Dead Leg (Charley Horse) – Symptoms, Grades, Treatment, and Recovery

Thigh Injuries

What is a dead leg?

A dead leg is an injury caused by heavy impact to the quadriceps. The impact causes the thigh muscle to be crushed against the femur (thigh bone), resulting in a contusion or bruising on the thigh bone and the leg unable to support body weight.

The injury is also known as ‘quadriceps contusion’, colloquially a ‘Charley horse’.  The injury is graded from one to three, resulting in anything from numbness to a debilitating injury.

A dead leg is often regarded as a minor injury. However, the correct diagnosis is required as immediate treatment is necessary. Generally, sports injuries need sufficient heeling time.  if an athlete attempts to play on, or undertakes exercise too soon or without the correct diagnosis then delayed healing can be caused and, in the worst case scenario, permanent damage.

Contusions in a dead leg can be intermuscular or intramuscular, with treatment depending on the level of injury and the type of contusion.

Intramuscular contusions
Intramuscular contusion is the result of a tearing of the muscle within the surrounding sheath. The increased pressure on the muscle prevents fluid from escaping, this may cause the bleeding to stop within the first few hours of the injury.

Intramuscular contusion may result in loss of function and/or a considerable amount of pain. However, the risk of bruising is low. Recovery time can take days or weeks.

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Intermuscular contusions
Intermuscular contusions are the result of a tearing of the muscle and a portion of its surrounding sheath. While initial bleeding in this form of contusion will take longer to stop, especially when not iced. The recovery is often faster as the blood and fluids are able to flow away from the site of injury through the tear in the muscle sheath. With intermuscular contusions there is an increased likelihood of bruising.
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Symptoms

Symptoms of a dead leg is often recognised as pain felt at or near the area of impact. Whilst a dead leg may stop some from playing sports immediately, others may find that they are able to continue playing sports. However, as the muscles begin to cool down and body temperature lowers, the pain felt from a dead leg may begin to increase. The increase in pain is a result of the bleeding and swelling that continues after the event has occurred.

In addition to pain at the site of impact, those suffering from a dead leg may also experience a sense of tightening and stiffening in the quadriceps.

Additional Symptoms of Dead Leg May Include:

• Mobility Issues
• Reduced Movement Range
• Muscle Spasms
• Muscle Cramps

Grades of Thigh Contusions

Grade 1
Grade 1 thigh contusions usually feel a sense of tightness in the thigh that can often cause the patient to walk with a limp. With Grade 1 contusions the likelihood of swelling is low and straightening the knee is not likely to produce much pain. Patients with Grade 1 contusions usually maintain a full range of motion when stretching the muscle.
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Grade 2
Grade 2 thigh contusions often affect the patient’s ability to walk properly. Patients with Grade 2 contusions will often feel sudden, sharp pains especially during activity. Also, swelling may occur when straightening the leg. Pressure on the injured area is likely to be painful and the knee may not be able to fully bend.
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Grade 3
Grade 3 contusions often means the patient will be unable to walk without the assistance of crutches. Grade 3 contusions cause severe pain and significant swelling is likely to appear immediately after injury. Patients with Grade 3 contusions will likely notice a visible bulge or gap in the muscle when flexing. Recovery can take 3 to 12 weeks.
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Treatment

dead leg treatment

Whatever the level of injury, the PRICE principles of treatment are best applied. These are:

  • Protection
  • Rest
  • Ice
  • Compression
  • Elevation

Treatment should be applied as soon as possible.

Ice and compression can be applied immediately, ice to be re-applied for ten minutes every two hours for up to three days. This will help to reduce internal bleeding, swelling and pain. The leg should be elevated to allow tissue fluids to drain away from the area. A compression bandage will offer support to the injury and further reduce swelling.

Misdiagnosis can be dangerous, and so assessment should be carried out by a competent professional. A complete rupture of an intramuscular injury can occur if the leg is used for exercise or sports too quickly, this can lead to a permanent injury/ disability.

Myositis Ossificans can result if heat is applied inappropriately. This is characterised by bone formations within the injured muscle and can be a very serious condition which requires expert medical examination and attention.

A dead leg can also be treated by medical person(s) or similar, they may use an ultrasound as it can speed up recovery. For the more serious cases,  to ensure that pressure is not applied to the damage before it has had a chance to adequately heal, a rehabilitation plan is advised. Furthermore, the use of crutches may be necessary.

How long does a dead leg take to heal?

The speed of recovery depends on the extent of the injury. For a grade one injury, recovery will be quite rapid with stretching possible soon after diagnosis and recovery likely within one to two weeks.

A grade two injury can take two to four weeks to recover, sometimes longer. Pain lingers, and it will be difficult for the patient to walk properly. Twinges are likely, and straightening the leg will be hard.

When the injury is at the most serious, Grade 3 level, the patient will suffer severe pain and have significant and immediate swelling. Recovery time can be between three to twelve weeks.

Recovery

Grade 1
For Grade 1 contusions, strengthening exercises can be performed to help rebuild muscles as soon as the pain has stopped. It is recommended to begin with a simple exercise routine and progress at a steady and comfort paste. Progressively introducing harder routines as part of the recovery process progresses
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Grade 2
For Grade 2 contusions, it may be over a week before strengthening exercises can be started. It’s important to warm-up before beginning any strengthening exercises and finish with a long stretch to ensure you are keeping your muscles healthy. Strengthening exercises should be continued for weeks or until the injury has fully healed.
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If you are unable to continue with your regular athletic training, cycling and swimming offer alternatives that still allow you to build and maintain leg muscle. If these exercises are too strenuous on your injury, it is recommended to focus on upper body strength building while you heal.

Adnan Munye

A certified personal trainer and sports nutritionist, Adnan specialises in weight loss, muscle building, body conditioning, core strengthening and injury rehabilitation. Adnan comes from sporting background, where he has played football, badminton, rugby, and swimming all at various levels.
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Last modified: 22nd September 2018