Thigh Hematoma

[QuakeMaker]

Three weeks ago a had a significant fall on a DH mountain bike. Among my injuries was a rather large hematoma (with significant bruising) on my left hip/thigh. I did manage to complete a sprint triathlon the week after with some discomfort but no real pain.

Other than the initial RICE, what is the best course of treatment for this injury?

As I don't experience any pain, is there any danger of running or cycling with this type of injury? Will exercise help prevent or promote myositis ossificans?

FWIW, I'm a 38 year old male in above average shape.

Thanks in advance.

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[thomas bibu]

hi dear,

well, the picture clearly explains the magnitude of your fall. lucky that you escaped without gross injury/fracture..

anyway, from your post I understand that you are rather comfortable. well, dont let many thoughts crowd your mind eg. new bone formation etc.

regarding ways to prevent new bone formation, there is no hard and fast rule, although there is a promising study regarding injecting hyaluronase. well, just be yourself. continue your normal activities of daily living.

the ecchymosis may take weeks or months to disappear completely, but please take care of your skin from any further bruises/injury because you cannot afford to have an infection. also try to continue your normal range of motion exercises.

you may ice massage for 10 minutes or more prior to exercise, but try to avoid normal conventional massage techniques as you may trigger further bleeding.

in the days to come if you develop increasing pain, fever, headache, muscle aches, dizziness or rather a general ill feeling visit your nearest doctor.

regarding diet, nothing special try to eat a well-balanced diet that includes extra protein such as meat, fish, poultry, cheese, milk and eggs and also double your fluid intake.

all the best and get well soon.

cheers,

thomas

[cordnels]

Hi, I was searching forsome information and came across this. I am a 48 year old male also in above average physical conditioning. I do martial arts and received a strike to the front/outer side of my thigh during sparring drills 10 days ago. It did not initially cause any pain, but within two hours after there was considerable pain and restricted motion.

I iced the muscle overnight, but was at a seminar and proceeded with conditioning drills and sparring for the next two days. I've continued training (4 days per week) since, and after warming up have approx. 70% motion when bending the knee, considerable pain beyond 70%. There is minor discomfort on extending. Also, after working out there is pain for a few hours. The thigh muscle is extremely tight at all times and I've developed blood discoloration similar to QuakeMaker, although away from the bruise site, opposite side (hamstring), I suspect due to sitting as I have a desk job.

I have a Dr.'s appointment today (it takes a while up here), but was wondering on two things, one, the myositis ossificans thing; any way to tell without x-rays? And second, any suggestions on accelerating the healing process?

Thanx very much

[jacquie]

I got the same sort of bruise here in NZ (world singlespeed championship)
I assumeyou healed up fine? Ihave only once before had sucha grotesque tie-dyed leg...and it's featured on my blog (Jacquiephelan.com, for the curious, and the perverse)
Let me know how long it took... ever,J

[memgem]

Hi, I was searching forsome information and came across this. I am a 48 year old male also in above average physical conditioning. I do martial arts and received a strike to the front/outer side of my thigh during sparring drills 10 days ago. It did not initially cause any pain, but within two hours after there was considerable pain and restricted motion.

I iced the muscle overnight, but was at a seminar and proceeded with conditioning drills and sparring for the next two days. I've continued training (4 days per week) since, and after warming up have approx. 70% motion when bending the knee, considerable pain beyond 70%. There is minor discomfort on extending. Also, after working out there is pain for a few hours. The thigh muscle is extremely tight at all times and I've developed blood discoloration similar to QuakeMaker, although away from the bruise site, opposite side (hamstring), I suspect due to sitting as I have a desk job.

I have a Dr.'s appointment today (it takes a while up here), but was wondering on two things, one, the myositis ossificans thing; any way to tell without x-rays? And second, any suggestions on accelerating the healing process?

Thanx very much

I dont usually advise my patients who have a haematoma to ice immediately or at all within the first 48 hours as cryotherapy in that area has been show to lead to some degree of coagulation of the blood and will not necassarily demonstrate the benefits cryotherapy usually may do.

