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Soft Tissue Injuries: Sprains, Strains, Bumps, and Bruises

You step off the curb and twist your ankle. You bang your head a little too hard on an open closet door and feel a bump forming. You fall on your knee and the bruise is a shade of purple you've never seen.

How do you know when these minor soft tissue injuries are severe enough to see a health care provider? And if you should see a doctor, where do you go?

UPMC's doctors can see sprains, strains, bumps, bruises, and other minor musculoskeletal injuries. We can often see you the same day, so you can avoid a trip to the emergency room.

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What Is a Soft Tissue Injury?

If bone is your hard tissue, soft tissue refers to your muscles, ligaments, and tendons. Soft tissues connect and protect your bones and other structures.

When you fall, collide with something hard, or suffer a blow, you can damage your soft tissue. This causes pain, swelling, and often bruising. Sometimes, you may even have a lump.

What are the most common types of soft tissue injuries?

The most common soft tissue injuries are:

  • Contusions (bruises). A bruise happens when blood leaks into the tissue under your skin. A direct blow with a blunt object or a fall onto a hard surface are common reasons for bruises. Most of the time, you can treat bruises at home. Learn how from UPMC HealthBeat.
  • Hematomas (bumps). When blood pools under your skin, it creates a lump. Like bruises, bumps tend to happen as a result of a blow or a fall. Most heal on their own.
  • Sprains. Sprains happen to ligaments, the strong tissue that connects bones together. A sprain means you've stretched the ligament and damaged some of its fibers. Ankles, knees, and wrists are the most common sprains.
  • Strains. Strains happen to muscles and tendons (tendons attach muscles to bones). People sometimes also call this a "pulled muscle." Common strains include hamstrings, the Achilles tendon, and the muscles of your low back.

What causes soft tissue injuries?

As a rule, trauma causes soft tissue injuries. The trauma can be so small that you almost forget about it until you see the bruise. Or it can be more serious, like a car crash or a bad fall.

People tend to wind up with bruises, bumps, sprains, and strains because of:

  • Slipping and falling, which causes a sudden impact to your soft tissue.
  • Twisting, which stretches and puts tension on your soft tissue.
  • Blunt force, like a blow or a collision with something.

The other big cause of soft tissue injuries involves overuse. Overuse injuries, like tendonitis and bursitis, are more chronic issues. These injuries happen over time and are often sports injuries.

Soft tissue injury complications

Many soft issue injuries heal on their own. Even the most purple bruise will get better with basic home care.

But sometimes a deep muscle bruise can cause painful swelling and lead to a problem called compartment syndrome. If your bruise keeps getting worse, and you start to have numbness and weakness, call the doctor.

As for sprains and strains, if the damage is severe, like a torn ligament or ruptured tendon, it causes instability. Without treatment, you can cause further damage to the ligament or tendon. You'll usually know if a strain or sprain is severe because you'll have limited mobility and severe pain.

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What Are the Signs and Symptoms of Soft Tissue Injuries?

Most soft tissue injuries cause:

  • Pain.
  • Swelling.
  • Bruising (possibly also hematomas, or bumps).

Depending on how severe the injury is, you may have trouble moving the limb. For example, a sprained ankle or sprained wrist will be tender (and you may have a wrist or ankle sprain bruise). A pulled hamstring will hurt if you try to bend down touch your toes.

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How Do You Diagnose a Soft Tissue Injury?

When you have a provider look at a potential soft tissue injury, they'll likely:

  • Ask you to describe what happened.
  • Examine the injury, lightly pushing on areas to see where it's tender.
  • Ask you to move your limb or body in certain ways, to check your range of motion.

Most of the time, minor soft tissue injuries don't require an x-ray. Doctors usually only order imaging tests if they suspect a severe sprain or strains.

For bumps to the head, if the provider suspects a concussion, they'll ask about other symptoms, including:

  • Dizziness.
  • Nausea or vomiting.
  • Confusion.
  • Loss of consciousness.

If you have these symptoms after hitting your head, tell your doctor right away.

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How Do You Treat Sprains, Strains, Bumps, and Bruises?

If you only have minor pain, bruising, or swelling, you can usually treat your injury at home, using RICE.

  • Rest. Rest what hurts (for example, stay off a sore ankle).
  • Ice. Use ice or cold packs every 1 to 2 hours, for 15 minutes each time. Ice helps reduce swelling.
  • Compression. Use a sports wrap or bandage, and wrap tightly (but still comfortably). This helps prevent swelling.
  • Elevation. Elevate the injury above the level of the heart. This also helps decrease swelling.

You can also take ibuprofen (Advil) and acetaminophen (Tylenol) for pain and swelling.

When should I call the doctor for a soft tissue injury?

For injuries that likely aren't fractures, call the doctor to make an appointment if you have:

  • Excessive swelling.
  • Severe pain, especially pain that doesn't respond to over-the-counter pain medicine.
  • Pain and/or bruising that doesn't improve after 7 to 10 days.
  • Pain from bruised ribs that doesn't allow deep breathing or coughing, even when using medicine to relieve pain.
  • Sudden numbness or weakness related to the injury.
  • Dizziness, nausea, confusion, headache, or disorientation after hitting your head.
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Last reviewed by Susan Marchezak, CRNP on 2024-04-24.