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The Irish Society of Chartered Physiotherapists

Contusion/Dead Leg by Keith Griffin

Dead Leg

What is a dead leg/muscle?

Most commonly a dead leg happens in the quadriceps which is a group of four muscles (Rectus femoris/Vastus lateralis/Vastus medialis and Vastus intermedius) that make up the thigh at the front of your leg.

A dead leg (also known as a contusion or haemorrhage) is damage to the muscle and secondary bleeding within the muscle. Treatment with your therapist is recommended for a dead leg to aid in the muscles return to normal function.

What causes a dead leg/muscle?

A dead leg is caused by a direct impact or blow to the muscle. This can happen by being struck by an object or by colliding with another person. The blow compresses the affected muscle against the underlying bone. This results in damage the muscle fibres and blood vessels in that area, causing bleeding, swelling, redness and possible bruising.

What are the common symptoms of a dead leg/muscle?

Pain is felt at the point of impact. With minor dead legs you may be able to continue participating in sports. However, as the muscle cools down after activity the pain may gradually increase. This is because the bleeding and swelling continues after the activity. You may also experience a gradual tightening and stiffening of the quadriceps.
Other symptoms may include:

  • weight baring problems
  • reduced range of movement
  • Pain
  • cramps

What should I do if I have a dead leg? 

To aid in your recovery and to limit the amount of damage to muscle tissue by following the recommended RICE protocol in the first 48 hours.

Inflammation or Swelling is necessary for you body to start to heal your injury; however, too much swelling can delay healing and lead to possible further tissue damage.

To limit the amount of swelling, the RICE protocol should be followed (Rest, Ice, Compression, Elevation). Using the RICE protocol, you will reduce blood flow to the injured area and, therefore, can help reduce the amount of swelling and tissue damage.

Rest involves limiting/restricting the amount of weight or force you put through the injured muscle.
The use of a support may be required if you are having using the injured muscle.

Ice should be applied to the injured muscle for 20 minutes every 2 hours. It should be applied using a bag of ice wrap in a wet towel or cloth so not damage your skin.

Compression involves the applying an elastic bandage or a compression tubing around the injury. It is important that the compression is not too tight.

Elevation involves placing the injury site in a resting position with the use of a support or pillow so that the above is positioned over the level of your heart.
The RICE regime should be continued until you have been fully assessed by your therapist. This should be ideally seen with 72 hours of the injury occurring

Treatment for a dead leg/muscle.

Treatment and assessment by your therapist are an important part of the recovery of any dead muscle. Initially, your therapist can determine the exact tissues/muscles damaged and the extent of the damage. Your therapist will also be able to provide you with an indication of how long the injury is expected to take to heal. Initial treatment is aimed at reducing pain and swelling and enhancing the healing of the injured structures. As you recover your therapist can provide a strengthening and stretching programme to accelerate your return to normal muscle function.

Treatment can include:

  • Manipulation / Soft tissue work
  • Dry Needling
  • TENs
  • Rehabilitation

What shouldn’t I do if I have a dead leg/muscle?

In the first 48 hours after a dead muscle, you should avoid activities that can increase blood flow to the damaged area.

An increase in blood flow can increase the amount of bleeding into the tissues and swelling. This in turn can cause increased pain and a prolonged recovery.

Activities to avoid include, hot showers, stretching, deep heat, massage, consumption of alcohol and excessive activity.

Are there any long-term effects from a dead leg/muscle?

A condition called myositis ossificans can be caused if a dead leg is caused to rebleed during recovery. This very serious condition can occur if someone returns to activity too soon, or through over-vigorous massage or stretching of the injured muscle.

by Keith Griffin

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