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UK Orthopaedics
Health Information
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Quadriceps Contusion
From DeLee JC, Drez D Jr.: Orthopaedic Sports Medicine:
Principles and Practice. Philadelphia, WB Saunders, 1994, p. 1103.
Description
Quadriceps contusion is bruising of the skin and underlying tissues of the
thigh, including muscle, its covering fascia, and occasionally bone, caused by a
direct blow. Contusions cause bleeding from ruptured small capillaries that
allow blood to infiltrate muscles, tendons, or other soft tissues. The thigh is
well suited to absorb direct blows, but contusions do often occur here.
Common Signs and Symptoms
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Swelling, pain, and tenderness of the thigh, either superficial or deep
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Feeling of firmness when pressure is exerted at the injury site
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Discoloration under the skin, beginning with redness and progressing to the characteristic black and blue or purple bruise
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Restricted activity of the injured leg proportional to the extent of the injury
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Knee stiffness or pain when trying to bend the knee
Treatment
Initial treatment consists of ice, and compressive strapping to relieve pain and
reduce swelling; stretching to prevent knee and thigh stiffness; and
modification of activities to allow the bruised muscles to heal. Referral to a
physical therapist of athletic trainer may be advised for further evaluation and
treatment, especially to regain knee motion. Nonsteroidal anti-inflammatory
medicines may be recommended starting 2 to 3 days after a severe injury to
reduce the likelihood of developing calcification of the contusion (myositis
ossificans). Rarely, surgery is recommended to remove the clotted blood.
RICE Principle With all acute injuries, follow the RICE principle to reduce swelling, pain and inflammation.
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Rest- Modify activity, staying away from those which cause extreme pain.
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Ice- Use an ice pack for 20 minutes every two to three hours during the first 72 hours.
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Compression- Use an ace wrap encompassing the entire thigh area.
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Elevation- Keep the injured leg above the level of the heart when sitting or lying down.
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