Thigh Size Reduction After Injury and Rehabilitation - Rehabilitation

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Regarding the reduction of thigh circumference?


Hello Dr.
Pan: I was involved in a car accident that resulted in an open fracture of my left leg and a reconstruction of the anterior cruciate ligament in my right leg.
It has been almost three years since the incident, and I have been consistently engaging in self-directed rehabilitation exercises.
I work out every other day for about an hour and a half, which includes brisk walking mixed with slow jogging.
I have not experienced any discomfort in my legs; however, I have noticed that the area above my knee, specifically the quadriceps, is significantly smaller than before the injury.
Before the injury, I weighed around 78 kg, but during my recovery, I gained weight up to 86 kg.
I have since reduced my weight to about 70 kg.
While my quadriceps are much firmer than they were during my recovery, my thigh circumference has decreased.
I would like to know if this is due to my weight loss, if it is common for individuals who have sustained injuries to have reduced thigh circumference, or if my rehabilitation approach might be incorrect.
I would appreciate your insights on this matter.
Thank you!

Xiao Jie, 20~29 year old female. Ask Date: 2008/10/20

Dr. Pan Yingda reply Rehabilitation


Since both of your legs are injured, there is no control group for reference! I believe that both weight loss and injury can cause your leg circumference to decrease, but what does it matter? What we care about more is whether your mobility and function have been affected.
If they are still good, then you don't need to worry too much about the reasons for the decrease in leg circumference! Keep exercising to make yourself healthier!

Reply Date: 2008/10/20

More Info


After experiencing significant injuries such as open fractures and ligament reconstruction, it is common for patients to notice changes in muscle size and strength, particularly in the affected areas. In your case, the reduction in thigh size, specifically in the quadriceps region, can be attributed to several factors, including muscle atrophy, weight loss, and the nature of your rehabilitation process.

Firstly, muscle atrophy is a common consequence of injury and immobilization. When a muscle is not used for an extended period, as often occurs after a significant injury, it can begin to shrink in size due to disuse. This is particularly true for the quadriceps muscle, which plays a crucial role in stabilizing the knee and supporting activities such as walking, running, and climbing stairs. Even though you have been actively engaging in rehabilitation exercises, the initial period of immobilization and reduced activity can lead to some degree of muscle loss.

Secondly, your weight fluctuations can also influence muscle size. You mentioned that your weight increased during your recovery period and has since decreased. Weight loss can lead to a reduction in overall body mass, including muscle mass, especially if the weight loss is rapid or if it involves a significant caloric deficit. While you have noted that your quadriceps are now more toned than during your recovery, the overall size may still be less than pre-injury levels due to the combination of muscle atrophy and weight loss.

Additionally, the type and intensity of your rehabilitation exercises play a crucial role in muscle development. While you are engaging in a consistent exercise routine that includes brisk walking and slow jogging, it may be beneficial to incorporate specific strength training exercises targeting the quadriceps. Exercises such as squats, leg presses, and lunges can help build muscle mass and strength in the thigh area. Resistance training is particularly effective for hypertrophy (muscle growth) and can help counteract the effects of atrophy.

It is also important to consider the psychological aspect of recovery. Injuries can lead to changes in confidence and motivation, which may affect how aggressively one pursues rehabilitation. Ensuring that you are mentally engaged and motivated in your recovery process can significantly impact your outcomes.

In conclusion, the reduction in thigh size you are experiencing is likely due to a combination of muscle atrophy from the injury, weight loss, and possibly the nature of your rehabilitation exercises. To address this, consider incorporating targeted strength training into your routine, focusing on the quadriceps and surrounding muscles. Additionally, consulting with a physical therapist can provide personalized guidance and ensure that your rehabilitation program is effectively tailored to your needs. With consistent effort and the right approach, you can work towards regaining muscle size and strength in your thigh.

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