A hamstring muscle contusion involves a direct blow to the back of the thigh causing the muscle to be crushed against the bone. Pain and bruising at the point of impact are some of the main symptoms, but the condition of the leg should be monitored over several days to make a more accurate and specific diagnosis. Contusions are graded depending on their severity, which you can read more about here.
Symptoms of a hamstring contusion
It will be pretty obvious if you have taken a hard impact to the back of the thigh although the exact damage and severity of the injury may not be so clear. Symptoms will include pain at the site of injury. There may be swelling or bruising and movement may be restricted.
After two to three days check:
- If the swelling has not gone then the athlete probably has an intramuscular injury.
- If the bleeding has spread and caused bruising away from the site of the injury then they probably have an intermuscular injury.
- If they are more able to contract the muscle then an intermuscular injury is suspected.
- Is there a deformation in the muscle or a gap?
It is important the correct diagnosis is made because trying to exercise on a complete rupture, or a bad intramuscular injury can inhibit healing, make things worse or cause permanent disability. If heat and massage are applied in the early stages then Myositis Ossificans (or bone forming within the muscle) may result.
Like muscle strains, contusions are grade 1, 2 or 3 depending on the severity.
What is a contusion?
This type of hamstring injury is more common in contact sports. An impact on the muscles can cause more damage than might be expected and should be treated with respect. The muscle is crushed against the bone. If not treated correctly or if treated too aggressively then myositis ossificans may result. Contusions are classed as intramuscular and intermuscular and recovery time will depend on which is sustained.
Intramuscular which is a tearing of the muscle within the sheath that surrounds it. This means that the initial bleeding may stop early (within hours) because of increased pressure within the muscle, however, the fluid is unable to escape as the muscle sheath prevents it. The result is considerable loss of function and pain which can take days or weeks to recover. There is not likely to be any bruising with this type – especially in the early stages.
Intermuscular which is a tearing of the muscle and part of the sheath surrounding it. This means that the initial bleeding will take longer to stop especially if cold therapy or ice is not applied. However, recovery is often faster than intramuscular as the blood and fluids can flow away from the site of injury. There is more likely to be bruising with this type of injury.
Treatment for a hamstring contusion
Contusions are graded 1,2 or 3 depending on the severity of injury:
Grade 1 contusions might have tightness in the back of the leg. The patient is likely to be able to walk although possibly with a limp. There will not be much swelling and the patient will have a full range of motion.
Rest and apply ice or cold therapy immediately. Ice can be applied for 10 to 15 minutes with compression every hour for the first 24 to 48 hours. See a sports injury professional for advice on treatment and rehabilitation.
A professional therapist can use sports massage and electrotherapy to speed up recovery after the acute stage has passed. A full rehabilitation program consisting of stretching and strengthening exercises is required to avoid future injury.
With a grade 2 contusion, the patient probably cannot walk properly and may experience sudden twinges of pain during activity. There may be slight swelling and pressing in on the injury will be tender. Contracting the hamstring muscles against resistance causes pain and the patient will have a limited range of movement.
Apply ice and compression as soon as possible and avoid walking on the leg for 3 to 5 days. Again, a professional therapist can use sports massage and electrotherapy to aid healing after the acute stage.
With a grade 3 contusion, the patient will be unable to walk without the aid of crutches. They will be in severe pain and swelling will appear immediately. A static contraction will be painful and might produce a bulge in the muscle. Expect to be out of competition for 3 to twelve weeks. If the injury is particularly severe then surgery may be indicated.