[besnard]

Wow, I'm also 38, and my leg looked almost exactly like yours, my bruising wasn't quite as bad as yours. my injury happen to me on March 25, my wife's birthday no less, I landed on a tree root when I fell from my mountain bike. On April 4th, I had approximately 300cc's aspirated from my thigh. On April 8th, I had another 177cc's aspirated. How much longer should I expect this trend to continue. I go back on April 18th, and expect at least another 177cc's to be removed!

Is there anything I can do to keep the fluid from coming back? The hematoma is so high on my thigh, close to my hip, that I can't properly wrap it without the wrap falling off. My bruise is gone as far as I can tell. I'm still a little tender where I made initial contact with the root right below my hip. I'm just happy to not have any broken bones! I am ready to start running and riding again...

[escapeartisthk]

I'm in the the right forum. I'm a dh mountain biker in living in Hong Kong. nearly 5 weeks ago, I crashed and took some blunt trauma to my inner thigh near my knee. Within minutes, the effected area ballooned up to the size of a baseball, with I now assume is hematoma. I kept my leg elevated and iced for 3 days. ONce I was able to walk, I went to work and soon saw a doctor at the the ER. He said my problems was circulatory and to keep the aria heated and the best way to get rid of the bubble was to message it. No having much confidence in this, a few few days later I visited a osteopath who said it was a major muscle tear. Also said I would be out of action (riding) for 3-4 months. His advise was to keep the are compressed and ice the area regularly.

Now, Its been nearly 4 weeks. The bruising has long gone but the hematoma remains. Now the size of 1/2 baseball and getting harder. I feel some slight muscle strain in my groin and behind my knee, but I'm moving around without pain. What I'm concerned about now is the bubble on my knee/ thigh. I was told by a sports doctor recently that left to itself, the lump could calcify. Which could cause new problems. I'm not getting any consistent or helpful advise from the local (smug) doctors so I would like to understand what I can do to help myself. I have been told doctors don't like to drain these for risk of infection, but when is "too-long"?

Thanks, Misha

[darren]

Hi, I am in much the same situation as the guys above. I had a crash while Downhill MTBing. Went ver the bars and smashed my thigh on the bars. Have a massive lump on the outside of my thigh that is numb to touch and feels full of fluid.
It's been about a week and a half, and was wondering how long it will take to go away, or will it need to be drained?

Tried to sleep on it last night and woke up in agony with a sharp, piercing pain in the area.

[wendyp]

Hi, wow its nice to know i'm not alone in this! I had a fall while running on a trail over 2 years ago. I have a large hematoma on my right upper/outer thigh as a result. I have full functionality, just a very unsightly lump and the dip above it at the point of impact. Anyone know of any procedures that are minimally invasive that can reduce the appearance of it? thanks

[physiobob]

Hi, wow its nice to know i'm not alone in this! I had a fall while running on a trail over 2 years ago. I have a large hematoma on my right upper/outer thigh as a result. I have full functionality, just a very unsightly lump and the dip above it at the point of impact. Anyone know of any procedures that are minimally invasive that can reduce the appearance of it? thanks

That sounds like a partial tear of the muscle. No possibility for a repair to that except surgical but it is probably just a cosmetic issue. Makes for a nice BBQ story

[wendyp]

thank you for the reply. so would surgical repair of something like that be considered a minor procedure or might i be sorry that i did it? would that be removal of the torn muscle tissue? i was told after the injury that the vastus lateralis was partially torn but by the end of the treatment (worker's comp) that the lump was a hematoma. thanks for your response

[physiobob]

A hematoma itself will eventually be reabsorbed by the body. A calcium deposit as a result of myositis ossificans (the body laying down bone instead of tissue repair) will not be reabsorded and it has been suggested that to much activity after a muscle tear can lead to that (You can diagnose thay on plain x-ray). People do show individual variance though in that. The sports dr's are trying all sorts of repiar types for town quads these days. I am not sure there is anything that is showing to be useful to regain a preinjury level of function. i.e. This is more cosmetic then anthing else.

