Quad Contusion - Self Management

Quad Contusions
Written by: Taylor Post
Certified Athletic Therapist

Quad contusions are one of the most common injuries seen in contact sports. Many of which are enjoyed during the winter months, for example hockey, basketball and indoor soccer. This injury can greatly impact level of function and can lead to serious complications if not managed properly.

A quad contusion is a bruise caused by a direct blow to the quadriceps. This is the group of muscles at the front of your leg that help flex your hip and straighten your knee when you walk or run. These muscles are attached to your femur, or thighbone, so a direct blow to the thigh can crush them against the bone. This causes bleeding, tissue damage, swelling, pain and dysfunction.

More commonly described as a “Charlie Horse”, the symptoms of a quad contusion include pain at the time of the injury, with swelling and bruising appearing later (depending on the severity). It may not be possible to fully bend the knee or even walk on the affected leg right after hurting it.
Treatments of quad contusions first

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Treatments of quad contusions first include the RICE protocol: Rest, Ice, Compression and Elevation.

• REST. Resting and protecting the limb is crucial after the injury. The use of crutches can help for the first 24-48 hours, depending on the severity of the pain.The athlete can slowly begin to weight bear as recovery progresses.
  
• ICE. Apply crushed ice to the area for 20 minutes on, followed by 20 minutes off as needed (if you must use a chemical ice pack be sure to use a wet towel to protect your skin). The athlete needs to be positioned with the knee bent in maximal flexion while the ice is applied. This is done to maintain the flexibility of the quadriceps muscle group while swelling may be present.
• COMPRESSION using a tensor bandage wrapped snuggly (not too tight) around the area will help support the injury and reduce the amount of swelling. However, is important to never sleep with a tensor bandage on.
• ELEVATION may also be used to manage swelling. This can be done by supporting the leg with pillows or elevating the foot of the athlete’s bed using extra blankets or suitcases under the end of the mattress.

 
As soon as the athlete is feeling better, they should begin gentle range of motion exercises and strengthening of the quadriceps. This must be done with caution because pushing through the pain or reintroducing activity too soon can put the athlete at increased risk for re-injury, and a serious complication: Myositis Ossificans.

Myositis Ossificans is a condition where new bone begins to develop inside of the muscle tissue after trauma, especially if a bad muscle strain or contusion is neglected. Applying heat too early, aggressive massage or returning to training too soon can increase risk of Myositis Ossificans. It is a very serious disorder and could even require surgery to remove the bone growth.
To prevent serious complication, it is best to consult a professional to help care for a serious quad contusion. They will be able to evaluate the severity of the injury and help you to progress through the stages of rehab safely and effectively.
Whether you’re a competitive athlete, training on your own, or simply enjoy keeping active for fun, your local Athletic Therapist is a great person to consult after any injury. We want to help you achieve your fitness goals – big or small, and get you back to doing what you love as soon as possible!