Gluteal Muscle Tears: Recovery Challenges and Symptoms

Sports Injury: Gluteus Medius Tear Re-injured After Three Weeks

Hello, Director Wang.
I have a left gluteus medius tear that has not healed after three weeks.
I slipped in the bathroom the day before yesterday and re-injured it (my foot split apart without impact).
At that moment, I only felt a sharp pain in my hip, and the area was larger than the previous tear, with no other discomfort.
The next morning, I noticed swelling and pain in my left hip, and I was unable to flex or extend my thigh.
I went to the emergency room at 804, where a CT scan of my pelvis confirmed that my hip joint and other structures were normal with no fractures.
A hematoma from the tear was accumulating at the lower edge of my hip, and I was advised to apply ice and monitor the situation.

In the afternoon, I noticed that the swelling in my thigh had increased, and I experienced numbness in my foot and the outer side of my calf, with my foot unable to dorsiflex.
I returned to the emergency department at Taoyuan General Hospital for a lumbar X-ray and blood tests, both of which were reported as normal.
I inquired about the possibility of developing compartment syndrome, and the doctor responded that they had never seen it occur in the hip and thigh area.
After receiving medication, I returned home to rest.

Today is the third day, and the symptoms mentioned above have not improved.
The swelling in my thigh has increased, and I continue to experience numbness in my foot and calf, inability to dorsiflex my foot, sciatica, and persistent sharp pain in my hip that feels like cramping.
I feel pain while standing, sitting, or lying down, and I have a rapid heartbeat and occasional shortness of breath.

Which specialty should I consult? Can a muscle tear cause damage to the blood vessels in the hip? What potential conditions should I be aware of? The previous tear did not present with so many symptoms, and the ongoing swelling and numbness are concerning.
Thank you for your guidance.

Jian Xiansheng, 40~49 year old female. Ask Date: 2022/12/30

Dr. Wang Zhaomin reply Rehabilitation

A hematoma caused by a laceration may compress nerves, leading to related symptoms, or there may have been nerve damage at the time of the fall, resulting in abnormal postures during sitting or lying down that could trigger nerve compression symptoms.
It is advisable to seek consultation with an orthopedic or neurosurgical specialist for accurate diagnosis and appropriate treatment.

Reply Date: 2022/12/30

More Info

Hello,
It sounds like you are experiencing significant discomfort and complications following your gluteal muscle tear. Based on your description, it appears that you may have sustained a more severe injury this time, especially since you mentioned increased swelling, numbness, and pain radiating down your leg.
Gluteal muscle tears, particularly involving the gluteus medius or minimus, can lead to various symptoms, including pain, weakness, and swelling in the affected area. These muscles play a crucial role in stabilizing the hip and pelvis during movement. When they are injured, it can lead to difficulties in walking, standing, or even sitting comfortably.
The symptoms you are experiencing, such as swelling in the thigh, numbness in the foot and calf, and pain that feels like cramping, could indicate several potential issues. The swelling and numbness may suggest that there is some degree of nerve involvement or vascular compromise. While muscle tears themselves typically do not directly damage blood vessels, the associated swelling and hematoma (blood accumulation) can exert pressure on nearby structures, potentially leading to symptoms like numbness or tingling.

Given your symptoms, it is crucial to seek further evaluation. You should consider consulting with an orthopedic specialist or a sports medicine physician, as they are well-equipped to handle musculoskeletal injuries and can provide a thorough assessment of your condition. They may recommend imaging studies, such as an MRI, to evaluate the extent of the muscle tear and to rule out any associated injuries to the nerves or blood vessels.

In terms of recovery challenges, muscle tears can take time to heal, especially if there is significant swelling or if the injury is more extensive than initially thought. Rehabilitation is essential, and it often includes physical therapy focused on restoring strength and flexibility to the affected muscles. However, if there is persistent swelling, numbness, or pain, it is crucial to address these issues before proceeding with aggressive rehabilitation.

You mentioned concerns about compartment syndrome, which is a serious condition that can occur when swelling within a closed muscle compartment increases to the point that it compromises blood flow and nerve function. While it is less common in the gluteal region, it is not impossible, especially if there is significant swelling. Symptoms of compartment syndrome include severe pain that does not improve with rest, increasing swelling, and changes in sensation (such as numbness or tingling). If you experience worsening symptoms or new symptoms, such as severe pain or changes in skin color, you should seek immediate medical attention.

In summary, it is essential to follow up with a healthcare provider who can evaluate your symptoms in detail. They may perform additional imaging studies and provide a tailored treatment plan to address your injury and any complications. Early intervention can help prevent further issues and facilitate a better recovery.

Take care, and I hope you find relief soon.

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