Corked Thigh

Corked Thigh

Article by I.Kelly, N.Stewart

What is a Corked Thigh?

(Also known as: “Dead Leg”, Quadriceps Contusions, “Charleys Horse”)

A corked thigh is very common in contact sports. In simple terms, your thigh muscles are usually “kneed” by an opponent during a tackle or similar impact. You crush the muscle tissue against the underlying bone. The effect of the muscles causes significant bruising and bleeding, both intramuscularly and also between the muscle and your femur (thigh bone).

Its damage can often be much more than you might expect for such a simple cause. Treat with respect.  If not treated correctly or if treated too aggressively, then myositis ossificans may result.

There are Two Types of Contusion

Intramuscular Contusion

An intramuscular contusion is a tearing of the muscle within the sheath that surrounds it. The initial bleeding may stop early (within hours) because of increased pressure within the tissue. However, the fluid is unable to escape the muscle sheath. The result is considerable loss of muscle function, power and pain which can take days or weeks to recover. You are not likely to see any bruising come out with this type – especially in the early stages. Physiotherapy and carefully performed massage therapy assist a speedy recovery. These interventions are essential to prevent functional morbidity related to the significant compression issues and myositis ossificans.

Intermuscular Contusion

An intermuscular contusion is a tearing of the muscle and part of the sheath surrounding it. Initial bleeding will take longer to stop if you fail to apply ice. However, recovery is often faster than intramuscular as the blood and fluids can flow away from the site of injury. You are more likely to see bruising come out with this one. These injuries respond very well to physiotherapy and massage.

What are the Symptoms of a Corked Thigh?

  • Pain after being whacked in the leg.
  • You might get swelling or bruising.
  • Restricted movement and reduced power.

What Can the Athlete Do?

Seek medical attention immediately. R.I.C.E. (Rest, Ice, Compress, Elevate.) Use crutches. Commence physiotherapy as soon as possible.

Corked Thigh Treatment?

Seek professional help quickly if you can. Otherwise, implement a RICE regime until professionally assessed.

After two to three days check:

  • If the swelling has not gone, then you probably have an intramuscular injury.
  • If the bleeding has spread and caused bruising away from the site of the injury, then you probably have an intermuscular injury.
  • If you are more able to contract the muscle, you probably have an intermuscular injury.
  • Can you feel a deformation of the muscle or a gap? If so, please seek professional assessment.

The correct diagnosis is critical. If you try to exercise on a complete rupture or a bad intramuscular injury, you can inhibit healing, make things worse or cause permanent disability.

If you apply heat and massage in the early stages then you could get myositis ossificans (or bone-forming within the muscle), then you are in trouble. Myositis ossificans can result in months or years away from your sport.

Contusions are Graded 1, 2 or 3 depending on the Severity.

Grade 1

What does it feel like?

  • Tightness in the thigh.
  • Unable to walk properly.
  • Probably not much swelling.
  • Trying to straighten the knee against resistance probably won’t produce much pain.
  • Lying on front and bending the knee should allow you nearly a full range of motion.

Grade 2

What does it feel like?

  • Probably cannot walk properly.
  • Occasional sudden twinges of pain during activity.
  • Possible swelling.
  • Pressing it causes pain.
  • Straightening the knee against resistance causes pain.
  • Unable to fully bend the knee.

Grade 3

What does it feel like?

  • You will be unable to walk properly without the aid of crutches.
  • You will be in severe pain.
  • You will have significant swelling appear immediately.
  • A static contraction will be painful and might produce a bulge in the muscle.
  • Expect to be out of competition for 3 to twelve weeks.

Seek the advice of your physiotherapist or sports doctor as soon as possible.

Sports Injury Management

You probably already know that a sports injury can not only affect your performance, but also your lifestyle. The latest research continues to change sports injury management considerably.  Our challenge is to keep up to date with the latest research and put them to work for you.

How we treated you last year could vary greatly to how we treat you this year. The good news is that you can benefit significantly from our knowledge.

What Should You Do When You Suffer a Sports Injury?

Rest?

