Light massage and bruising?

September 26, 2022 7:39 AM

YANMD. Why did a very gentle post-injury massage leave me bruised? I'm recovering from a broken ankle and just started physical therapy. As part of my first session, the PT gave my foot/ankle the world's lightest massage while gently exploring my (very limited) range of motion. I was in zero pain. The next morning I woke up heavily bruised. I'm curious about why that happened.

I'm planning on asking during my next session but thought I'd also ask here. The entire session was gentle and respectful, very in-line with what I expect from a PT evaluation post-injury. (I've been through a lot of PT, LOL.) I certainly was not pushed beyond my limits in any way, and I have no trouble speaking up if I'm experiencing pain. I was not experiencing pain, which just made the bruising the next day more curious.

My ankle and foot are still a little swollen from my original injury. My ortho told me that's normal, and ankles take a while to lose all their swelling. I keep it elevated for a big part of the day.

So why did this happen?

posted by BlahLaLa to Health & Fitness (5 answers total)

Best answer: Sometimes when you have had a good bit of swelling, you have bruising well under the surface of the skin that you don't see, and massage and movement can help (it's useful!) break up those hematomas and get them moving, which they need to do to leave the area. So you'll see those old red blood cells where you didn't before, and I don't even know if technically it's considered "bruising" still or some other post-bruise syndrome, but it's not an indicator that you were harmed (recently, I mean - obviously the break was harmful).

You may also have very delicate capillaries at the surface of the skin, thanks to the swelling and confinement of whatever split/boot/cast you had. Again, not indicative of abuse to see bruising there if they break easily.

I have skin that will speckle and bruise from pretty much anything - carrying a heavy bag with a shoulder strap will leave a mark on my shoulder, throwing up really hard will leave me a lovely bandit-mask of bruising around my eyes - and there's a surprising array of very small things that will make some red blood cells show up, which are especially visible on really pale skin.
posted by Lyn Never at 8:01 AM on September 26, 2022 [6 favorites]

Some people just bruise easily, lots of capillaries that bleed when massaged.
posted by kschang at 8:17 AM on September 26, 2022

I started getting regular massages a few months ago and even light massage on my regular-mode non-injured body cause me to bruise. I've always been one of those people who can bruise with a whisper. It's just a thing for some people.

This may be the first time you're in this situation and so the first time you're actually seeing it, or maybe you're just especially sensitive right now due to your injury.

Anyway, for me personally this isn't, and would not be, any cause for concern.
posted by phunniemee at 9:02 AM on September 26, 2022

Are you taking baby aspirin for circulatory health? I found that blood pressure cuffs made me bruise when i was taking it.
posted by Morpeth at 9:02 AM on September 26, 2022 [1 favorite]

Skin tone changes from a cast or other occlusive device can make any bruising look far more apparent (my skin in translucent and seems to have no undertone beyond light orange according to the colour matching/highlight filters and according to a phlebotomist I will always have horrible looking bruises since every single colour of healing shows through).
posted by geek anachronism at 11:14 PM on September 30, 2022