Hamstring injuries like contusions are caused by blunt force trauma. Think hard, direct impact to the muscle from a collision, with a player or ball, or a fall directly onto something. This can cause internal bleeding inside the muscle. This bleeding differs from a grade 2 or 3 muscle tear, as no muscle fibers are torn, but small blood vessels on the surface burst. Usually a massive bruise forms over the impact area and you may notice that the bleeding will start sagging lower down.
The contusion will change color as it gets reabsorbed by your body. A superficial contusion, where the bleeding is between the muscle and skin (intramuscular) is best case scenario. You can a PRICE protocol described above. If the impact was so severe as to cause bleeding inside the muscle fibers (intramuscular), there is cause for more concern. Re-absorption is extremely important in this case, so that the muscle fibers do not see the pooled blood as foreign and start forming scar tissue around it. In very bad cases bone may form in the area which will act like sharp crystals scraping along the muscle fibers.
Contusions usually present with pain, swelling and skin discoloration (blue). Contusions are also classified as grade 1 – 3. The severity of the contusion will influence your function, the worse the contusion, the more pain and the more you will struggle to walk. Crutches may be necessary.
Physiotherapy will include ultrasound to encourage re-absorption of the bruise, static muscle contractions, taping and gentle stretching. Depending on the severity of the contusion, we may see you more often initially to aid healing and thereafter follow up to make sure your muscle length and strength is back to normal.