After the initial 24 to 48 hours, therapy continues with the start of quadriceps stretching exercises, range of motion, and electrical stimulation and continued cryotherapy. Prone passive stretching of quadriceps with or without a therapist is recommended. Ice massage with the knee in maximum flexion can be done to relieve pain and spasm. The athlete performs no exercises which are not pain-free. Many orthopedists suggest anti-inflammatory medicine once the initial hemorrhaging has subsided.
Acute aspiration is justifiable if there is a collection of blood or hematoma.
Unfortunately, many rugby teams in the United States do not have rapid access to medical facilities and personnel. In addition, many rugby players do not seek medical attention until after significant intramuscular bleeding and spasm has occurred. Aronen has recommend a modified protocol for these individuals with severe thigh contusions. He suggests isometric knee extension exercises until the quadriceps fatigues, thus decreasing the spasm. Next, the therapist passively stretches the quadriceps until the player experiences pain.