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Posted by Kathy Sellwood, Sep 8 2008 3:07AM

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Compression syndrome of the quadriceps

Whilst at a football match a defender collided with his own goal keeper and they both had an injury to the quadricep and thought it was just a dead leg so both decided to see if they could run off the pain. Tightness was felt in the rectus femoris and vastus lateralis. The defender then came off 10 minutes later still complaining of extreme pain and rested on the side lines. Later that evening he was still complaining of intense pain and was unable to lift the leg to get up stairs or bend the knee. Swelling was very noticeable although there was no bruising present and he had little feeling from the knee downards. Whilst walking short distances the leg would give way causing more intense bouts of pain. I advised to seek medical attention although he was very reluctant.

He was admitted to A&E, taken to a ward and put on morphine shortly after. A&E Drs said they suspected compression syndrome and they may need to operate by making an incision from knee to hip to release pressure from the swelling. Alternatively they will wait and see if they can drain the swelling by syringe.

I wanted to know if another therapist has had a client with an injury similar to this, what the outcome was, what rehabilitation massage/exercises to use when he is able to?
Mike Colquhoun
Dec 13 2008 10:36AM
Hi Kathy
Sorry I didn't answer sooner and I understand why you have still had no answer. Compression syndrome is a tricky one and strictly speaking this is not what your athletes were suffering from. Compression syndrome is an excess of interstitial fluid.
Though this is basically the same this is bruising, a bleed into the muscle tissues, it is complicated by the bleed being contained within the muscle endomysium or the perimysium, that is the bags containing bundles of muscle fibres. The proper term is 'an intramuscular haematoma' whereas we are more familiar with an 'intermuscular haematoma' [ra not er] where the bag has burst.
The problems this presents are mainly due to the pressure being contained and not allowing the flow of fluids around it. This can become 'acute compartment syndrome' [where the pressure on an artery has become so great it has stopped the flow of blood through to areas beyond] which requires surgery so you were absolutely right to send this one to the hospital.
Treatment afterwards? Well once treated it is only bruising as the pressure has been released, so long as the flow of blood was restored soon enough to prevent damage to tissues beyond the blockage.
Much too late to help you but maybe someone else will find this and find it useful.
Yours aye Mike

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