Docs - Leg Muscle Trauma. Bloodclot Concern?

[Jandrews]

Last Sunday (8 days ago now), I was out trail riding with some friends. I am 48 years old and I would say an intermediate (but aggressive) enduro rider, riding my KTM 525 EXC. We were riding in an area that is wooded and has many, many creek crossings of various technical aspects. I approached a shallow (15 foot banks), but steep (>45 degree grade). Descended fine, and came up the other side, only to find an overhanging vine (probably 3 inch diameter) crossing the trail at helmet level.

For a little color:



Well, the vine caught me right across the visor of my helmet, and knocked me off the bike backwards. Considering I was approaching the crest of the creek bank, I couldn't have been going more than 10 mph. But even at that speed, and the abruptness with which it caught me, it was an instantaneous crash. Crash is a bit strong, as it was more like a clotheslining...I stopped, and the bike kept going.

I jumped up quickly, as I wasn't hurt at all, and walked over and killed the ignition on the bike as it was still running laying on its side. I was immediately thrilled that I didn't hurt my neck or my face or back in any way, and my friends circled by to make sure I was ok. No problem.

Within a minute or so (after the adrenaline subsided I presume), I noticed that my upper left calf on my leg had taken a hard hit, and was sore and tingling. I said to myself, ouch, that is going to swell up and be a nasty bruise, not knowing what had even hit my leg to cause the pain. But, considering this was very tight woods, I figured I must have bounced off a small tree somewhere during my fall, and not noticed it. Clearly no broken bones, as I could walk fine. I jumped on the bike, and proceeded to ride the rest of the day (probably 2.5 more hours).

It was a cold day (literally 15 degrees F), so I was wearing three layers. A thin capilene pant, a thin micro fleece pant, and then my riding pants. When the day ended, I stopped by the car wash to blast the mud off the bike. I had taken the riding pants off, and I could see swelling of my calf beneath the fleece and capilene. No biggy.

When I got home and took the layers off, I was surprised to see two abrasions (scabbed over nicely now). I told my wife, "wow, this went through three layers of pants without ripping them, and still broke the skin in two places". No biggy.

Well, it has been a week now, and there is a large bruised area as I would have expected. It is still VERY sore to the touch, but here is my main concern, and purpose for the long-winded thread:

At night while sleeping, if I flip over in bed, there is a strong surge of pain that feels like pressure and painful tingling. It is localized to the very bruised area right on the outside of my calf, and dissipates within 15 seconds or so every time. This surge of pain happens EVERY time I flip over, and has not really gotten any better for a week now. The same surge and brief, painful tingling happens when I stand from a sitting position, and then dissipates within 15 seconds or so. I can manually reproduce the pain and tingling from a sitting position if I flex or extend my ankle sharply (obviously heavily involving the calf muscle in that movement).

In addition, I noticed last night (for the first time, but could have been there all along), that there is some soreness well below the injury (down inside of what my motocross boots covered), and also some blood pooling (just bruise-like, really) down on my ankle. Here are some pics, taken today, 8 days after the incident. On the calf pic, the bruising is not easy to see. but it generally represents an area about 8 inches long starting at the thickest part of the side of my calf muscle below my knee, and running down the side of my leg. On the ankle, you can see the darkness of the pooled blood under the skin. Again, my motocross boots are very heavy duty, and cover probably half way up my lower leg.





Oh, I forgot to mention, when I got home from riding, I just took two Advil, and didn't ice my leg. Stupid, now, in retrospect, as that would have likely help constrict the blood vessels, stop some of the internal bleeding and swelling, and maybe help things heal faster. I did finally ice it once yesterday, and also took two Aspirin as I started worrying about a blood clot.

So, I debated last night about going to the Emergency Room. I hate to walk in there perfectly healthy, and bother them with just a simple bruise. I also hate to pay for emergency service if I don't really need it, and I have been able to function all week no problem. That said, I must admit that after a week, I am concerned of the risk of a blood clot from the trauma, or potentially continual bleeding internally (although there is very little swelling and hardly visible bruising). I could also go to my primary care doc, which I might try just for some medical advice (although I suspect they will send me to the ER if they think there is an issue).

Sorry for the long note. I am not really expecting free medical advice here, but I have seen a number of miracles happen / tragedies avoided from the guidance on this board, so I thought I would float this for the value of opinion from a trusted, educated and helpful group of like-minded people.

