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Dead Leg

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Introduction

‘Dead leg’ or more technically referred to as quadriceps contusion, results from an impact injury to the thigh musculature, causing it to be compressed against the thigh bone.

Information Video

Signs & Symptoms

Directly following this type of injury an individual will stereotypically experience varying levels of discomfort and reduced range of movement, the extent of which will be dependent upon the velocity of impact at the time of injury. It can cause varying degrees of damage to the muscle normally resulting in a haematoma (bleeding) with swelling to the injured region which is tender to touch. The pain will be worse when the knee is bent as this will place a stretch on the injured tissue and the pain may cause the patient to limp due to not being able to tolerate bearing weight through the injured leg.

Causes

Contusions are most commonly associated with contact sports such as rugby or sports such as cricket where being struck by a hard object or ball might cause a direct impact injury. Blunt force trauma is the most common injury mechanism.

Assessment & Diagnosis

Seeking advice from a musculoskeletal specialist is recommended. At Pure Physiotherapy, our clinicians complete a thorough assessment which facilitates in making an accurate working diagnosis and the subsequent development of an individualised condition specific rehabilitation protocol and treatment plan.

Self-Management

Following assessment, if a quadriceps contusion has been found to be the source of pain, your clinician will inform you of the suspected grade of your injury. Grading refers to the level of injury and contributes to a clinician’s ability in developing appropriate treatment strategies and will be something your Physiotherapy can provide more information on.

 

Immediately following this type of injury it is recommended that individuals follow a basic protocol that encourages healing and improved function. The protocol P.E.A.C.E & L.O.V.E (see picture – taken from the British Journal of Sports Medicine and produced by The Running Physio Tom Groom).

 

Your Physiotherapist will educate you on your injury and work with you to develop goals personal to you. Your individualised treatment and management plan will be tailored to help you achieve those goals and regular re-assessment will help track your progress and make any adjustments to your treatment to support full recovery.

 

It is important to highlight that following a severe contusion some individuals experience calcification where small amounts of bone form within the haematoma of the affected muscle resulting in a condition known as Myositis Ossificans. Your Physiotherapist will discuss this with you and are well placed to asses and treat this condition. Symptoms are similar to that of what has already been described but might be heightened, individuals might also be able to feel a hard lump within the muscle. Stereotypically, after approximately 6 weeks bone begins to break down and is reabsorbed by the body. However, in severe cases recovery can take up to 12 months.

 

To finish with, and According to Sports Medicine Australia, return to normal activities of daily living, inclusive of sport may be significantly improved with appropriate early assessment and injury management practices.

Physiotherapy

Your Physiotherapist will create a bespoke rehabilitation programme that will be modified in line with your progress. Gentle, gradual, pain free stretching of the muscle will be prescribed early on to assist in restoring full range of motion in mild muscle contusion injuries. Moderate to severe contusions may require a period of rest. As you progress, the exercises will be altered to more of a strength focus and then towards a return to sporting activity where relevant. Your Physiotherapist will provide ongoing support so that you can effectively manage your symptoms going forward.

 

Our clinicians are skilled in hands on treatment modalities which they can utilise to help support your recovery. Manual therapy techniques in the soft of soft tissue mobilisation and deep tissue massage can be useful in reducing pain, improving range of motion and supporting healing.

References

Sports Medicine Australia (2020). Quadriceps Contusion (Cork Thigh). Available: https://sma.org.au/resources-advice/injury-fact-sheets/quadriceps-contusion-cork-thigh/. [Accessed 21.4.20].

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