Welcome to Goalie Training Pro TV, episode 48. Today, we’re talking about taking a puck right off your thigh.
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So playing hockey on Sunday and had something that had never happened to me before, happen. So I went to drop into my butterfly and a guy took a wrister from the side and I felt that “Oooooh” off my thigh, just off the inside of my thigh. You can see there’s a little bit of a bruise – I’m not a real bruiser.
And I was like, “Holy snappers!” And I think my pants maybe got hung up on my pad and lifting up or something because it’s sort of weird because there’s really good padding in that area. So my pants must have lifted up somehow and snap it went.
But it made me think right away of you, not of me, of you. (I made the save by the way)
But I was thinking, okay, here’s a thing that you guys probably aren’t even aware of. So two things that I thought of. The first thing I thought was oh, I hope that doesn’t give me an acute compartment syndrome. That would suck. And then the other thing I thought was, oh, I hope I don’t get hit there again because I’d hate to also get a myositis ossificans, which is probably exactly what you think when you take a puck off your thigh bone.
So what are those two things? They’re pretty rare. In my whole time working at the sport medicine clinic I probably saw each one two or three times but here’s what they are.
Number one, acute compartment syndrome.
So you might have some teammates or know somebody who’s had compartment syndrome, usually in their lower leg and they’ve had to have surgery to release the fascia. That’s an exertional compartment syndrome.
Acute compartment syndrome is when there’s a blunt force trauma to usually a big muscle and your muscle has connective tissue around it. The way that a sausage has a casing and that connective tissue, as you know, is called fascia because we do myofascial release to sort of work on that, the quality of that tissue that surrounds all the muscles. But that fascia is pretty strong and it expands a bit but only to a limit and then it becomes quite restrictive.
So what happens if you get, bang, with a puck on a big muscle and that causes trauma to the muscle and the muscle starts bleeding inside, that’s what a bruise is. A bruise is just the bleeding and then as you’re blood just gets… rotten… it turns colours. I don’t know how else to describe it.
It’s also why some people be, “Oh my God. He hit here but I’ve got a bruise here in my knee. But how did I hurt my knee?” You didn’t hurt your knee it’s just that, that bleeding kind of followed gravity down and you’re seeing a bruise there.
But anyway, so I get smashed here and then that muscles starts bleeding and it’s bleeding inside the fascia and if it’s a really significant injury it’s gonna bleed so much that it fills up the fascia like a balloon and now it can’t expand anymore. And it sort of cuts off the circulation.
So what it means is that blood can’t get out of there, fresh blood, arterial blood, can’t come in to nourish the muscle and now the muscle is basically suffocating. It actually is a medical emergency and it wouldn’t happen like, “I got hit right now and I need to go to emergency.” But it’s like wow this is really sore and it’ll be swollen and your skin will probably be shiny and it’ll probably be warm to the touch and just like, “Whoa, what is that?”
That’s time to get to the hospital right away because what they’re gonna do is, if you actually have an acute compartment syndrome, they’re gonna rush you into surgery and they’re gonna basically open you and open that fascia and that muscle is gonna pop right out pretty much. It’s pretty gross.
So they can’t even sow your skin back together because it’s so swollen and they have to leave it open for a few days and often they’ll have to do a skin graft because they’ve opened that fascia and they don’t stitch back together so now you’ll have huge quads, if that helps at all.
But a lot of times they’ll have to do a skin graft to kind of close over it so yeah, it is a medical emergency because it’s gonna go away by itself. Icing isn’t gonna fix it and it will starve the muscle and the muscle will die.
So it’s just a weird thing and again if it’s not on your radar, you’ll just be like, “Wow, this is really, really weird,” and you might let it go till it’s longer than it should be.
The other one is called myositis ossificans. It’s basically a calcification in the muscle and this is how it happens.
It happens when you get a blunt trauma and then a day or a couple of days or before that’s healed you get another smash right on the same spot. So I remember for sure seeing it in a baseball player who was batting and he took a pitch off his arm and then, I forget if it was a day later or a week later but anyway, before it healed he took another one to the same spot.
And so kind of what your body thinks is like, “Wow, this area is taking a beating. We need some more armour there,” because our skin isn’t really enough to handle the trauma of being hit by a baseball all the time. So what it does is it actually… bone starts to develop in the muscle and it’s really weird because you can feel it. It’s just like, “Yup, there’s a big old lump of bone,” and it makes the muscle quite stiff as well.
Now it’s not a medical emergency.
Your body actually reabsorbs it over time so it just takes quite a while to get it feeling better but the muscle is gonna be quite stiff during that time and susceptible to getting tear because obviously bone isn’t really stretchy.
So if you do take a trauma, for example, I’ll go to stick and puck tomorrow I’ll really try to figure out, how did that area get exposed? And then make sure when I play on Sunday that it’s not gonna get hit again, even if I have to put an extra piece of foam or something inside, maybe in my long johns or something like that or put a wrap with a piece of foam there so that if I do get hit there again it’s gonna dissipate that trauma.
And again, if it was my collarbone or something it’s like, okay, that would really hurt if I took another ding off my collarbone but it’s in the muscle and in those big muscles, if they take blunt trauma that can happen.
Again, pretty rare. That one will over time, like months and months, it will reabsorb and same thing, it’s not like you get hit twice and then all of a sudden it’s like, “Oh, now I have bone in there.” It’s like then your body starts to lay down bone or start to sort of calcify in there. And so you’ll notice like, “Why do I have this big lump in my leg?” And then over time it’ll gradually go away again.
The first one, medical emergency, you’re gonna need a scalpel to fix that. Don’t try it at home, though.
So those are two really weird blunt trauma injuries but yeah, for sure I’ve seen acute compartment syndrome in hockey from a guy that got hit with a puck in the leg and another one was a guy playing basketball and somebody came down and their elbow hit his quad and same thing.
So it happens so just be aware so that you know what it is and what to do and that’s the scoop, gang. I will see you next week for episode number 49. Rumour has it that on episode 50 there’s gonna be cake.