A contusion is what’s suffered when a direct blow is received to the thigh commonly known as a corked thigh or a charley horse. Contusions are very common in contact sports, especially during tackles. The trauma causes damage to the muscle, fascia and blood vessels. Localised bleeding in the area may place pressure on surrounding tissues causing secondary damage due to hypoxia (decreased oxygen supply). If this swelling is severe it can be classed as compartment syndrome, where the increased pressure can result in nerve and muscle damage. For this reason it is important to reduce the swelling as soon as possible. Injury prognosis varies depending on the extent of the injury.
Some contusions develop into myositis ossificans, a condition which occurs when the haematoma calcifies. This bone growth in the muscle becomes very painful and restricting. It is unknown what the cause of it is, however it is more common with very severe haematomas. Rehabilitation for myositis ossificans has been known to take up to 12 months. It is for this reason heating and massage is not recommended in the first couple of days following as it is thought to increase the risk of complications.
Symptoms following a quadriceps contusion include:
- Tenderness, swelling and bruising to the thigh and the surrounding area following a direct blow.
- Restrictions with stretching the quads.
- Decreased strength of the quads.
- Trouble walking up and down stairs.
- Your knee may give out on you as you try to walk.
RICED (Rest, Ice, Compression, Elevation and Diagnosis)
The NO HARM method should be followed for the first couple of days after a quadriceps contusion:
- No Heat
- No activity
- No running
- No massage
After the initial inflammation period is finished, your physiotherapist will know when this is; physiotherapy will include:
- Massage to help remove swelling, bruising and break up scar tissue.
- Strengthening to ensure the return of full knee control and strength to the leg.
- Stretching to restore movement to the quadriceps.
- Taping to maintain good knee control.
- Return to work/sports training.