Jul 14, 2019

What are “corkies” and how to treat them?

What is it?

Muscle contusions/haematomas, commonly known as ‘corkies’, are often sustained in contact sports. They occur from direct impact to a muscle, during collision with another player or piece of equipment, which compresses it against the bone beneath.  This compression damages the underlying muscle tissue, causing it to bleed. This takes place under the skin surface and can show up as a bruise or swelling the following day. 

The athlete may experience varying degrees of pain and restriction in their range of motion around the injury site, depending on its severity. Stretching, poking and using the muscle may also cause pain in the early days.

Early management

Treatment should consist of the RICER protocol (rest, ice, compression, elevation, referral) for the first 48-72 hours. 

This helps dampen the inflammatory response, decrease swelling and reduce further damage to the muscle. 

Within the first 72hrs applying the No HARM (heat, alcohol, running, massage) principal will also help to prevent any further damage as all of these elements increase blood flow in the area and may cause more pain and swelling.

Moving around gently is encourage to help reduce stiffness and promote removal of swelling from the area. In rare cases walking may be restricted due to pain in the first 24hrs so crutches may be beneficial for a short period of time.

In the event pain persists for greater then 24hrs or is of a severity that is limiting normal movements seeking assistance from a physiotherapist will allow for assessment to ensure no greater damage has been caused and offer treatment solutions to decrease pain.

What about ‘anti-inflammatory’ medication? Anti-inflammatory medication such as voltaran or neurofen is used to decrease or stop the inflammatory process. However, in many cases that is not actually what we want to do. The bodies inflammatory process is a naturally occurring process that is how our body heals damaged tissue. Stopping this process can alter the way our tissue heals actually delaying healing and return to play.

‘Corkies’ will commonly resolve over a period of 7 days allowing the athlete to return to sport with no ongoing issues. In rare cases due to significant severity or poor management, haematomas may begin to calcify leaving a hard, bone type lump in its place (myositis ossificans). These areas will feel very firm and often sore to touch. Seeking advice from your physiotherapist is advised if you suspect this may be occurring.