Muscle Strains

A muscle strain or a "pulled muscle" is a partial or complete tear of the group of fibres that make up a muscle. We can help you recover and reduce risk of reoccurance.

Muscle Strains

A muscle strain or a "pulled muscle" is a partial or complete tear of the group of fibres that make up a muscle. We can help you recover and reduce risk of reoccurance.

What is a Muscle Strain?

A muscle strain or a “pulled muscle” is a partial or complete tear of the group of fibres that make up a muscle. Muscles are not one solid unit, rather a collection of tiny fibres called fascicles that are bunched together, all running in the same direction, and surrounded by an outer sheath. The outer sheath allows the muscle fibres to contract and lengthen smoothly over surrounding tissues to create movement.

Minor injuries may only overstretch a muscle, while more severe injuries may involve partial or complete tears in these tissues. There are different grades of muscle strains that are dependent on the severity of the injury.

Grade 1 – Mild strain; a stretch, possibly with small fibre ruptures, minor swelling, and usually described as a sharp pain at the time of injury. A mild strain does not usually cause a loss of function or stops activity participation.

Grade 2 – Moderate strain; mild fibre ruptures, increased swelling, and reduced strength of the musculotendinous unit. These injuries usually result in the inability to continue with activity.

Grade 3 – Severe strain; a complete rupture, significant swelling and pain, and a loss of muscle function.

What causes Muscle Strains?

A muscle strain commonly occurs when the force on a muscle is greater than what the muscle is able to tolerate resulting in a tear. Muscle strains commonly occur in the region where the muscle turns into a tendon, the musculotendinous junction, and are a result of excessive tensile forces. The tensile force put through a muscle (usually trying to control a specific movement), may lead to excessive stretching of the muscle fibres resulting in a tear.

Muscle strains usually arise from indirect trauma, from the application of excessive tensile forces. They are commonly seen in sports where there are large forces being placed through muscle groups around one or more commonly two joints, such as sprinting and jumping. There is usually an imbalance between the coordination of muscles that are meant to work together to generate and control such movements. 

A muscle strain is often reported as a sudden pinch, or a sudden stabbing sensation in the muscle. Initially, the pain can worsen when the muscle is contracting or “flexing”, there can be partial or complete loss of strength, a reduction in joint range of motion, and local swelling and bruising can occur.

Signs and symptoms of a strained muscle may vary depending on the severity of the injury, however generally there will be:

  • Pain or tenderness
  • Swelling or redness
  • Bruising
  • Limited movement
  • Muscle weakness
  • Reduced muscle function
  • Muscle spasm

The diagnosis of a muscle strain is obtained via a detailed clinical history, a physical examination where an experienced healthcare professional, such as our practitioners, palpate the muscles involved, and perform functional and manual muscle tests.

Imaging such as ultrasound, computed tomography, and magnetic resonance can be relied upon to provide useful information for investigating and defining muscle strains more precisely including the exact size and location when required.

How to treat a Muscle Strain?

Treatment protocols for muscle strains vary depending on the severity of the injury itself. Generally, it is wise to follow the principals of P.E.A.C.E. & L.O.V.E. These principals are spelt out in more detail below, however the extent of the injury will dictate the best treatment protocols. For more severe strains, the sooner you seek the appropriate medical attention, the better. Failure to address a muscle strain appropriately, significantly increases the risk of re-injury.

The treatment of a muscle strain involves progressive loading. However, immediately following a muscle strain it is important to rest the injured limb. This prevents muscle retraction later on, and reduces the immediate risk of increasing the size of the tear and subsequent connective scarred tissue formation. By controlling inflammation and resting the injured muscle, the torn muscle can start to reattach and repair. Once the repairing tissue has matured to the point where it is no longer the weakest part of the muscle early mobilization is required to invigorate the adhesion, the orientation of the regenerating muscle fibres, the revascularization, and the resorption of the connective scar tissue that has formed.

Exercise rehabilitation programs are developed by trained healthcare professionals to ensure that the exercise program is suited for the injury. Rehab consists of maintaining range of motion, movement, and balance, while progressively loading the healing tissue, and returning the strength and length to the muscles involved.

