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Muscle Injury: Cramp, Strain or Contusion?

By Gabby Charlton
Physiotherapist at Life Ready Physio Yokine


Muscles have a large blood supply and consequently bleed quite heavily when they are injured. Below are some guidelines on how to distinguish between three common muscle injuries – and the most up to date advice for early recovery and injury prevention.

 

  1. MUSCLE STRAIN

A muscle strain is a tear in the fibres of the muscle belly and is most commonly caused by overstretching a muscle. Muscle strains are graded depending on what percentage of muscle fibres are torn. Partial tears recover well with a specialised rehabilitation program, however a full thickness tear or a muscle rupture may require surgical repair. Muscle strains most commonly occur in large muscle groups (e.g. quadriceps, hamstrings and calves), however can occur in any skeletal muscle.

A athlete with a muscle strain will feel a sudden sharp pain in the muscle belly and an immediate loss of strength. Pain on stretch and/or pain on resisted muscle contraction are common symptoms of a strain. A good indication of the severity of the strain is the athletes’ post-injury function (can they walk/run or do they need assistance?)

What to do

  • RICE (Rest, Ice, Compress, Elevate) for 48 hours following injury
  • The athlete will cause further damage to the muscle if they continue playing
  • Leave ice on for 10 minutes, off for 20 minutes
  • Tubigrip or a compression bandage is the most efficient way to compress a muscle
  • When elevating, ensure the injured muscle is above the level of the heart so gravity can assist blood flow
  • A good warm-up prevents muscle strains during sport as it improves flexibility and contractility of the muscle fibres
  • See your physio as soon as possible after a muscle strain. Best rehabilitation results are achieved with early intervention. Strengthening and gentle walk/jogs can be started as early as 2-3 days post injury

What not to do
The following all increase the local inflammatory response, increasing pain and delaying recovery;

  • Take anti-inflammatories
  • Massage or place heat on the muscle within the first 48 hours
  • Drink alcohol within 48 hours of injury

 

 

  1. CORK/CORKIE (CONTUSION)

A contusion (aka corkie) is a common injury in contact sports such as AFL and rugby. It occurs when a large external force (e.g. an opposition player) comes into contact with muscle or other soft tissue, causing bleeding and swelling of the area. Contusions can be extremely painful and often limit a player’s speed and power as excessive bleeding inhibits the muscle’s ability to contract.

The athlete will be very tender over the injury site and may have discolouration or bruising. Corkies can occur in any soft tissue, depending on where the player was contacted.

What to do

  • RICE (Rest, Ice, Compress, Elevate) for 48 hours following injury
  • The athlete will cause further damage to the muscle if they continue playing
  • Leave ice on for 10 minutes, off for 20 minutes
  • Tubigrip or a compression bandage is the most efficient way to compress a muscle
  • When elevating, ensure the injured muscle is above the level of the heart so gravity can assist blood flow
  • Light exercise 12-24 hours after injury (e.g. walk, swim, bike ride)
  • See your physio if the pain from a corkie lasts longer than 3-4 days. Manual therapy and a guided exercise program will speed up recovery

What not to do
The following all increase the local inflammatory response, increasing pain and delaying recovery;

  • Take anti-inflammatories
  • Massage or place heat on the muscle within the first 48 hours
  • Drink alcohol within 48 hours of injury

 

 

 

  1. MUSCLE CRAMP

A cramp is an involuntary, painful episode of sudden muscle contraction that can last from seconds to minutes depending on the severity. Constant firing of motor neurons cause a continuous muscle contraction, which can be visible. The exact cause of cramps has not been scientifically proven, however it is believed dehydration results in an imbalance of minerals in the body, triggering a change in motor neuron activity. Muscle cramps usually occur after an extensive period of activity, when the muscle is the most fatigued and the athlete is at most risk of dehydration.

Once a cramp has subsided, the muscle should return to full pain free strength and the athlete can continue to exercise. The most common muscles to cramp are hamstrings and calves, however any skeletal muscle can be affected.

What to do

  • Stretch the cramping muscle to stop the contraction
  • Ice the muscle AFTER ceasing exercise
  • Prevent cramping by hydration properly prior, during and post exercise
  • Replenishing electrolytes (lost in sweat) help the body retain water and prevent dehydration. Electrolytes are found in sports drinks like Gatorade
  • See your physio if the pain from a cramp lasts longer than 48 hours to rule out a muscle strain

 
What not to do

  • Consume drinks with diuretics, which will result in further dehydration. This includes coffee, tea, soft drink and alcohol

 


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