| WHAT COACHES SHOULD KNOW Bruises |
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| Abrasions |
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Though they are less serious injuries, bruises and abrasions are two of the most common injuries in sports. Most are not reported to the coach or athletic trainer unless they interfere with participation. They usually can be managed with simple measures, and the athlete may miss little if any time from the sport. Coaches can treat and protect their players from further injury.
Bruises are simply areas of bleeding trapped under the skin. When an area of bruising is caused by blunt force to the injured area, it is called a contusion. Bruises are often associated with falls or being struck by another object such as a helmet or football. This force causes the small blood vessels in the skin to burst and bleed into the soft tissue. The blood then gives the area its characteristic color that changes as the blood is reabsorbed.
Sometimes bruising is caused when a muscle or ligament is torn or a bone is fractured. In these cases, the bleeding is not caused by blunt force, but the appearance of the skin is basically the same. The bruised area is referred to as an ecchymosis. An area of ecchymosis can also happen for no apparent reason in people with bleeding disorders. Any player that has an area of ecchymosis or bruising should undergo prompt medical evaluation when it occurs for no reason or when a broken bone or muscle or ligament tear is suspected.
Bruises should be treated initially by applying cold compresses or ice along with elevation of the affected area above the level of the heart. This will decrease local bleeding and swelling. The affected body area should also be checked for a fracture, or a muscle or ligament tear. If swelling and pain are severe, a fracture should be suspected and the injury should be evaluated immediately by a physician.
With abrasions, there may be external bleeding and the skin may be scraped away. Abrasions are typically caused by friction between the skin and a rough surface. Players and coaches often refer to superficial abrasions as "strawberries." The athletic trainer and/or the team physician should evaluate very large or deep abrasions.
A coach or responder should always use a barrier, such as latex or vinyl gloves, when there is a chance of coming into contact with blood or other body fluids. Clean an abrasion with warm soapy water immediately even if the incident occurs on artificial turf. If the injury is particularly dirty, a soft brush should be used to dislodge any imbedded particles. Keeping the injury moist with antibiotic ointment and covering with a sterile bandage helps it heal faster.
| An abrasion should be observed over several days after the incident for signs of infection. The signs of infection include: |
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If any of these signals appear, consult a physician immediately.
Most bruises and abrasions are benign and do not require a visit to the physician, but coaches should be able to recognize them and know how to care for an injured player. They should also be able to recognize more serious associated injuries and seek prompt medical attention.
MORE READING
American Medical Association. (1990). The American Medical Association handbook of first aid and emergency care. Random House: New York.
Andrews, J., Clancy, W.G., Jr., & Whiteside, J.A. (Eds.). (1997). On field evaluation and treatment of common athletic injuries. St. Louis, MO: Mosby.
Gallaspy, J.B., & May, D. (1996). Signs and symptoms of athletic injuries. St. Louis, MO: Mosby.
The evaluation of any athlete, whether as a part of health evaluations prior to activity or as a diagnosis of an injury as the consequence of sports activities, is specific to that individual and the history and current state of the individual presented. Advice, diagnosis and treatment is individualized according to numerous factors, including patient health and age information, medical history and symptoms. All athletes should be cleared by a physician or other appropriate medical professional before engaging in physical activities and, after injury, diagnosis and treatment, for return to play.