Contusion

Scenario:
A contusion is a crush injury caused by a blow. For example, smacking your elbow against a tree as you ride by. Or landing your palm on a small pebble during a fall.

Description:
A contusion has pain only at the site of the blow. There may be a little swelling and bruising. But in general the pain decreases quickly and the injured part can be used soon after. In other words, if you can ride your bike without pain, chances are it's only a bruising injury -- not a broken bone, ruptured muscle, torn tendon, or serious sprain.

Concerns:
Even if there's no fracture, a contusion occasionally can be serious. If swelling becomes severe, circulation can be cut off downstream from the injury. (This is called compartment syndrome.) A contusion that severely bruises a nerve can leave permanent numbness.

This biker fell down, smacking the tip of the elbow against the ground. But the elbow has full range of motion. It can be moved without pain (until the bending starts to stretch the swollen area). It hurts only when the swollen area is touched.
This biker fell down, smacking the tip of the elbow against the ground. But the elbow has full range of motion. It can be moved without pain (until the bending starts to stretch the swollen area). It hurts only when the swollen area is touched.

See the doctor if:
    there's deformity or severe swelling
    the part can't be used normally after an hour of rest
    there's continued severe pain
    there's numbness or weakness below the injured area.

Immediate care:
The treatment of contusions is "RICE:" Rest, Ice, Compress, and Elevate. Immediately elevate the injured part and apply an ice bag. Once the area is thoroughly cooled, apply an elastic wrap to compress the injury.

Ongoing care:
For the first 48 hours, repeat ice and elevation 1/4 of the time (for example, 30 minutes of ice every two hours). As the pain subsides, return to activities. The rule is: "If it hurts, don't do it." You can usually stop using the elastic wrap after 2 to 3 days.

A compression wrap applied over the swollen area.
A compression wrap applied over the swollen area.

Watch for:
New bruising may continue to appear for several days. The area will be tender to touch for a couple of weeks, but you should be able to use the injured part normally (unless this presses on the injured area). If the injury stops improving, or if there are new symptoms, see the doctor.