As a general commetnt for everyone else in this topic. Please do post your images of your injuries, scans, x-rays as this makes ijt better for us to comment. Seems we have a good but of interest in MTB injuries and this is one of the common ones. I has the same myself last yr road cycling in Majorca and am still hesitant in the wet. Rather annoying actually

[mizMo1]

While mountain biking 8 days ago (Friday July 22), I skidded out on a corner and smacked the end of my handlebars into my inner thigh (so hard I though I was going to vomit or passout, but luckily did neither), resulting in a huge, swollen, bruised inner thigh! I iced and elevated it on and off throughout that day and the next day (was then Saturday night so went to an outdoor festival where I just sat around in a lawnchair) iced when I got home. Iced and elevated on and off on Sunday. Had to go to work in office (sitting at computer) Monday and Tues and wrapped my thigh with ace bandage. Iced and elevated some on Monday evening. Tuesday after work, I went on 11 mile bike ride (mtn biked on flat area with a few dips). Afterwards alternated ice and warm. Wednes went on 15 mile bike ride in same area, once again did a little ice/warm alternating. Thurs had to work in office again and didn't wrap. No ride but alternated hot/cold that evening. 11 mile ride again on Fri afternoon after running errands (in and out of car and stores) once again hot/cold alternating that night.
This morning (Saturday) had a doctor check it out, since it doesn't appear that the swelling has gone down any and still lots of dark purple bruising. I can tell the bruise is dispersing some on the edges, but center is still VERY swollen, tight and tender to the touch. Only pain during walking or biking is when the lump brushes again something. Doctor took xrays and didn't see any fractures (I wasn't expecting him to do so but figured might as well have it checked out while there.) Otherwise, he basically just said it would heal in time and wrote a prescription for naprosyn (anti-inflammatory) in case I wanted to give it a try or could just take Aleve if I wanted OTC or just take nothing as I'd been doing.
So, I'm wondering if there's anything I CAN do that will speed healing plus help prevent any complications or whatever. I'm in good physical shape and was training for my first XC race coming up Aug 21. I've been applying Arnicare gel since Sunday evening. I was already taking vitamins before this happened: mulitvitamin, calcium, vit C and fish oil. I also eat a couple sheets of laver/dried seaweed a day. I've had scrapes and bruises before but nothing like this, so really no idea what I should/can do: ice only? ice/heat alternating? anti-inflammatory medicine? aspiring/blood thinner? anything?
Thanks!
Here is photo of thigh on Tues (still pretty much looks same):

[BayAreaMarc]

So, exactly the same injury as QuakeMaker above - even the same left leg. Dumped it on a downhill and slid. Broad bruising pattern and tender (hardly bruised) area in the middle that is tender and seems filled with fluid. I have run twice since then with only mild discomfort.

Will it go away on it's own or do I need to do anything? I did normal RICE for first two days

JPEG Attached for the curious

[Bassmanmike]

Hi there

I am another mountain biker living in Discovery Bay, Hong Kong, who has suffered a similar injury to the other contributors. I crashed my bike, and my left thigh landed on a handle bar, which caused a massive haematoma on the front of my upper thigh muscle. After 2 weeks, the swelling and bruising is still running down my leg. I cannot bend my knee beyond 120 degrees (i.e. not even to 90 degrees), and consequently cannot lift my leg fully or bend my leg in order to walk normally. I now have a large lump on my thigh the size of half a baseball, and the front of my thigh muscle is tight (like a permanent cramp) with no function.

I am interested in finding out how the other mountain bikers with similar injuries recovered, and whether the large lump eventually disappears, or whether surgery or other forms of treatment are required to restore the muscle to normal size, function, strength and flexibility. Also how long it took for full recovery.

Your replies and comments would be most appreciated.

Bikemanmike

[BayAreaMarc]

Hi there - feel free to email me to talk directly - [email protected]

I was fortunate in that mine did not restrict movement - it was not getting smaller after a month so I went to my doc and he drained it and immediately it went down a ton. He said it may come back and he could drain again, but it would *eventually* go away. It's been almost 3 months and I still see the remnants with a slight lump and slight tenderness, but nothing close to what it was before.

