There are two types of contusions: intramuscular and intermuscular contusions.

Intramuscular contusions involve the tearing of the muscle in its sheath. Initial bleeding stops early due to the increased pressure inside the muscle. Any blood is trapped within the sheath and the result is that you won’t see any bruising. One loses proper function in that leg and can be in pain for a few weeks. You will know that you have this type of contusion if the swelling has not gone down within two to three days.

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Intermuscular contusions are tearing of the muscle and the sheath around it. If you do not apply ice immediately, bleeding will take a long time to stop. You will see bruising from this type of contusion, but recovery is usually speedier than intramuscular contusions as blood is able to flow freely away from the injury.

If you are able to contract the muscle, you have an intermuscular injury.

If you do not seek help and continue exercising on either kind of contusion, you may inhibit healing and do permanent damage.

There are three different grades of contusions depending on the severity.

Grade one contusions
Symptoms

• Tightness in the thigh
• You can’t walk properly
• Little or no swelling
• It won’t hurt that much if you straighten your knee
• Full range of motion in the knee

What can be done?

• R.I.C.E. (Rest, ice, compress and elevate) immediately
• Apply a compression bandage or heat retainer until the pain subsides
• Do gentle quadriceps stretching five times a day

Grade two contusions
Symptoms

• You can’t walk properly
• Sudden twinges of pain when moving
• Slight swelling
• It hurts when you apply pressure
• It hurts when you straighten your knee
• You can’t bend your knee totally

What can be done?

• R.I.C.E. (Rest, ice, compress, elevate)
• Use crutches for three days at least

Grade three contusions
Symptoms

• You can’t walk without crutches
• Severe pain
• Bad swelling
• Static contraction of the muscle will be painful and might produce a bulge in the muscle
• You will be out of action for three to twelve weeks

What can be done?

• Use crutches – you don’t have a choice!
• R.I.C.E. (Rest, ice, compress, elevate)

Note: In all three grades the following can help:

• Consult a sports injury specialist immediately
• Sports massage techniques will speed up recovery
• Ultrasound and electrical stimulation
• Follow a rehabilitation programme prescribed by a specialist

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