A thigh contusion is also known as a dead leg or charley horse and is caused by direct trauma to the muscle.
- Pain at the time of injury.
- Restricted movement and inability to run properly.
- If your contusion is severe, even walking may be difficult.
- Swelling may develop quickly, and later bruising may or may not appear depending on the type of injury sustained.
If you have a grade 1 thigh contusion will feel tightness in your thigh. You may walk with a limp. However, you are unlikely to have much swelling. Trying to straighten your knee against resistance probably won’t produce much pain and you will still have nearly a full range of motion when stretching.
With a grade 2 you are unlikely to be able to walk properly. You will have occasional sudden twinges of pain during activity. You may have swelling and trying to straighten your knee against resistance will be painful. Pressing in (palpating) over the site of injury will be painfu
Grade 3 contusions mean you will be unable to walk without the aid of crutches. You will be in severe pain and significant swelling will appear immediately. Contracting the muscle may produce a visible bulge or gap in your thigh. Expect to be out of competition for 3 to 12 weeks.
Skeletal muscles are made up of bundles of muscle fibres. The muscle is surrounded by a protective sheath called the Epimysium. Contusions are either intramuscular or intermuscular depending on whether the bleeding is contained within the muscle sheath, or whether the sheath is also damaged and the muscle bleeds outside the muscle sheath.
Intramuscular hematoma is a tearing of the muscle within the sheath that surrounds it. This means that the initial bleeding may stop early within hours because of increased pressure within the muscle, however, the fluid is unable to escape as the muscle sheath prevents it. The result is considerable loss of function and pain, which can take days or weeks to recover. You are not likely to see any bruising come out with this type – especially in the early stages.
Intermuscular hematoma is a tearing of the muscle and part of the sheath surrounding it. This means that the initial bleeding will take longer to stop, especially if you do not ice it. However, recovery is often faster than intramuscular as the blood and fluids can flow away from the site of injury. You are more likely to see bruising come out with this one.If after two to three days the swelling has not gone, then it is probably an intramuscular injury.
The aim of rehabilitation of a thigh contusion is split into 4 phases.
Reducing pain and swelling
It is very important to apply cold and compression to a contusion. Applying heat or deep massage in the acute stage may cause further injury or lead to myositis ossificans which is a bony growth within the muscle.
Gentle stretching if it is not painful. A professional therapist can apply sports massage techniques to speed up recovery but ONLY once the acute phase has definitely passed.
Restoring muscle strength
For a grade one contusion, strengthening exercises may be performed as soon as they can be done without pain. With a grade two contusion, it may be a week before strengthening is possible and a grade three even longer
Returning to full fitness
This is a gradual process. For a grade one contusion normal training may be resumed with a few days. It is important to maintain a stretching and strengthening program alongside training to ensure full strengthening and mobility of the muscle.
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