(Damage to a muscle through Impact)

What is a contusion?

This type of hamstring injury is very common in contact sports. An impact to the muscles can cause more damage than might be expected and should be treated with respect. The muscle is crushed against the bone. If not treated correctly or if treated too aggressively then myositis ossificans may result.

There are two types of contusion:

Intramuscular  which is a tearing of the muscle within the sheath that surrounds it. This means that the initial bleeding may stop early (within hours) because of increased pressure within the muscle however the fluid is unable to escape as the muscle sheath prevents it. The result is considerable loss of function and pain which can take days or weeks to recover. There is not likely to be any bruising with this type - especially in the early stages.

Intermuscular  which is a tearing of the muscle and part of the sheath surrounding it. This means that the initial bleeding will take longer to stop especially if cold therapy or ice is not applied. However recovery is often faster than intramuscular as the blood and fluids can flow away from the site of injury. There is more likely to be bruising with this type of injury.

What are the symptoms?

* pain at the site of injury.
* There may be swelling or bruising (see below).
* Restricted movement is not uncommon.

After two to three days check:

* If the swelling has not gone then the athlete probably has an intramuscular injury.
* If the bleeding has spread and caused bruising away from the site of the injury then they probably have an intermuscular injury.
* If they are more able to contract the muscle then an intermuscular injury is suspected.
* Is there a deformation in the muscle or a gap?

It is important the correct diagnosis is made because trying to exercise on a complete rupture, or a bad intramuscular injury can inhibit healing, make things worse or cause permanent disability. If heat and massage is applied in the early stages then Myositis Ossificans (or bone forming within the muscle) may result.

Like muscle strains, contusions are grade 1, 2 or 3 depending on the severity.

GRADE 1 : WHAT  DOES  IT  FEEL  LIKE?

- Might have tightness in the back of the lower leg.
- May be able to walk properly.
- Probably won't have much swelling.
- Nearly a full range of motion.

What can the athlete do?

- Rest, Ice, Compress and Elevate (R.I.C.E.) immediately.
- See a sports injury professional for advice on treatment and rehabilitation.

What can a Sports Injury Professional or Doctor do?

- Use sports massage techniques to speed up recovery (very important).
- Use ultrasound and electrical stimulation.
- Prescribe a rehabilitation programme consisting of stretching, strengthening and sports massage techniques.

GRADE 2 : WHAT  DOES  IT  FEEL  LIKE?

- Probably cannot walk properly.
- Occasional sudden twinges of pain during activity.
- May notice swelling.
- Pressing in causes pain.
- Contracting the hamstring muscles against resistance causes pain.
- May have limited range of movement.

What can the athlete do?

- Ice, compress, elevate, use crutches for 3 to 5 days.
- See a sports injury professional who can advise on treatment and rehabilitation.

What can a Sports Injury Specialist or Doctor do?

- Use sports massage techniques to speed up recovery (very important).
- Use ultrasound and electrical stimulation.
- Prescribe a rehabilitation programme.

GRADE 3 : WHAT  DOES  IT  FEEL  LIKE?

- Unable to walk properly without the aid of crutches.
- In severe pain.
- Bad swelling appear immediately.
- A static contraction will be painful and might produce a bulge in the muscle.
- Expect to be out of competition for 3 to twelve weeks.

What can the athlete do?

- Seek medical attention immediately.
- R.I.C.E. (Rest, Ice, Compress, Elevate.) Use crutches.
- See a sports injury professional who can advise on treatment and rehabilitation.

What can a Sports Injury Specialist or Doctor do?

- Use sports massage techniques to speed up recovery (very important).
- Use ultrasound and electrical stimulation.
- Prescribe a rehabilitation programme and monitor it.
- Operate if needed.

© 2005-2008. Barrie Spirit Soccer
Hamstring  Contusion
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We would like to thank Mike and www.sportsinjuryclinic.net for allowing us to publish this article on the Barrie Spirit Soccer website.
Please remember the information on this site is for information purposes only and cannot replace the sports injury specialists.
What is Myositis Ossificans?

If you have a bad muscle strain or contusion (dead leg!) and it is neglected then you could be unlucky enough to get Myositis Ossificans. It is usually as a result of impact which causes damage to the sheath that surrounds a bone (periostium) as well as to the muscle. Bone will grow within the muscle (called calcification) which is painful. The bone will grow 2 to 4 weeks after the injury and be mature bone within 3 to 6 months.

What causes myositis ossificans?

Not applying R.I.C.E. (rest, ice, compression and elevation) immediately after the injury.
Having intensive physiotherapy or massage too soon after the injury. Use someone who is properly qualified and insured.
Returning too soon to training after exercise.

Symptoms of Myositis Ossificans include:

Restricted range of movement.
Pain in the muscle when you use it.
A hard lump in the muscle.
An X ray can show bone growth.

What can be done?

See a sports injury specialist or doctor as soon as possible who will
Advise you to rest or immobilize the limb for 3 to 4 weeks.
X-ray the muscle to see when it is safe to start rehabilitation.
Operate in worst cases to remove the bone.
Myositis Ossificans (Heterotopic Bone Formation)