Contusion du quadriceps

A quad contusion (shortened name for a “quadriceps contusion”)  is an injury that results from forceful impact to the four quadricep muscles at the front of the thigh. It is a special case of the more general group of injuries that doctors call contusions. Other names for this injury include “thigh bruise”, “charley” or a “cork thigh”.

This is one of the more common muscle contusion injuries that athletes in contact sports like football or rugby tend to experience. It is also a risk in other sports such as cricket, field hockey and lacrosse that are played with a hard ball or “puck”. Players of these sports who experience a blow to the front of the thigh can easily experience a quad contusion.

Quad contusions can cause deep rupturing of the muscle fibers at the front of the thigh, as well as hemorrhaging (internal bleeding) and inflammation. The reason that this injury tends to be more severe than other types of contusion is that the quadricep muscles sit against a hard and dense bone structure (the femur or thigh) and have nowhere to move to absorb the impact of a direct frontal blow.

Quad Contusion Symptoms

Sports medicine doctors generally divide the symptoms of this injury into three categories depending on their severity:

• Grade 1 – In which the athlete can continue playing or training but may feel mild soreness directly after he or she ceases play, or possibly on the following day. In addition to soreness, the area of the bruise may be tender to the touch and the athlete may experience slight diminution of muscle strength and ability to stretch the muscle;
• Moderate or Grade 2 – In which the player may have to stop activity immediately but may nevertheless experience stiffening and/or swelling of the affected area. In addition, the athlete may experience a reduction in mobility (such as having to limp). The range of motion of the knee will also be reduced, by as much as 50%. Players with thigh bruises of this severity will not be able to bend their knees by the full 90 degrees;
• Severe or grade 3- For the most severe category of injuries, the athlete will usually experience rapid swelling of the affected area and obvious bleeding. In the most serious cases, the bleeding may be uncontrollable. The player will lose most of his or her ability to move the leg or to place the full body weight on it.

If your quad contusion injury is severe and does not receive proper medical attention, the result may be a complication known as myositis ossificans. This involves the development of bone tissue inside the damaged muscles.

Although this bone tissue is usually ultimately reabsorbed into the body, myositis ossificans can significantly increase the time that the player spends out of action.

If you can call your doctor as soon as possible for treatment of a possible quad contusion injury, you will be less at risk of developing this unpleasant condition.

Diagnosis & Treatment Of A Quad Contusion Injury

If you are experiencing the above symptoms after a frontal blow to your thigh, you should arrange for a consultation with a sports medicine doctor. He or she will be able to make a diagnosis of your injury and recommend a treatment plan.

Diagnostic

Your doctor will physically examine the affected area and ask you questions about the injury and how you received it. He or she will also likely ask about the severity of your symptoms, including the degree of pain and stiffness you are experiencing.

Traitement

In most cases, your doctor will opt for a treatment plan based on application of the R.I.C.E. protocol for 48-72 hours:

• Rest the quadricep muscles by ceasing athletic activity for a period;
• Applying Ice or a Cold Compress to the area of the contusion to reduce pain and swelling. For optimal results, do this every 2-3 hours and for periods of about 20 minutes. Avoid applying the ice or cold pack directly to the naked skin. This could result in skin damage;
• Apply Compression to the quad contusion using a tensor bandage or thigh compression sleeve. This will improve blood flow through the area of the injury and promote faster healing;
• Whenever possible (when lying or sitting down, for example), Elevate the injured area above the level of your heart to improve drainage of blood from the contusion. This will also help with the replenishment of fresh blood and faster healing as a result.

In addition to R.I.C.E. , your doctor will likely also advise adherence to the No HARM protocol:

• No Heating of the affected area;
• No consumption of Alcohol ;
• Avoid Running or other athletic activity;
• No Massaging of the area of the quad contusion.

You should not return to sports activity until you are completely pain free and the other symptoms have gone.

However, as part of preparation for your return to sports activity, you should commence a physical therapy program once the symptoms have started to recede. This will generally include quadricep stretching and strengthening exercises. A physiotherapist will be able to devise an exercise program that will include, but not necessarily be limited to, these exercises.

Quad Contusion Prevention

If you regularly play sports that increase your risk of experiencing a thigh bruise, it is wise to take precautions to reduce the risk of this injury:

• Wear thigh pads to absorb the impact of a blow from the ball or other hard object. This is already a common practice in cricket, for example. However, you can easily use thigh pads when playing other sports also;
• Pursue an exercise program to strengthen your quadricep muscles and improve their ability to withstand a powerful frontal blow.