A direct blow to the muscle is the most common mechanism of a muscle contusion. The muscle is compressed and crushed between the person, the muscle and the underlying bone. Consequently, resulting in micro-tears to the surrounding soft tissue fibres and connective tissue, resulting in an inflammatory response which can induce a large degree of swelling in severe cases.
If the blow is severe enough, bone bruising can accompany it. The most common site is the quadricep muscle – graded 1 (mild), 2 (moderate) or 3 (severe).
Symptoms can range from mild bruising and swelling to severe bruising and swelling and a large reduction in range of motion and function.
Acute management of muscle contusions include a period of rest and protecting the injured area, often limiting avoiding aggravating activities for a short period of time. Elevation and compression will help reduce swelling. Ice can be used to help ease the pain. Heat is not recommended acutely within the first 72 hours but can be applied after 3 days to facilitate blood flow to the tissue. Excessive use of anti-inflammatory medications should be avoided within the first week. Inflammation during the acute period is important to some degree as it helps with the healing process.
After a week, gentle range of motion and isometric exercises are encouraged to help regain range at the joint and start the process of strengthening. As symptoms subside, more challenging exercises can be added to the program working through range under more load. Rehabilitation can take anywhere from two weeks to 6 weeks depending on the degree of the contusion.
Common symptoms/complication to monitor include numbness and weakness developing post injury. This is a sign of nerve damage and further investigation may be warranted. In rare cases, rapid bleeding can cause a sudden increase in pressure in the thigh which may need to be drained surgically.
If you have recently sustained a muscle contusion, it is important to be assessed by an experienced physiotherapist at the Optimal Health Lab to start you with your rehabilitation. Book via our Client Portal on the website, or you can call us within opening hours on 9431 5955.