[Bassmanmike]

Hi Marc

Thanks for your reply. I guess I will just have to wait until it subsides by itself (hopefully). I've been told by my doctor to wait until the blood vessels have healed before going to a physio, so that seems to be the next step. Good to know that the lump will eventually disappear!

Cheers Bassmanmike

[YZMABABY]

WOW, Im glad I found other people with somewhat the same issue. Im gettin kind of worried, Ive had a hematoma on my left upper outer thigh for almost 10 years now, from a fall off of a moving vehicle. A day or two after the fall the hospital drained it, it was alot and I honestly cant remember how much. There is basically a dent in the middle of it from the draining, but balooned out on both sides of the drain. It hasnt been "painful" in years ofcourse, I basically forget its there sometimes, until I go to sit and accidently sit on it or put pressure on it. I was just wondering if its dangerous to keep going like this, ofcourse if I was rich and had insurance I would have had it taken care of completely by now, but the initial draining was thousands of dollars and money doesnt grow on trees. I know its dumb to let something like this go on for so long but now Im gettin worried as Im gettin older and I dont want it to turn into some kind of aneurysm or anything. It has always had that numb fluid filled feeling and its just a weird feeling to touch it, and Ive noticed throughout the years that when I take antibiotics for something when im sick, the hematoma starts to get all tingly and noticeable.... Should I leave it be or is it really dangerous to my health??

[sueffun]

I fell with my full weight onto the left trochanteric area of my left leg at ice skating five weeks ago. To say it was painful would be an understatement as I thought I was going to throw up. I apparently went very white and I was sweating.
When I got home I did the usual R.I.C.E technique but it continued to swell and was extremely tender. My husband just happens to be a surgeon and he told me it was just a heamatoma and it will eventually go away and to stop focussing on it.
Well I
cannot lie on that side in bed and its still very swollen and has formed a large solid mass, I am really at a loss as to what to do as its really sore even if I run, it burns. I am 58yrs old, very agile, supple and fit, so this is really a problem especially as it wakes me up at night. Any advice would be appreciated.

[miro42]

Hi also from me. I was looking for a solution for my problem (recovering the muscle after the hematoma removal), but it looks like nobody in this forum went that far.

I had my contusion and the subsequent hematoma in 1994. I had a small lump on the upper part of my outer thigh for 16 yrs...Finally, in 2010 decided to have it removed. The first surgeon who had to operate it cancelled the appointment due to a fear that the hematoma could be still alive and that would create some complications. He recommended another clinic where the surgeon was braver.
The result is that I don't have the lump anymore, and don't have pain. Unfortunately, however, I pretty much also don't have any vastus lateralis muscle left. The VL muscle on the left thigh was not as strong as the right one ever since the injury, but now I feel the middle part of the VL pretty numb. I guess, it was due to having some nerve cells being removed during the surgery. I've been cycling quite a lot after the surgery but, as you can see from the attached photos, it didn't help fill in the emptiness in the VL. The overall result is that the other quad muscles hypertrophated in order to compensate for the missing one. One physiotherapist told me that the hypertrophated muscles press the VL and don't allow it to recover properly...
The truth is that I never found the time to make physiotherapy/massages only on the VL. Probably, it would have helped. Not sure.
I plan to make another round of examinations in the coming days and get some professional advice how to finally recover the VL at the 20th Anniversary of the injury....
I will post further, if there's any progress.
Hope, this helps!Removed Hematoma_1.jpg

[roadie]

6 weeks ago i fell hard on my right hip...wet train tracks in the rain..huge bruise but above it was a pretty large contusion that was so painful...any clothing hurt..even a loose sundress or the bed sheets on my skin was like a stabbing pain..

2 weeks ago i had 70 cc's of fluid drained and i am like 85%...i heard all sorts of horror stories of infection, and maybe they wouldn't get much out....it was a lot and even the dr. was quite surprised...

headed back tomorrow to see if he can drain off anymore...but i would suggest to anyone in the same boat...do not wait 7-8 months for your body to reabsorb it..it's an instant relief when you get it drained...