Quadriceps Contusion
Definition
Miriam Webster's Dictionary defines a contusion as: a region of injured tissue or skin in which blood capillaries have been ruptured without a laceration; a bruise.
Grade 1
A grade 1 contusion presents with mild discomfort, no swelling, and no detrimental effect on gait (Dutton). The patient may present with mild tenderness upon palpation with little to no loss of ROM (NISMAT).
Grade 2
A grade 2 contusion presents with moderate discomfort, swelling which may have an effect on gait (Dutton). The injury site may present with discoloration and ROM will between 45-90 degrees of flexion (NISMAT).
Grade 3
A grade 3 contusion involves an underlying mass which may begin to bulge outward. Symptoms will include severe pain, edema, and ecchymosis. Active knee flexion ROM will be under 45 degrees (NISMAT).
Miriam Webster's Dictionary defines a contusion as: a region of injured tissue or skin in which blood capillaries have been ruptured without a laceration; a bruise.
Grade 1
A grade 1 contusion presents with mild discomfort, no swelling, and no detrimental effect on gait (Dutton). The patient may present with mild tenderness upon palpation with little to no loss of ROM (NISMAT).
Grade 2
A grade 2 contusion presents with moderate discomfort, swelling which may have an effect on gait (Dutton). The injury site may present with discoloration and ROM will between 45-90 degrees of flexion (NISMAT).
Grade 3
A grade 3 contusion involves an underlying mass which may begin to bulge outward. Symptoms will include severe pain, edema, and ecchymosis. Active knee flexion ROM will be under 45 degrees (NISMAT).
Treatment
Phase 1 - The purpose of this phase is to limit the hemorrhage which is primarily done through RICE (Dutton). When icing the patient should be instructed to keep the knee in a flexed position to promote healing. For patients with grades 2 or 3 crutches should be supplied and compression should be supplied with an ACE bandage with the knee in a flexed position (NISMAT).
Phase 2 - This phase should include pain free isometric quad exercises and mild stretching of the quads to restore ROM. Crutches can be discontinued when the patient displays proper quad control and normalized gait patterns (NISMAT).
Phase 3 - This is the return to function phase which should include strengthening and exercises specific to patient goals (NISMAT).
Phase 1 - The purpose of this phase is to limit the hemorrhage which is primarily done through RICE (Dutton). When icing the patient should be instructed to keep the knee in a flexed position to promote healing. For patients with grades 2 or 3 crutches should be supplied and compression should be supplied with an ACE bandage with the knee in a flexed position (NISMAT).
Phase 2 - This phase should include pain free isometric quad exercises and mild stretching of the quads to restore ROM. Crutches can be discontinued when the patient displays proper quad control and normalized gait patterns (NISMAT).
Phase 3 - This is the return to function phase which should include strengthening and exercises specific to patient goals (NISMAT).
References:
1. NISMAT http://www.nismat.org/traincor/quad_contusion/
2. Dutton M. Orthopaedic Examination, Evaluation, and Intervention. 2nd ed: The McGraw-Hill Companies, Inc.; 2008.
3. Image http://drdanrae.files.wordpress.com/2012/05/quad-contusion.jpg
1. NISMAT http://www.nismat.org/traincor/quad_contusion/
2. Dutton M. Orthopaedic Examination, Evaluation, and Intervention. 2nd ed: The McGraw-Hill Companies, Inc.; 2008.
3. Image http://drdanrae.files.wordpress.com/2012/05/quad-contusion.jpg