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Identifying And Treating An Intramuscular Hematoma

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What is a Hematoma

A hematoma is defined as blood that has leaked and then clotted in the surrounding tissue. The blood would have come from a damaged blood vessel such as an artery, vein, or capillary and then become hardened outside of its intended vessel. On the outside hematoma can look like very bad bruising, however, they are much more severe and can often require surgery or draining to prevent any further damage to the body; some are even life threatening. Hematoma are caused from trauma, normally through an accident or injury using a large force.

Intramuscular hematoma will normally develop through the result of a broken bone in the lower leg or forearm, however they can occur in the lower limbs after intensive exercise. When a bone is broken, fractured or even shattered it can rip apart muscle and blood vessels and during this initial phase of of trauma is when the body will develop a hematoma. If there was a lot of damage, and therefore a lot of blood, the hematoma can grow quite large and when it starts to harden it will need to be drained or surgically removed as it will be too big for the body to reabsorb. Smaller hematoma are often nothing to worry about and will be reabsorbed after a couple of weeks.

Symptoms Of An Intramuscular Hematoma

When you break a bone, for example a broken ankle, it can be quite obvious and painful and you'll need medical attention straight away. However, with smaller breaks and fractures (such as a fractured wrist) it can easily be mistaken for a sprain or bad bruise which is why it is always important to get checked out by a medical professional. The main symptoms that you'll have with an intramuscular hematoma are:

  • Pain when moving the limb (normally exercise induced)
  • Swelling
  • Pressure
  • Heat

If the hematoma is left to grow and is not treated soon then the blood can continue to leak for some time and can cause a condition known as 'compartment syndrome' which can cause nerve and muscle damage. Please see the video for more information on compartment syndrome.

An Explanation of Compartment Syndrome

This is what a hematoma can look like on the outside when healing.

This is what a hematoma can look like on the outside when healing.

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Treatment For Small Or Moderate Intramuscular Hematoma

If the hematoma is caused by extreme exercise and is caught quickly then the patient can start treatment immediately and reduce their risk of surgery using the RICE procedure:

  • R: rest
  • I: ice
  • C: compression
  • E: elevation

Smaller hematoma will start to heal within 7 days and moderate within approximately 10 days. You will first notice that the tenderness decreases and the swelling reduces to the point that it will flatten out and be flush against the skin. As the swelling reduces further you will find that you are left with a lump below the skin, this is normal when a hematoma is healing and you will find that over a series of weeks the body will absorb this and it will eventually go.

At any point you are worried that your hematoma is not healing properly and something feeling wrong then get it checked by your health care provider who will give you an assessment and make any adjustments to your rehabilitation as necessary.

Treatment For Severe Intramuscular Hematoma

If the hematoma is caused by something more extreme like a car accident or a bad fall and you have suffered a broken bone that has rupture a blood vessel then surgery will likely to be the only course of action. During the surgery your surgeon would need to repair the ruptured vessels and reset the bone in place so that you can then begin to heal without risking another bleed.

It is likely that the patient will go on some blood thinner medication such as Clexane or Warfarin whilst on bed-rest to prevent any blood clots. When you have experienced a bleed and then become immobile then you will be at an increased risk of getting a clot but your health care provider will develop a rehabilitation plan to reduce any risks to you.


This hub is for informational purposes only and should not replace the care of your doctor.

More Information on Hematoma Types


Mohan Kumar from UK on July 14, 2012:

Well presented, Bobski- succinct, simple and easy to follow info on the intramuscular haematoma. well done!

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