What should you know about deep muscle contusion?

A contusion, also called a muscle bruise or dead leg, can affect tissue beneath the skin even when the visible mark is small. Pain, tenderness, swelling, stiffness and reduced strength may develop soon after the impact or become clearer later. A thigh or calf bruise can make walking, climbing stairs or bending the nearby joint uncomfortable. The injury does not automatically mean that the muscle is torn, but a clinician may need to distinguish a contusion from a fracture, tendon injury or a collection of blood that is restricting movement.

For the early phase, stop the activity that caused pain and protect the area from another blow. Use a wrapped cold pack for short periods, keep the limb comfortably supported, and avoid forceful stretching, heat or deep pressure while swelling is increasing. Gentle movement within comfort can help prevent stiffness; do not push through sharp pain. As walking and joint movement improve, a physiotherapist can guide gradual strengthening and return to sport. Heat and cold therapy may be useful at different stages, and sports massage should wait until an examination confirms that deeper pressure is appropriate.

Arrange prompt medical assessment if pain is severe, swelling is rapidly increasing, the limb feels very tight, you cannot bear weight, or normal movement is markedly limited. Seek urgent help for numbness, weakness, a pale or cold foot, or pain that seems out of proportion to the impact. A bruise that is not improving, keeps enlarging, or follows a significant collision also deserves review. Calf pain with new swelling or breathing difficulty needs urgent attention because it may have a cause other than a bruise.

Ask whether the injury needs imaging, when to restart stretching or exercise, and which movements should be avoided. You can also ask how to monitor swelling, whether medicines you take affect bruising, and when physiotherapy is appropriate.