Managing a Corked Quad
Corks (or muscle contusions) make up a large percentage of injuries in rugby league. The injury occurs most frequently when there is a deep impact to the quadricep, causing it to be compressed against the bone underneath (the femur). This causes a rupture to the muscle, and then bleeding and inflammation. This can happen to other body parts such as 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. A limp may be present in the early stage, worsening after the game when the player has cooled down.
One of the biggest myths regarding a cork is that you can “rub/massage it out”. Unfortunately, massaging or rubbing a cork can potentially make it worse, and the heat would increase blood flow to the injured area, and so make it swell more.
Instead, 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 our without 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 quad flexibility and knee range of motion. Depending on the severity of the injury, return to sport can be between 2 weeks to 3 months.
A more severe cork can sometimes run the risk of turning into Myositis Ossificans, where instead of healthy muscle fibre being regenerated, small bones are developed in the area. This type of injury typically has a “woody” or “bony” feel to it when pressed. Fortunately a well managed cork will not progress to this point.