Severe cramp may have caused a blood vessel to burst

DEAR DR. ROACH: Several months ago, I was just relaxing, watching a movie at home, when suddenly I got a tremendous pain in my inner left thigh. I tried to walk, thinking it was a bad cramp, but the pain was so intense that I almost passed out. This lasted for only a few minutes (but it felt like an hour). The next day, the area was very sore and tender to the touch. By afternoon, discolouration had begun. I saw my physician two days later and by that time it had a bruise larger than my hand. I was immediately directed to a radiology centre, where they determined that there were no blood clots. My doctor advised that, apparently, a blood vessel had burst. I am wondering how common this is, and if I should expect a recurrence? I would not wish such pain on anyone. – Anon.

ANSWER: I see this occasionally. It’s possible that the initial pain was the blood vessel, but I suspect that the muscle cramp came first, and the muscle fibres pulled so hard that they literally tore the tissue, allowing for bleeding into the muscle. Bleeding into a muscle can be very painful, but the blood will eventually find its way out of the muscle, at which point it will show up as a bruise. I suspect that the damage was somewhat higher on the leg than where the bruise was initially, as gravity pulls the blood downward. The bruise will gradually change colours (from dark red to green to yellow to brown) as the blood is digested and absorbed by the tissue macrophages (cells that eat what doesn’t belong).

I seldom see recurrences of this. Stretching and regular exercise are the best ways to prevent severe muscle cramps.