having a sore throat or feeling dizzy. Signs and symptoms of HELLP syndrome can appear during pregnancy or after giving birth. Some women develop HELLP suddenly, without having any signs or symptoms.
Signs and symptoms of HELLP syndrome include:
- Blurry vision
- Chest pain or pain in the upper right or middle part of the belly
- Headache, fatigue (feeling really tired) or feeling unwell or throwing up that gets worse
- Quick weight gain and swelling
- Nosebleed or other bleeding that doesn’t stop. This is rare.
- Seizures or convulsions. This is rare. Convulsions are when your body shakes quickly and without control.
If you have any signs or symptoms of HELLP syndrome, call your health care provider or emergency services (911) or go to a hospital emergency room for medical care right away.
Signs and symptoms of HELLP syndrome are the same as for other health conditions. So sometimes HELLP is misdiagnosed as:
- Flu or other illness caused by a virus
- Gallbladder disease. The gallbladder is an organ under your liver that stores bile, a fluid your liver makes to help the body break down fat.
- Hepatitis. This is inflammation (swelling) of the liver.
- Idiopathic thrombocytopenic purpura (also called ITP). This is a bleeding disorder. If you have ITP, you may bruise easily or have a lot of bruising (also called purpura). You also may bleed easily or heavily. For example, you may have bleeding from the gums or nose or bleeding into the skin that looks like a rash of pinpoint red spots.
- Lupus flare. A lupus flare is a period of time when you have many or intense lupus symptoms. Lupus is an autoimmune disorder that can cause health problems during pregnancy. Autoimmune disorders are health conditions that happen when antibodies (cells in the body that fight off infections) attack healthy tissue by mistake. Lupus and other autoimmune disorders can cause swelling, pain and sometimes organ damage. Lupus also can affect joints, skin, kidneys, lungs and blood vessels.
- Thrombotic thrombocytopenic purpura. This is a rare condition that causes blood clots to form in small blood vessels throughout the body. These clots can cause serious health problems if they block the flow of blood to organs, like the brain, kidneys and heart.
What health problems can HELLP cause?
- Bleeding and blood clotting problems. Some women with HELLP develop disseminated intravascular coagulation (also called DIC). This is a blood clotting disorder than can lead to heavy bleeding (also called hemorrhage).
- Fluid buildup in the lungs (also called pulmonary edema). This can cause breathing problems.
- Kidney failure
- Liver hemorrhage or failure . This is a serious condition in which the placenta separates from the wall of the uterus before birth.
How is HELLP syndrome diagnosed?
To find out if you have HELLP syndrome, your provider does a physical exam to check you for:
- Belly pain or soreness, especially in the upper right side
- An enlarged liver
- High blood pressure
- Swelling in your legs
Your provider may do blood tests to check your liver enzyme levels and your platelet count. He may do a CT scan to see if there’s bleeding in your liver. A CT scan is a test that uses X-rays and computers to take pictures of your body.
Your provider may do tests like a non-stress test or ultrasound to check your baby’s health. A non-stress test (also called NST or fetal heart rate monitoring) checks your baby’s heart rate in the womb to see how the heart rate changes when your baby moves. Your provider uses this test to make sure your baby’s getting enough oxygen. Ultrasound uses sound waves and a computer screen to show a picture of your baby inside the womb.
Many women are diagnosed with preeclampsia before they have HELLP. Sometimes signs and symptoms of HELLP symptoms are the first signs of preeclampsia.
How is HELLP syndrome treated?
If you have HELLP, your provider may give you medicine to control your blood pressure and prevent seizures. You may need a blood transfusion. This is when you have new blood put into your body.
If you have HELLP syndrome, you may need to give birth as soon as possible. This may mean that your baby is born prematurely, before 37 weeks of pregnancy. Early birth may be necessary because HELLP complications can get worse and harm both you your baby. If you’re giving birth early, your provider may give you medicines called antenatal corticosteroids to help speed your baby’s lung growth. Your provider can induce labor (make labor start) with medicine or other methods. Or you may have your baby by cesarean birth (also called c-section). This is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus.
How common is it?
Naturally occurring thrombocytopenia affects about one in 30,000 adults a year in the United States.
As for the suspected vaccine-induced kind, according to data collated by the Thrombosis and Haemostasis Society of Australia and New Zealand, VIPIT is as rare as one in 500,000 people. But the society notes the data are incomplete.
Different countries have reported different rates. Norway, for example, has so far reported one in 25,000 vaccinated adults under the age of 65 have experienced low platelet counts, bleeding, and widespread thromboses (blood clots).
