What is Quadriceps Contusion

Quadriceps contusion is a deep bruise of the large muscle in the front of your thigh. Deep bruises happen when an injury causes bleeding under the skin. The skin over the deep bruise may turn red, blue, purple, or yellow. Minor injuries will give you a deep bruise that is painless.

Deep bruises that are worse may stay painful for a few weeks or more. This condition may make it hard for you to bend your knee. This condition is treated with rest, ice, pressure (compression), and elevation. This is often called RICE therapy.

Follow these instructions at home:

RICE Therapy

• Rest the injured area until the pain and swelling get better.
• If directed, put ice on the injured area.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times per day.
• Use pressure (compression) wraps as told by your doctor.
• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down. You can do this by lying on your back and placing a pillow under your knee.

If you have a splint:

• Wear the splint as told by your doctor. Remove it only as told by your doctor.
• Loosen the splint if your toes tingle, become numb, or turn cold and blue.
• Do not let your splint get wet if it is not waterproof.
• If your splint is not waterproof, cover it with a watertight plastic bag when you take a bath or a shower.
• Keep the splint clean.

Activity

• Return to your normal activities as told by your doctor. Ask your doctor what activities are safe for you.
  • Exercise and stretch as told by your doctor.
  • Before you stretch the injured area, apply moist heat for 15–20 minutes, or as told by your doctor.
  • Avoid movements and exercises that cause pain.
• If you are told to use crutches, use them as long as told by your doctor.

General instructions

• Take over-the-counter and prescription medicines only as told by your doctor.
• Keep all follow-up visits as told by your doctor. This is important.

How is this prevented?

• Wear protective gear while you exercise and while you play contact sports.
• Keep your muscles strong and flexible, especially in the thigh area.

Contact a doctor if:

• You have symptoms that last longer than 3 weeks.
• You have bruising or swelling that gets worse.
• You have more trouble bending your knee.
• You have pain that does not get better with medicine or gets worse.
• You get new symptoms.

Get help right away if:

• You have numbness or a “pins and needles” feeling in your feet or legs.
• You cannot walk because of pain.

Quadriceps Contusion Rehabilitation

Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do not begin these exercises until told by your health care provider. Right after you are injured (acute phase), it is often more important to rest your quadriceps, and starting exercises too soon can make your healing take longer.

Stretching and range of motion exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your thighs. These exercises can also help to relieve pain, numbness, and tingling.

Exercise A: Knee flexion, active

1. Lie on your back with both knees straight. If this causes back discomfort, bend your healthy knee so your foot is flat on the floor.
2. Slowly slide your left / right heel back toward your buttocks until you feel a gentle stretch in the front of your knee or thigh.
3. Hold for __________ seconds.
4. Slowly slide your left / right heel back to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise B: Hamstring stretch, doorway

1. Lie on your back in front of a door frame with your left / right leg resting on the wall and your other leg flat on the ground in the doorway. There should be a slight bend in your left / right knee.
2. Straighten your left / right knee. You should feel a stretch behind your knee or thigh. If you do not, scoot your buttocks closer to the door.
3. Hold this position for __________ seconds.

Repeat __________ times. Complete this exercise __________ times a day.

Strengthening exercises

These exercises build strength and endurance in your thighs. Endurance is the ability to use your muscles for a long time, even after your muscles get tired.

Exercise C: Quadriceps, isometric

1. Lie on your back with your left / right leg extended and your other knee bent.
2. Gradually tense the muscles in the front of your left / right thigh. You should see your kneecap slide up toward your hip or see increased dimpling just above the knee. This motion will push the back of your knee down toward the surface that is under it.
3. For __________ seconds, hold the muscle as tight as you can without increasing your pain.
4. Relax the muscles slowly and completely after each repetition.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise D: Wall slides

Follow the instructions for form closely. If your feet or knees are not placed properly, this can lead to knee pain.

1. Lean back against a smooth wall or door and walk your feet out 18–24 inches (46–61 cm) from it. Place your feet hip-width apart.
2. Slowly slide down the wall or door until your knees bend __________ degrees. Keep your knees over your heels, not over your toes. Do not let your thighs angle inward.
3. Hold for __________ seconds. Stand up to rest for __________ seconds after each repetition.

Repeat __________ times. Complete this exercise __________ times a day.

Your health care provider will alter the knee angle that you should use during this exercise based on your symptoms and progress. You may start with just a small motion.

Balance exercises

These exercises improve or maintain your balance. Balance is important in preventing falls.

Exercise E: Single leg stand

1. Stand near a railing or in a door frame that you can hold onto as needed.
2. Stand on your left / right foot. Keep your big toe down on the floor and try to keep your arch lifted.
3. Hold this position for __________ seconds.
4. If this is too easy, try doing it with your eyes closed or while standing on a pillow.

Repeat __________ times. Complete this exercise __________ times a day.