Download quadriceps contusion

AMSSM SPORTS MEDICINE TOPICS
QUADRICEPS CONTUSION
Patient Resource Courtesy of SportsMedToday.com.
What is It?
A quadriceps contusion is commonly known as a “thigh bruise.”
The quadriceps is a group of four muscles that runs down
the front of the thigh from the hip to the knee, and a quad
contusion occurs from forceful impact anywhere in that area. A
quad contusion is one of the most common injuries in contact
sports, such as American football.
Symptoms
Common symptoms of a quad contusion include pain at the site
of impact, bruising, and decreased range of motion, which may
cause difficulty walking. Swelling and deformity of the muscle
may also be noted.
Sports Medicine Evaluation and Treatment
Quad contusions are typically classified into three categories
or “grades”. A doctor will assess this severity with a physical
exam, which will include inspection of the area to look for
any bruising, as well as palpation of the thigh to assess for
swelling or deformity. Strength testing of the muscle will also
be performed. A sports medicine physician may use diagnostic
ultrasound to visualize muscle fibers. An X-ray may or may not
be needed depending on what the doctor finds during the
physical exam, and very rarely will magnetic resonance imaging
(MRI) be needed.
AMSSM SPORTS MEDICINE TOPICS
QUADRICEPS CONTUSION
One possible complication of this condition is “myositis
ossificans,” which indicates unexpected transformation of the
muscle into bone within the site of injury. Myositis ossificans
may develop in up to 20 percent of quad contusions if
inadequately treated and will lead to prolonged recovery. After
the injury has occurred, prevention of myositis ossificans can
best be achieved by avoiding early heat or massage. Therapeutic
ultrasound treatments, a form of deep heat, should also be
avoided during the acute, painful stage.
Patient Resource Courtesy of SportsMedToday.com.
Return to Play
The timeframe for returning to play varies widely based off the
severity of the injury. One study showed that average disability
time varied from approximately 2 to 3 weeks; however, some
severe injuries may take much longer. In order to return to
participation after a quad contusion, the player should be able
to demonstrate full, pain-free range of motion and should be
able to perform all aspects of functional activity needed to
participate.
Treatment of a quad contusion consists of early icing and
compression wrap. Bracing may be used to keep the knee in a
flexed position. Keeping the knee in a flexed position initially
can significantly speed healing in more severe injuries. Gentle
stretching and massage may be used after a brief period of rest
(usually about 24 hours). The doctor may also recommend the
use of anti-inflammatory medications.
Injury Prevention
This injury is best prevented by using proper protective
equipment in any sport where impact in this area is likely (for
example, wearing thigh pads in football). Because a significant
amount of time can be lost from quad contusions, the use of
thigh pads should be encouraged by coaches and team medical
staff.
AMSSM Author Members: Author: Nicholas R. Phillips, M.D.
References
Kary, JM. Diagnosis and management of quadriceps strains and contusions. Curr
Rev Musculoskelet Med (2010) 3:26-31.
MackKnight, JM. Football. In O’connor FG, et al. ACSM’s Sports Medicine: A
comprehensive review. pp629, Philadelphia, PA: Lippincott Williams & Wilkins.
AMSSM is a multi-disciplinary organization of sports medicine physicians dedicated to education, research, advocacy and the care of athletes of all ages. The majority of
AMSSM members are primary care physicians with fellowship training and added qualification in sports medicine who then combine their practice of sports medicine
with their primary specialty. AMSSM includes members who specialize solely in non-surgical sports medicine and serve as team physicians at the youth level, NCAA,
NFL, MLB, NBA, WNBA, MLS and NHL, as well as with Olympic teams. By nature of their training and experience, sports medicine physicians are ideally suited to provide
comprehensive medical care for athletes, sports teams or active individuals who are simply looking to maintain a healthy lifestyle. Find a sports medicine physician in
your area at www.amssm.org.