When is a bruise more than a bruise?

Q:

My son is a high school football player. He’s in excellent health and does well at the game but all season long he gets repetitive bruises on his arms from the hitting. Clearly this must happen to many football players – but I am wondering if multiple bruises are something I need to be concerned about.

 A:

This is a great question, and it is tempting to simply say that the bruises are from football, and leave it at that, but let’s think about bruises a little bit.

Normally bruises form when small blood vessels at the surface of the skin break, usually from an injury.  This could happen during football quite easily.   The blood leaks out of the vessels and darkens the skin. Eventually the body reabsorbs the blood.  As we age, the bruising gets more common, and some people just bruise more than others.

Sometimes medications or dietary supplements can cause bruising more easily, especially ones that reduce the body’s ability to form clots.  However, high school students are not usually on these substances.

Occasionally, bruises indicate something more serious going on, such as a problem with the body’s ability to form blood clots, or a blood disease.  This is especially true if large, or painful bruises develop, if they occur for now known reason, or if there is any bleeding occurring elsewhere, such as gums, nose, or intestines.

If you’re concerned about it, then the bruises warrant an evaluation.  A physician can examine your son for signs of bleeding problems, and perform additional testing as indicated.