Thigh Contusion - Vastus Intermedius injury

Nothing here on this injury - hoping others might help inform me. I’m 8 weeks into a severe thigh contusion. A pedal strike flipping me up to my handlebars which applied a tourniquet with my top tube on my upper thigh as I contorted over the handlebars. X-ray and MRI confirm no bone injury.

About a week in I was back on the bike doing short, non-fitness rec rides in the neighborhood waiting for the contusion/swelling to go away. I was ‘re-learning’ to walk during this period as my fine motor function/mechanics got pretty screwy. Critically, my knee flexion was at about 110 degrees which was just enough to spin the pedals.

About 3 weeks in, I had a minor toe stub while walking and it sent me reeling in abject pain up my problem thigh to my pelvis. Since recovering from this, I’m now stuck at maximum 75 degrees knee flexion which is no where near enough to bike or really do any activity. My knee sustained no damage and does not hurt, but my upper front thigh (pain) prevents my knee from bending beyond this. I accidentally went over my flexion limit sitting down on the toilet and it was excruciating and resulting in a minor setback. I’ve stopped all fitness activity since week 3, though I go on 20-30 minute walks now for sanity.

Two weeks ago an updated MRI confirmed diagnosis of moderate grade partial tear of the vastus intermedius muscle and/or muscle contusion with 3x4.5x12 cm hematoma primarily in the vastus intermedius muscle. Proximal and distal tendons and muscle attachments appear intact.

I’m hoping someone on here has experienced or seen something like this? Both PTs seem anxious to over stretch me or perform deep tissue massage and not cause more damage. Progress has just stalled the last 4 weeks and doctor says come back in 4 weeks if no improvement.

Figure I’d close out this thread for future sufferers. The following day after I wrote this ‘depth of despairs’ missive, I woke up and my knee could suddenly bend 25 more degrees. Since then I’ve been on a strict PT regimen and slowly ramping up the bike. Obviously I temporarily lost a lot of fitness and the time away took a particularly hard toll on the high end efforts and hills. I’m doing lots of squat like strength exercises to rebuild the muscle and retrain the neuromuscular system. I suspect this rebuilding is playing into some of the difficulty on hard efforts. At the current rate of improvement, I think I’ll be back to form in 30-45 days.