What Is It?
Athletes in all contact sports have many opportunities to get a muscle contusion which is mostly referred to as a “corkie”. They occur following a direct or repeated blow to an area of the body, crushing underlying muscle fibres and connective tissue, without breaking the skin surface.
Corkies will vary in severity and this will in turn determine the prognosis and eventual return to sport. It is important, however, regardless of the severity to follow the same procedure in the first 24hrs following injury as this is the most important time period.
What to do?
To control pain, bleeding and inflammation it is best to keep the affected muscle in a gentle stretch position and use the RICE formula
R: Rest- protect the injured area by stopping play. Continuing play risks excessive bleeding into the area and may result in a more severe injury.
I: Ice- apply ice to the area as soon as possible (remove after 20minutes)
C: Compression- lightly wrap the injured area in a bandage or stretch tape
E: Elevate the area as best possible
During the first 24 to 48 hours after the injury it is best to keep applying the RICE principal. As alcohol is a blood thinner, and the area may still bleed for a period of time, it is always suggested to avoid alcohol following this type of injury to again prevent excessive bleeding into the area and to prevent a longer rehabilitation process.
It is also important not to massage or apply heat to the area in the first 48 hours for the same reason of aggravating bleeding. The aim of soft tissue therapy in the first few days is to promote lymphatic drainage and should only be undertaken by trained professionals.
After a few days inflammation will subside and the injury will start to feel better. At this point you may start the rehabilitation process. After a moderate-to-severe contusion there is a considerable risk of re-bleed in the first 7 to 10 days so players must be careful not to overstretch the area or partake in excessive physical activity.
Contact training should be avoided for at least a week (depending on severity) following injury due to the risk of re-injuring the area. When returning to sport the player may wear protective padding or foam over the area to minimize the affect of contact.
Complications
Occasionally after a severe muscle contusion or corkie, it may calcify. This condition is call “Myositis Ossificans” and can usually be seen on an x-ray three weeks after the injury. In myositis ossificans bone forms within the muscle tissue. Inappropriate treatment such as heat or massage directly following a corkie may increase the risk of this complication arising. Symptoms include an increase in morning pain, pain with activity and night pain.
Physiotherapy treatment following a corkie is not always necessary depending on the severity but may ensure a quicker return to activity and sport. The moderate-to-severe corkies should always be assessed by a physiotherapist or health professional and appropriate treatment enforced. As corkie injuries are common, particularly in football, they are often not considered severe and hence not treated appropriately. To avoid a “simple corkie” preventing you playing football for the majority of a season take note of the above.
Karla Hunt is a physiotherapist with Lake Health Group, who is currently undertaking a post graduate in Sports Physiotherapy at La Trobe University. Karla can be seen most weekends on the football field as the physiotherapist for the North Ballarat Roosters VFL team. At Lake Health Group in Howitt Street Wendouree, we can assist in the treatment and recovery of muscle contusions. Please call 03 5335 3200 to arrange an appointment with one of our physiotherapists.
Last Modified on 04/06/2012 16:18