Compression rupture of m.quadriceps femoris
Rehab of the injury
Description of Compression rupture
Compression rupture of the quadriceps femoris muscle is the result of a trauma, in which the four-headed thigh muscle is compressed between a hard outer object and the hard surface of the femur. When this happens, there will often time be an injury deep inside the muscle where a bleeding and subsequent inflammation occurs. Such an injury can actually occur anywhere, on the arm, lower leg, etc. It is one of the most well-known injuries in contact sports,When the muscle is injured, two types of bleeding can occur, namely intra- which means “within the muscle” and intermuscular which means “between the muscles”. Around all muscles we have a muscle membrane (myofascial) and if this doesn’t break during the trauma, we have an intramuscular (within the muscle) bleeding. This bleeding can be severe because the blood pressure can rise to the level, where it squeezes on the blood supply. When this happens, the muscle can’t get oxygen and will die. (necrosis due to ischemia). If you get the intramuscular, you will also not be able to see the blood flow, and the pain will accumulate and get worse, because the bleeding presses on the nerves. In the case of less severe bleeding, intermuscular (between the muscles), the membrane of the muscle is broken and the bleeding runs out between the different muscles. In this case, you will usually also see a blood leak in the skin, because the blood runs out to the tissue that is loosest. A compression rupture is very often seen in contact sports such as. football, rugby, hockey or where an object can impact an athlete’s thigh.
Symptoms of Compression rupture
- At the occurrence of trauma, a practitioner may experience varying levels of pain and reduced movement.
- The extent of pain and loss of movement will depend on the force of the trauma.
- The traumatized area becomes swollen and painful to touch.
Compression rupture can be classified according to how severe they are:
Mild
An athlete who experiences a mild compression will usually be able to continue practicing his sport, but may feel a bit sore after cooling down or the following day. The affected area may be tender to the touch, the ability to stretch the muscle may be reduced, and the strength of the muscle may also be reduced.
Moderate:
A moderate compression can prevent an athlete from continuing, however, swelling will be experienced the most when he rests. The athlete may experience pain and the affected area will be tender to the touch. An athlete with moderate compression of the quadriceps muscles will often experience approximately a halving of the movement.
Severe
Severe compression will be characterized by rapid swelling and bleeding. Both swelling and bleeding may be uncontrollable. Loss of movement will be severe and the patient will experience difficulty having full weight on the affected leg. The affected area will be very tender and the muscle strength will be less. It takes a minimum of 8 weeks to recover from a severe compression rupture.
Myositis Ossificans
The more severe a compression, the greater the risk of developing myositis ossificans. This happens when the clotted bleeding forms a smaller bone inside the muscle where the bleeding was previously. Some of these small bones (limescale deposits) disappear on their own within six-seven weeks, while larger ones can take more than a year, to be absorbed into the body, and some never disappear and must be removed.
Examination of Compression rupture
- Conversation, direct examination of the injury occurrence.
Inspection of the muscle and surrounding tissue.
The 4 muscle tests. (Power, Palpation, Tensing and, useability of the muscle).
Treatment of Compression rupture
- Light stretching.
- Light massage.
- EMS (electro-myo-stimulation).
- Cryotherapy (is i 9 min) og herefter let stretching.
- Class 4 laser.
- Light training exercises. (see rehab here).
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