A haematoma is a collection of blood in tissue. It can feel firm as it breaks down. A hard lump, however, proves neither normal healing nor that it should be dispersed by massage. Cause, size, pain and progression need to be considered together.
Do not vigorously massage recent or painful areas
Strong pressure can further irritate injured tissue. Avoid self-massage of recent, growing or very painful bruises. The area should also be professionally assessed first if you have a clotting disorder, take anticoagulants or have had an operation.
What may help initially
After a minor injury with a known cause, rest the affected area, cool it gently if needed and elevate it if possible. Wrap a cold pack in a cloth rather than placing it directly on the skin. Do not treat it with strong pressure, aggressive rubbing or attempts to squeeze the lump.
When examination matters
A growing, very painful or persistent lump should be examined. The same applies to unexplained bruises, frequent large haematomas or additional bleeding. Numbness, marked loss of function or rapidly increasing tense swelling require immediate medical assessment.
Treatment of an older haematoma depends on the findings. Gentle movement or physiotherapy may be appropriate after professional assessment. The age of a bruise alone is not clearance for massage.
Frequently asked questions
Is every firm lump beneath a bruise harmless?
No. A collection of blood is possible, but not every firm area can be identified reliably just by looking at it.
Should I stop blood thinners because of a haematoma?
Do not stop prescribed medicines on your own. Contact the treating practice promptly for new or unusual bruises; get immediate help for severe acute symptoms.
Sources
Healthdirect: Limits and risks of massage; Mayo Clinic: First aid for bruises
