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THIGH CONTUSION

General Information

DEFINITION--Bruising of skin and underlying tissues of the thigh (between knee and hip) due to a direct blow. Contusions cause bleeding from ruptured small capillaries that allow blood to infiltrate muscles, tendons or other soft tissue. The thigh is well-suited to absorb direct blows, but contusions do occur here.

BODY PARTS INVOLVED

The thigh, including blood vessels, muscles, tendons, nerves, covering to bone (periosteum) and connective tissue.
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SIGNS & SYMPTOMS

  • Swelling of the thigh--either superficial or deep.
  • Pain and tenderness in the thigh.
  • Feeling of firmness when pressure is exerted at the injury site.
  • Discoloration under the skin, beginning with redness and progressing to the characteristic "black and blue" bruise.
  • Restricted activity of the injured leg proportional to the extent of injury.

    CAUSES

    Direct blow to the thigh, usually from a blunt object (frequently the edge of a thigh pad in football pants.)

    RISK INCREASES WITH

  • Violent contact sports, especially football.
  • Medical history of any bleeding disorder such as hemophilia.
  • Poor nutrition, including vitamin deficiency.
  • Inadequate protection of exposed areas during contact sports.
  • Use of anticoagulants or aspirin.

    HOW TO PREVENT

    Wear appropriate protective gear and equipment, such as thigh pads, during competition or other athletic activity if there is risk of a thigh contusion. Keep thigh pads strapped in position.

    WHAT TO EXPECT

    APPROPRIATE HEALTH CARE
  • Doctor's care unless the contusion is quite small.
  • Self-care for minor contusions and for serious contusions during the rehabilitation phase.
  • Physical therapy following serious contusions.

    DIAGNOSTIC MEASURES

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor for all except minor injuries.
  • X-rays of the thigh, knee and hip to assess total injury to soft tissue and to rule out the possibility of underlying fractures. The total extent of injury may not be apparent for 48 to 72 hours.

    POSSIBLE COMPLICATIONS

  • Excessive bleeding leading to disability. Infiltrative type bleeding can often lead to calcification and impaired function of injured muscle.
  • Prolonged healing time if usual activities are resumed too soon.
  • Infection if skin over the contusion is broken.

    PROBABLE OUTCOME

    Healing time varies with the extent of injury, but average healing time for a thigh contusion is 1 to 2 weeks.

    HOW TO TREAT

    NOTE -- Follow your doctor's instructions. These instructions are supplemental.

    FIRST AID

    Use instructions for R.I.C.E., the first letters of REST, ICE, COMPRESSION and ELEVATION. See Appendix 1 for details.

    CONTINUING CARE

  • Wrap an elasticized bandage over a felt pad on the injured area. Keep the area compressed for about 72 hours.
  • Use ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage gently over the injured area in a circle about the size of a softball. Do this for 15 minutes at a time, 3 or 4 times a day, and before workouts or competition.
  • Massage gently and often to provide comfort and decrease swelling.

    MEDICATION

  • For minor discomfort, you may use: Acetaminophen or ibuprofen. Topical liniments and ointments.
  • Your doctor may prescribe stronger medicine for pain.

    ACTIVITY

    Begin activities slowly and stop exercise as soon as pain begins. Increase activity as healing progresses.

    DIET

    Eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Your doctor may prescribe vitamin and mineral supplements to promote healing.

    REHABILITATION

    Begin daily rehabilitation exercises when supportive wrapping is no longer needed. See section on rehabilitation exercises.

    CALL YOUR DOCTOR IF

  • You have a thigh contusion that doesn't improve in 1 or 2 days.
  • Skin is broken and signs of infection (drainage, increasing pain, fever, headache, muscle aches, dizziness or a general ill feeling) occur.
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