Corks (or muscle contusions) make up a large percentage of injuries in contact sport. These occur after impact to the muscle causing it to be compressed against the underlying bone, leading to a small muscle rupture and localised bleeding and inflammation. The most common area is the quadricep, followed by the calf and hamstring.
Signs and Symptoms
Pain, loss of range and strength are common symptoms. The affected area will generally be sore to touch, and depending on the severity there could be bruising or swelling.
Acute Management
One of the biggest myths regarding a cork is that you can “massage it out”. Unfortunately, massaging a cork can make it worse and run the risk of Myositis Ossificans. Myositis Ossificans, where instead of healthy muscle fibre being regenerated, small areas of hard calcification are developed in the area. Fortunately a well managed cork will not progress to this point.
Acute management should focus on compressing the injured area with a bandage or tape. If the player is able to continue playing (as they could in a minor cork), foam padding should be put over the injured area and strapped down.
Post game the usual ice, compression and elevation should be completed, with the player being encouraged to walk with assistance.
Long Term Management
Long term, the injury should be managed similarly to a muscle strain. A progressive strengthening program is essential to return to play, along with manual therapy/stretching to restore the flexibility and range of motion. Depending on the severity of the injury, return to sport can be between 2 weeks to 3 months.
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