A contusion occurs in a muscle when there has been a direct impact. This injury can often occur in contact sports like rugby and American Football. The impact causes bleeding and damage to the muscles which makes the area very painful. The most common site for a contusion is the quadriceps muscle, which is sometimes then referred to as a 'charley horse' or a 'dead leg'. 

Contusions can occur in any muscle, with the hamstrings and calf muscles being other common locations.

A hard impact causes local muscular damage and bleeding as the muscle is crushed against the underlying bone. Contusions are common in contact sports during tackles and also in events where a hard object (such as a ball) moves at high pace.

Contusions should not be confused with a muscle strain, which tends to occur as a result of a sudden movement or burst of speed. Contusions should be treated slightly differently to strains.

What are the Symptoms?

  • A sudden impact to a muscle.
  • Pain in the area.
  • Bruising and swelling are common.
  • There may be a decrease in motion.
  • Contracting the muscle will be painful.

How Should a Contusion be Treated?

Treatment of a contusion should be quite cautious. Continuing to play after injury, over-aggressive treatment or applying heat or massage too soon to the injury can result in the development of myositis ossificans. This is where the hematoma (bleed) calcifies and a bony growth develops within the muscle. This can affect the muscles function on a long-term basis.

Immediate treatment of a contusion should involve rest and cold therapy application. The injury should also be elevated and a compression bandage or support applied, to help minimise bleeding and swelling. This protocol should be continued until all bleeding has stopped. Only when this is certain, should other treatments which may put heat into the muscle, be applied.

Treatment can then be progressed cautiously, using electrotherapies such as ultrasound and soft tissue therapy e.g. sports massage. Stretching exercises should also be used if a decrease in motion is noted.

Those involved in sports where the risk of contusion is high (such as Rugby and American football) should consider the use of protective equipment such as padded shorts and shirts.