Muscle injury from direct impact
A common footballer’s injury, this results from blunt force trauma in any muscle – most commonly the thigh. Some impacts can be so severe that muscle is fully ruptured, so the more severe cases will need further examination from an orthopaedic specialist. Most injuries just cause local bruising and swelling and the muscle is still intact. At the site of impact the muscle cells are significantly damaged and required relative immobilisation and rest so that they can heal rather than tear further. Hence, only the mildest of ‘corked muscles’ can be ‘run out’. If there is definite weakness in the muscles it is best retiring from the sport and icing immediately as further blood flow will only pressurise the damaged area and make it worse. A good general rule with ice is 20 minutes every 2 hours until the swelling is under control, which in most cases is 24 hours.
The presence of bruising indicates that bleeding has occurred within the muscle, so massage at this stage is not advised. Indeed, direct soft tissue work on this sort of injury can result is worse outcomes if it is done too soon. So proper assessment and advice is important at this stage – in some cases treatment can begin right away, while in others, ice and rest is all that should be done initially. Once the repair process has progressed well enough, sports specific exercises are introduced to transition the patient back to their activity, this restores appropriate strength and minimises the risk of re-injury.