Week 2 - Acute Contusions I

Question 1

What causes acute muscle contusions?

Answer 1

• forceful impacts
• localised (blunt) trauma involving damage to the fibres and bleeding
• pain
• bruising (ecchymosis), edema (swelling) & hematoma (pool of clotted blood)

Question 2

What is a mild cork?

Answer 2

• return to play 1-3 weeks
• usually able to continue playing
• soreness after cooling down or following day

Question 3

What is a moderate cork?

Answer 3

• return to play around 4 weeks
• may prevent player from continuing
• stiffening/swelling may be experienced with rest
• ROM will be diminished up to 50%

Question 4

What is a severe cork?

Answer 4

• return to play up to 8 weeks
• rapid onset of swelling and obvious bleeding
• movement loss severe, difficulty bearing weight on affected leg, muscle strength diminished

Question 5

What is the sequence of an acute muscle contusion?

Answer 5

• initially red (fresh, oxygen-rich blood newly pooled underneath skin)
• after 1-2 days, blood loses oxygen - appear blue, purple, or black (haemoglobin)
• around 5-10 days, yellow/green (bilirubin)
• after 10-14 days, yellowish brown or light brown

Question 6

What are the common and rare sites for muscle contusions?

Answer 6

Common “vulnerable” sites - vastus lateralis & biceps brachii
Less common “protected sites” - thigh adductors & medial gastrocnemius

Question 7

What is “ICE not HAM”?

Answer 7

I = ice
C = compression
E = elevation

H = heat - avoid
A = alcohol - avoid
M = massage - avoid

Question 8

What position is best for acute muscle contusion recovery?

Answer 8

• place in pain free stretched position
• muscle fibres not in shortened position
• may reduce rate of myositis ossificans (boney growth within a muscle) (heterotrophic ossification)

Question 9

What is the mechanism with myositis ossificans traumatica?

Answer 9

• bone deposition @ 2-4 weeks
• differentiation of fibroblasts into osteoblasts

Question 10

What are the potential causes of myositis ossificans traumatica?

Answer 10

• local factors (reserve of calcium in adjacent skeletal tissue, vascular stasis tissue hypoxia, mesenchymal cells with osteoblastic activity
  Unknown systemic factors

Question 11

What is compartment syndrome?

Answer 11

A build up of pressure a swelling from one or multiple contusions that often needs to be addressed with surgery to release the pressure, otherwise the site can become necrotic