ZocdocAnswersWhy does it take a longer time for bruises to disappear from certain areas of the body?

Question

Why does it take a longer time for bruises to disappear from certain areas of the body?

I play rugby and get a lot of bruises even for a male rugby player. I wish to know why it takes longer for bruises to heal on my leg and back than my arms even though they stop hurting in the same amount of time.

Answer

First of all, my hat is off to you as a rugby player...it is a wonder that you only have soft tissue bruises, and not broken bones. So fundamentally the first question to answer is what is a bruise in the first place? Essentially what happens with trauma is that small blood vessels called capillaries are broken which causes blood to leak out into the extraluminal space, and into the surrounding tissues where it does not belong. These red blood cells are then eaten (phagocytosed) by immune cells called white blood cells (WBCs). The WBC's break down the cell walls of the red blood cells (RBCs). This releases the hemoglobin that is inside of RBCs and carries the majority of the oxygen in your blood. The hemoglobin is enzymatically broken down into bilirubin which gives the bruise the characteristic "black and blue" color. With time the bilirubin is converted into hemosiderin which has a more yellow/brown appearance to it, and explains why there is color change to bruises as they mature. So getting to your question about why they seem to linger for longer on certain areas of your body...there are multiple factors that are likely involved, making it not easy to answer without more questioning. For instance the size of the bruise, the depth of bruising, status of the clotting factors in the blood, medications (aspirin, blood thinners, etc), diet, whether there is another injury in combination with the soft tissue trauma, immune status of the person, and blood flow to the area. All of these likely play a role. For instance, the higher rate of blood flow to a tissue means that it will likely bleed more once traumatized, but it also means that there will be more immune cells brought to the area after the fact to help break down the bruise. Hope this helps.

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