Butt Bruise: Overview and More

A butt bruise, or gluteal contusion, is an injury to the glute muscles of the buttocks. A butt bruise most often results in pain and visible discoloration of the skin at the injury site.

This article will describe symptoms and causes of a butt bruise, how it's diagnosed, and treated. 

woman with pain in buttocks

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Butt Bruise Symptoms

A contusion, or bruise, is a type of muscle injury that can affect any of the body's skeletal muscles. A butt bruise can be painful, with a black and blue mark that changes color over time. Other symptoms may include:

  • Tenderness to touch over the injury site
  • Increased pain with contraction of the glutes
  • Swelling 
  • Discomfort with sitting

Causes

A butt bruise occurs from direct trauma to the gluteal muscles of the buttocks. Forceful impact to a muscle causes damage to muscle fibers and underlying blood vessels, resulting in bleeding underneath the skin. 

Direct impact to the gluteal muscles that can cause a butt bruise include:

  • Falls
  • Direct blows to the buttocks from another person or piece of sports equipment
  • Bumping into a door, counter, or furniture 
  • Motor vehicle accidents
  • Intramuscular injections into the glutes

If you take blood thinners, or anticoagulant medication, like warfarin and Coumadin, you have an increased risk of bruising with direct contact injuries.

Diagnosis

A butt bruise is usually diagnosed through a physical examination as it is generally easy to diagnose based on physical appearance, symptoms, and type of injury. 

All bruises, or contusions, can be graded based on the severity according to the following criteria:

  • Grade I: A grade I bruise is an injury that affects only a small amount of muscle fibers, resulting in minimal tenderness, pain, and possible swelling. Grade I bruises cause very little or no loss of strength in the affected muscle or range of motion limitations. Muscle use is typically unaffected with grade I bruises.
  • Grade II: A grade II bruise causes a greater extent of damage to muscle fibers, resulting in increased pain and impaired muscle contraction ability. A small muscle defect can be felt to the touch with a grade II bruise. Increased discoloration under the skin develops within two to three days, and complete healing can take two to three weeks. Return to sport is typically resumed after one month.
  • Grade III: A grade III bruise is an injury that involves extensive muscle fiber damage and bleeding across an entire area of a muscle that results in severe, and sometimes complete, loss of muscle function. Grade III bruises also cause severe pain and significant discoloration of the skin. Grade III bruises can take up to four to six weeks to heal and often requires rehabilitation to restore muscle strength and range of motion.

When contusions are larger, deeper, and involve a significant amount of blood pooling and swelling under the skin, they are referred to as hematomas

If bruising is severe, a diagnostic ultrasound, CT scan, or MRI of your hip may be performed to determine if there is damage to any underlying structures. 

Treatment

Treatment for a butt bruise typically involves rest and time to allow your body to heal in order for the bleeding and bruising under the skin to dissipate. Butt bruises are generally mild injuries that do not require more involved treatment. 

Applying ice to the injury site can help relieve pain and inflammation. If the bruising is severe, significant physical activity like participating in sports, dancing, running, jumping, and weight lifting should be avoided until your injured gluteal muscles heal. With more severe bruising, contraction and stretching of the glutes will be painful and can delay healing.

Rehabilitation through physical therapy may be needed for more significant injuries to restore muscle function.

Prognosis

A butt bruise is generally a mild injury that heals on its own with time and rest. More significant injuries take a longer time to heal, and may require physical therapy to build up strength and range of motion if muscle function is affected.

Summary

A butt bruise, or gluteal contusion, is an injury to the gluteal muscles of the buttocks caused by damage to muscle fibers and blood vessels, resulting in bleeding under the skin. A butt bruise is caused by direct impact to the body, commonly from falls, motor vehicle accidents, bumping into things, or being struck by an object or another person.

Like all bruises, a butt bruise can vary in severity from grade I to grade III, with higher graded bruises requiring more time to heal. Most butt bruises can heal on their own with time and rest, but if your bruising is severe, you may require physical therapy to restore full muscle function.

A Word From Verywell 

While they might be unsightly, butt bruises are often mild injuries that heal on their own with time and rest from activity. Small bruises typically do not impact muscle function but larger injuries that affect a greater proportion of muscle fibers may limit your strength and range of motion of your hip. If your bruising is severe, make sure to see your healthcare provider to determine if any other injuries to underlying structures, including muscle or tendon tears, are present.

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  1. Fernandes TL, Pedrinelli A, Hernandez AJ. Muscle injury - physiopathology, diagnosis, treatment and clinical presentation. Rev Bras Ortop. 2015;46(3):247-255. doi:10.1016/S2255-4971(15)30190-7.