It had been a couple of decades since I’d last chanted “Hey batter, batter,” but there I was, playing second base, reliving those hot afternoons on Miss Opal Ryan’s championship girls’ softball team. When I heard the crack of the bat, reflexes took over and I flung myself horizontally toward the ball.
As I felt the line drive slam into my mitt, I enjoyed about a millisecond of glory before landing, hipbone first, on the hard-packed dirt. By the next day, I was black-and-blue with nostalgia. My hip swelled, turning shades of red, purple and blue. The bruise later evolving into a greenish-brown splotch roughly the size and shape of South America.
I’ve always come away from athletic encounters with more bruises than trophies. For one thing, I’m fair-skinned. While it’s less obvious when swarthier types get black and blue, even a minor bump can make me look like a victim of Ted Turner’s colorization squad.
Maybe one reason I bruise so easily is that, like many women, I’m also thin-skinned. Not that I’m hypersensitive to criticism. Apparently it’s a physical reality: A woman’s skin tends to be only two-thirds as thick as a man’s. And thin skin is less able to cushion the force of a blow.
Your skin is made up of three layers-the paper-thin outer layer called the epidermis, the middle layer with a network of tiny blood vessels called the dermis, and a fatty subcutaneous layer underneath. It’s this subcutaneous layer that serves as a buffer between the upper layers and the muscle, bone or fat below. The thinner all these layers are, the more likely you are to get a deep bruise.
Thin skin is also why older people of both sexes are prone to bruising-and why some areas of your body get black and blue more easily than others. “The skin around your eyes is very thin. That’s why black eyes are so common,” explains Andrew Lazar, a Highland Park dermatologist. “You hardly ever see a bruise on the palm of your hand or the sole of your foot, even though those parts put up with a hundred times more wear and tear. The skin there is five times as thick as the skin around your eyes.”
What lies underneath the skin and how hard you’re hit also have a lot to do with how nasty a bruise you end up with. “It’s much easier to get a bruise right over a bone because it’s harder, and there’s no cushion of fat to absorb the blow,” says Rodney Basler, head of the Task Force on Sports Medicine of the American Academy of Dermatology.
You might not even notice bumping against a desk drawer until a bronze blotch turns up on your knee the next day. Such minor bruises damage only the dermis. But the force of landing on a softball diamond can easily crush that layer as well as the subcutaneous layer beneath it. A severe blow can penetrate even further, damaging fat or muscle. “A bruise on your hip will look a lot different from one on your shin,” says Basler. “If something hits you hard enough to bruise a fatty area like the hip, you’re going to get a larger, darker bruise because there are more blood vessels in a fatty area.”
No matter where you’re bruised, here’s what’s happening: Something hits you or you hit something with sufficient force to crush blood vessels without breaking the skin. The blood vessels don’t actually tear; it’s as if they turn to cheesecloth, allowing the blood to seep out into the injured area. By the time you’ve finished dusting off your shorts, the bruised site has turned a nasty, irritated red and begun to swell. The more blood the vessels leak, the darker the area becomes.
A time for healing
Within 48 to 72 hours, healing begins as the body floods the area with enzymes that dilate the blood vessels and cause more swelling. It’s your body’s way of setting up a scavenger operation to clear the area of injured cells and excess fluids. Specialized cells called phagocytes and macrophages swing into action like garbage trucks, hauling the refuse to the bloodstream for disposal.
It’s the healing process that really sets off the decorative fireworks. The ecchymosis, as the darkened area is called, changes colors as the hemoglobin in the blood that’s spilled into the injured area is broken down before being whisked away as debris. Cut off from the oxygen that gives it its red coloring, the hemoglobin turns blue. (The spectacular purples and blacks you sometimes get are simply the way the bluish, oxygen-starved hemoglobin looks as it’s filtered through the skin’s natural pigments.) Later, usually just as the bruise begins to fade, the hemoglobin is broken down into several pigments: bilirubin, which makes the bruise appear yellowish; biliverdin, which has a greenish tint; and hemosiderin, which is bronze hued.
Kitchen remedies
You can forestall some of that unsightly discoloration by applying ice to the injured area as soon as possible. Ice constricts blood vessels and slows down the bleeding that causes black and blue marks. When a bruise is severe enough to hurt around the clock, it should be treated like a sprain, by applying an ice pack and compression with your hand or an elastic bandage, elevating the area to slow the blood flow and cut down on swelling, and resting the injury if you feel pain. Some traditional remedies-putting steak on a black eye, pressing a half-dollar against a barked shin-are fairly effective because they’re basically homespun methods of cooling or compressing an injury.
Food for thought
Old-fashioned strategies to prevent bruising are less reliable. Miss Ryan passed out bananas and oranges to her thin-skinned teens, but nutritionists say the notion that eating potassium-rich bananas somehow cuts down on bruises is just another locker-room myth. And though they may be great at restoring fluids and sugar, those mid-inning oranges probably don’t do a whole lot to thwart discoloration.
It’s a good idea to check with a doctor if you experience repeated, severe bruising for no reason; in very rare cases, it could be a sign of a blood disorder like hemophilia or leukemia, or a side effect of certain anti-clotting medications. But for most people, the occasional bruise is simply an unsightly-and temporary-nuisance. “You bruise, and it gets better,” says Sheldon Pinnell, head of the dermatology department at Duke University.
