Bleeding within a muscle may be caused by rupture or impact . It begins within the muscle sheath (fascia) and causes an increase in intramuscular pressure which counteracts any tendency to further bleeding by compressing the blood vessels. The resultant swelling persists beyond the first 48 hours and is accompanied by tenderness, pain, and impaired mobility. Swelling may increase as the bleeding draws fluid from the surrounding tissue (osmosis), and muscle function may be completely absent. If the muscle sheathis damaged, blood may spread into the space between the muscles (see below) or out into the surrounding tissues. Intramuscular hematomas may create an acute compartment syndrome due to increased intracompartmental pressure, but this is rare.
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