Of course, the possibility that some of these cases of thrombocytopenia may have occurred regardless of the vaccine makes understanding vaccine-induced cases more complicated. But taken together, thrombocytopenia appears to be more common in the general population than among those who have been vaccinated.
As we continue to vaccinate the world, it’s likely small subsets of people will continue to experience this complication. Whether we can establish a causal link between the AstraZeneca vaccine and thrombocytopenia is subject to continued investigation.
Types - Bleeding Disorders
Bleeding disorders can be inherited , or they can be acquired, meaning you develop them during your lifetime. Acquired bleeding disorders are more common than inherited bleeding disorders.
You may develop a bleeding disorder if something in your body, such as a disease or a medicine, causes your body to stop making blood clotting factors or causes the blood clotting factors to stop working correctly. In addition, problems with your blood vessels can lead to bleeding.
Acquired bleeding disorders include:
Inherited bleeding disorders include the following:
- Combined deficiency of the vitamin K–dependent clotting factors (VKCFDs), caused by a problem with clotting factors II, VII, IX, and X.
- HemophiliaA, a condition in which you are missing clotting factor VIII or have low levels of clotting factor VIII. Hemophilia A is the most common type of hemophilia.
- Hemophilia B, a condition in which you are missing clotting factor IX or have low levels of clotting factor IX.
- Hemophilia C, a rare condition also known as factor XI deficiency.
- Von Willebrand disease (VWD), the most common inherited bleeding disorder. The different types of VWD are numbered based on how common the condition is and how severe the symptoms are. For example, VWD 1 is the most common, and symptoms are usually mild, and VWD 3 is uncommon with symptoms that are usually severe.
- Other inherited bleeding disorders include other factor deficiencies, such as I, II, V, V + VIII, VII, X, XI, or XIII deficiencies. These rare bleeding disorders are named by the clotting factor causing the problem. is a rare inherited condition in which your blood vessels get tangled in different parts of the body, which can lead to bleeding.
Ways to Manage Bleeding and Bruising
Steps to take if you are at increased risk of bleeding and bruising:
- Avoid certain medicines. Many over-the-counter medicines contain aspirin or ibuprofen, which can increase your risk of bleeding. When in doubt, be sure to check the label. Get a list of medicines and products from your health care team that you should avoid taking. You may also be advised to limit or avoid alcohol if your platelet count is low.
- Take extra care to prevent bleeding. Brush your teeth gently, with a very soft toothbrush. Wear shoes, even when you are inside. Be extra careful when using sharp objects. Use an electric shaver, not a razor. Use lotion and a lip balm to prevent dry, chapped skin and lips. Tell your doctor or nurse if you are constipated or notice bleeding from your rectum.
- Care for bleeding or bruising. If you start to bleed, press down firmly on the area with a clean cloth. Keep pressing until the bleeding stops. If you bruise, put ice on the area.
Bruises -Types, Causes, Factors, Color Changes and Significance
Extravasation of blood into the tissues due to rupture of capillaries, venules and small arterioles usually as a result of trauma, is called a bruise.
Types of Bruises
Depending on the location, bruises are classified into:
- Blunt trauma is the common cause of bruising, e.g. with stick, stone, stick or fist.
- Pathological bruising may also occur due to trivial trauma, as in hemophilia and other bleeding disorders.
Bruises often co-exist with abrasions and lacerations. The degree of violence required to produce bruise varies from firm gripping to heavy blows, depending on many other factors.
Factors Affecting Bruising
1. Tissue type
Loose connective tissue type sites e.g. eye, face, genitalia, show more bruising. Bruises are also more marked in sites overlying bones, but are rarely seen on the scalp, palms or soles.
2. Severity of Trauma
More severe is the trauma, more bruising occurs
Infants and elderly bruise easily. Infants have loose and delicate skin while elderly have lost elasticity of skin and blood vessels
Women bruise more easily than me
5. Skin color
Fair skinned persons have more obvious bruises
Blood dyscrasias, hypertension patients bruise more easily.
7. Gravity Shifting
Fascial planes more prevent blood from torn vessels to reach the surface, thus bruise appears in remote areas. E.g.
- a person having fracture of upper end of humerus may show bruising in elbow
- a person hit on forehead may show bruising over eyes (Spectate hematoma, black eye)
- fall on the vertex –bruise may be behind the ear (Battle’s sign)
Aging of Bruise/Color Changes
These are due to degradation products of blood.
Color Approximate Time Cause Red Fresh Hemoglobin Blue 24 hours Deoxygenated hemoglobin Bluish black 2-4 days Hemosiderin Greenish 5-7 days Biliverdin Yellow 7-10 days Bilirubin Disappears 2-4 weeks
Exception is subconjunctival hemorrhage (or bruise, black eye) which follows the following sequence: