I came off a horse a week ago (Saturday) and ended up with a large contusion/hematoma in the right shin, not over the bone but to the left on the soft tissue. LARGE lump remains -- literally the size of an egg. Lots of discoloration and edema from knee into the ankle; old blood is pooling there. I saw a doc on Thursday; he did X rays to check for tibial fracture and did not feel aspiration was needed.
However, the pain is not resolving and may be getting worse. It is around the 'egg' area and up and down the sides of the shin bone as well as at the ankle where there is the most swelling. Sometimes there is pain that feels like it's underneath the top of the calf muscles. Lortabs help, but don't fully resolve the pain. I am also using hot soaks and icing the shin/calf several times a day.
Is this normal? Should I continue using compression even after a week?
Sub-periosteal hematoma and intra-muscular hematoma in the tibial area are both difficult and frustrating to treat. Often draining them leads only to temporary relief, and reoccurance is the norm. I usually add PT, where your therapist can add various modalities to aid in the resolution of the blood collection. Continued compression, as well as the heat and ice as you are doing are also important. I have seen these persist for 6 months.
However, there is one complication to worry about if the pain is that sever that you still require narcotic pain killers. A compartment syndrome occurs when the swelling in the muscle becomes so severe, that it cuts of the blood flow to the muscleand muscle necrosis occurs. when this happens, it is an emergency. If the pain is that bad reevaluation by your doctor may be a good idea.
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