So when is a corky, no longer a corky?
Most contusions are minor and heal very quickly without limiting competition time. In some cases however, more severe contusions can lead to complications. A common complication of severe contusion is myositis ossificans – this occurs when a haematoma calcifies. Myositis ossificans should be expected in any contusion that fails to resolve within the normal time frame.
Some signs and symptoms that may indicate myositis ossificans are;
- Morning pain
- Persisting pain on muscle contraction
- Hard lump in the muscle
The most appropriate management for myositis ossificans is conservative and expected recovery is usually slow. The bone formation in response to the bleed usually ceases after 6-7 weeks.
Although it is far less likely, it is important to be aware of another, more serious complication of contusion, known as Acute Compartment Syndrome. This occurs when pressure within the muscular compartment at the site of impact builds to dangerous levels. The increased pressure can disrupt blood flow to the muscles and nerves within the compartment. Acute Compartment Syndrome requires immediate surgical decompression so it pays to know the difference. When an acute compartment syndrome occurs, early diagnosis and intervention is necessary to prevent permanent damage.
Some features of this syndrome include:
- Persistent pain (greater than one would expect given the nature of the injury)
- Swelling, feeling of tightness or fullness within the muscle
- Pain on passive muscle stretch of the involved compartment
- Progressive loss of sensory and motor function
When can I return to full activity?
Providing there are no hiccups along the way and the contusion is gradually improving, within the first 2-7 days post injury, you should begin to see a significant reduction in pain and return of range of motion. This is the case for most mild to moderate contusions with full resolution of symptoms in 4-6 weeks.
In some cases, more severe contusions may take a little longer to fully recover. Returning to play will be dependent on the ability for you to achieve pain free range of motion and full strength under load of the affected area.