Rest from painful exercise or a movement is essential in the early injury stage. "No pain. No gain." does not apply in most cases.  The rule of thumb is - don't do anything that reproduces your pain for the initial two or three days.  After that, you need to get it moving or other problems will develop.

Ice or Heat?

We normally recommend avoiding heat (and heat rubs) in the first 48 hours of injury. The heat encourages bleeding, which could be detrimental if used too early. In traumatic injuries, such as ligament sprains, muscle tears or bruising, ice should help reduce your pain and swelling.

Once the "heat" has come out of your injury, heat packs  can be used. We recommend 20 minute applications a few times a day to increase the blood flow and hasten your healing rate. Heat will also help your muscles relax and ease your pain. If you're not sure what to do, please call us to specifically discuss your situation.

Should You Use a Compressive Bandage?

Yes. A compressive bandage will help to control swelling and bleeding in the first few days.  In most cases, the bandage will also help to support the injury as the new scar tissue is laid down. This should help to reduce your pain. Some injuries will benefit from more rigid support such as a brace or strapping tape. Please ask us if you are uncertain what to do next.

Elevation?

Gravity will encourage swelling to settle at the lowest point.  Elevation of an injury in the first few days is very helpful, especially for ankle or hand injuries.  Think where your injury is and where your heart is. Try to rest your injury above your heart.

What Medication Should You Use?

Your Doctor or Pharmacist may recommend pain killers or an anti-inflammatory drug. It is best to seek their professional advice as certain drugs can interfere with other health conditions, especially asthmatics.

When Should You Commence Physio?

In most cases, "the early bird gets the worm".  Researchers have found that intervention of physiotherapy treatment within a few days has many benefits.  These include:

  • Relieving your pain quicker via joint mobility techniques, massage and electrotherapy
  • Improving your scar tissue using techniques to guide the direction it forms
  • Getting you back to sport or work quicker through faster healing rates
  • Loosening or strengthening of your injured region with individually prescribed exercises
  • Improving your performance when you do return to sport - we'll detect and help you to correct any biomechanical faults that may be affecting your technique or predisposing you to injury

What If You Do Nothing?

Research tells us that injuries left untreated take longer to heal and have lingering pain.  They are also more likely to recur and leave you with either joint stiffness or muscle weakness. It's important to remember that symptoms lasting longer than three months become habitual and are much harder to solve.  The sooner you get on top of your symptoms the better your outcome.

What About Arthritis?

Previously injured joints can prematurely become arthritic through neglect. Generally there are four main reasons why you develop arthritis:

  • Previous injury that was inappropriately treated (eg old joint or ligament sprains)
  • Poor joint positioning (biomechanical faults)
  • Stiff joints (lack of movement diminishes joint nutrition)
  • Loose joints (excessive sloppiness causes joint damage through poor control)

What About Your Return to Sport?

Your physiotherapist will guide you safely back to the level of sport at which you wish to participate.  If you need guidance, simply ask us.

What If You Need Surgery or X-rays?

Not only will your physio diagnose your sports injury and give you the "peace of mind" associated, they'll also refer you elsewhere if that's what's best for you. Think about it. you could be suffering needlessly from a sports injury.  Please use our advice to guide you out of pain quicker . and for a lot longer.

If you have any questions regarding your sports injury (or any other condition), please contact your physiotherapist to discuss. You'll find our friendly staff happy to point you in the right direction.

Acute Sports Injury Clinic

PhysioWorks has established an Acute Sports Injury Clinic at our Ashgrove, Clayfield and Sandgate practices to assist with the early assessment and management of acutely injured sports injuries.

The acute sports injury consultation fee is significantly lower than a routine assessment and treatment consultation. In most cases, your private health will cover the full cost of your full acute injury physio assessment fee.

How to Best Care for Your Sports Injury?

There is never an excellent time for an injury. But we do know that most sports injuries occur over the weekend! That's why at PhysioWorks, we have established an Acute Sports Injury Clinic at a selection of our clinics on a Monday and Tuesday.

Why Use an Acute Sports Injury Clinic?

Your Acute Sports Injury Assessment Consultation allows us to provide you with:

  • A quick and accurate diagnosis. One of our Sports Physiotherapist's or an experienced sports injury-focused Physiotherapist will confidently guide yo