Thanks in advance,

JA

[KFC911]

Originally Posted by Jandrews

...Sorry for the long note. I am not really expecting free medical advice here...

BCs are serious business...go get checked out.

That'll be $20 that you owe me ....

Good luck!

[Don Ro]

Your story is too long for me...lost interest. Sorry.

[Jandrews]

Originally Posted by Don Ro

Your story is too long for me...lost interest. Sorry.

LOL, Don!!! No problem. I wanted to provide enough detail for anyone who might have some medical insight to form a recommendation. I realize some of the details about the ride might be a bit extra, but figured I would set up the incident.

JA

[recycled sixtie]

Originally Posted by Don Ro

Your story is too long for me...lost interest. Sorry.

Your attention span is shorter than mine. Go get it checked out now. $20 please.

[apriliaguy]

Been in several motorcycle incidents myself. On and off road. I would give it another week. It is localized in one area. The area that got hurt. You have localized trauma. I'm sure capillaries and blood vessels were broken and muscle tissue damaged.

[genrex]

In my opinion, the fact that the pain hasn't gotten any better in a week is not good, and justifies a visit to the doctor... today.

_

[Don Ro]

Originally Posted by recycled sixtie

Your attention span is shorter than mine. Go get it checked out now. $20 please.

Touche!

[dave 911]

I'm a runner, and had a blood clod in my calf develop about 5 years ago after I sprained my ankle on a run and was then immobile (long car ride home). It felt like my calf muscle was 'tight' - i was wearing an aircast due to the sprain and I asked the doc(3-4 days after the injury) if I had it on too tight because my calf hurt and he immediately measured my calf, compared it to the other side and sent me to the ER.

Agree, blood clots are dangerous - go get it checked out if you suspect you have one.

[gduke2010]

Get it checked by a Dr. It would be better to have a Dr. Say that it's just a deep bruise and you'll be fine, than not have it checked out and find out the hard way that it is a clot.

[pavulon]

Typically, DVTs result from venous stasis related to extended sitting and/or low mobility. However, there are other ways to experience a DVT. They are a potential big problem when they occur and then break loose and head to the heart and lungs>>pulmonary embolus or PE>>PE's have potential to be a show stopper. The key here is that they occur inside of a vein.

Blood clots outside of a vessel can cause problems too...but even more rarely than inside of a vessel. Compartment syndrome is a possibility but pretty rare and is another sort of emergency.

Of course you may have a deep soft tissue bruise or even a bone bruise. Seems unlikely that you have a fracture but may be as well.

So, all sorts of possibilities but only you can determine what the right move here might be.

Good luck.

[Jandrews]

pavulon, thank you for your thoughts. You are one of the gang here who I hoped would chime in. Thanks also, to all the other folks here for their experience and advice.

I held out today, and did not go have it looked at. I rode for two hours each day Saturday and Sunday, so I attributed the recent pain and lack of improvement to that rigorous activity. We will see how tonight goes, and tomorrow. If it is still not any better with a full day's rest (I laid low all day today), then I will go to my primary care doc to see what he says.

I appreciate everyone taking the time to read. This Pelican community is a phenomenal resource. My 11 year old son asked me if I was going to talk to a doctor. I said, "yeah, maybe, but I am going to check with Pelican first". He asked why. I said because it is a community of people with a vast amount of life experiences from all over the world, and I will get a lot of good information to help me determine next steps". He nodded his head, and said, "ask them if there are any doctors that drive Porsches". I just nodded and said, "good idea, son"!

JA

[vash]

Your boots didn't protect that area? My bruises stay forever.

[Jandrews]

Just a follow up as a courtesy to all those who provided suggestions and thoughts on this...

I ended up just riding it out, and not going to have this looked at. It has been over two months, and is just now back to normal (i.e. no longer tender to the touch).

I guess it must have been just an extremely deep bruising. It is funny, because I didn't even know I hit my leg when this happened. And to Vash's question about my boots, I am 6'6", so my boots (size 15 Fox Comp V) only cover about half way up my shin. But yeah, somehow the area inside my boot was also smashed pretty good. Must have been a hell of a hit. Surprised it didn't break something. I think it must have just completely smashed the front outside of my calf muscle.

So, no blood clots, and pretty much back to normal. Strange injury, and incredibly slow to heal. Maybe just part of getting old on the outside and still feeling young on the inside.

Thanks very much to all who weighed in. It is great to have such a valuable community to bounce all kinds of things off of and get reliable, intelligent and experienced advise.

JA