The principles of P.E.A.C.E. & L.O.V.E. are as follows:

P- Protection; Avoid activities and movements that increase pain during the first few days after injury.

E- Elevation; Elevate the injured limb higher than the heart as often as possible.

A- Avoid anti-inflammatories; Avoid taking anti-inflammatory medications as they reduce tissue healing.

C- Compression; Use elastic bandage or taping to reduce swelling.

E-Education; Seek the appropriate medical attention to be assessed and educated. Education is one of the most important means of empowering people with the knowledge, understanding, and skills necessary to participate fully in the recovery process and achieve the best health outcomes.

AND

L- Load; Let pain guide your gradual return to normal activities. Your body will tell you when it’s safe to increase the load.

O- Optimism; Condition your brain for optimal recovery by being confident and positive.

V- Vascularisation; Choose pain-free cardiovascular activities to increase blood flow to repair tissues.

E- Exercise; Restore mobility, strength, and proprioception by adopting an active approach to recovery.

When can I return to sport after a Muscle Strain?

Full return to sport or activity is usually permitted after regaining full, pain-free active range of motion, and over 90% strength of the injured muscle, as well as the surrounding muscles that contribute to the injured muscles movement.

When a muscle is injured, the focus of rehabilitation is not just on the injured muscle itself. It is also on the coordination and balance between the muscles that work together to provide movement, in addition to any muscular deficits of dysfunctions that may have contributed to the injury or place the person at risk of re-injury.

Therefore, a person’s readiness for full return to sport or activity should be assessed and advised by an experienced healthcare practitioner. Furthermore, maintenance programs should be continued to avoid any dysfunctional adaptation or compensation that may result in or lead to further injury.

How do I prevent a Muscle Strain?

To prevent a muscle strain, it is important to ensure that you have the appropriate flexibility and strength to perform the activity you wish to engage in. An experienced healthcare provider, such the practitioners here at Bespoke Health and Performance can assess your bodies flexibility, strength, endurance, balance, and proprioception, via a biomechanical assessment. During a biomechanical assessment a podiatrist can assess for adequate agonist/antagonist ratios, balances in major joints such as the hip, knee, and ankle, and identify whether strength and flexibility should be attained prior to an activity. Furthermore, our podiatrists can advise on the appropriate warm-up and stretching regimes recommended for a desired activity.

If you suffer aches and pains, if you have had a muscle strain in the past, if you are looking at entering a new activity, or if you have felt a pinch lately, we can help. Book in for a biomechanical assessment and we can help create specialised training program to suit your new passion.

Click here to book an assessment with one of our experienced practitioners.  

FAQ's

The difference between a strain and a sprain is that a strain is when there is an injury to a muscle or the tendon of a muscle (the band of tissue that attaches a muscle to a bone), while a sprain is when there has been an injury to a ligament (the band of tissue that connect two bones together). The grading system for sprains and strains is quite similar, however the recovery and rehabilitation process is completely different.

Immediately following a muscle strain, you should not stretch the injured muscle. During the acute, inflammatory phase of a muscle strain the inflammation lasts up to three to four days. During this time the healing process weakens the tissue and stretching the injured muscle can cause irritation and further damage. Aggressive stretching should be avoided in this stage.

Once the inflammatory phase has passed, and the repairing tissue is no longer the weakest part of the muscle, maintaining range of motion and movement is important, therefore gentle, and pain-free stretching can begin. Signs of inflammation are pain, swelling, red-ness, and warmth, and are indications that tissues are overstressed. Once these signs have dissipated, gentle, pain-free stretching can be incorporated into contract-relax techniques to help align collagen fibres.

Gentle, pain-free stretching and pain-free submaximal isometrics can be incorpo-

rated into contract-relax techniques to help align collagen fibers.

Stretching should always be pain-free.

Healing times for muscle strains vary depending on the severity of the injury, the body’s natural healing process, and the response of the repairing tissue to new demands. During the healing process the muscle goes through multiple phases, the inflammatory phase, the repair phase, and the maturation and remodelling phase. Throughout these phases rehabilitation is guided to ensure that the repairing tissues are having the appropriate stresses applied to them at the right times to optimise recovery and return to sports/activities. Therefore, recovery is not based on specific times, rather the body’s functional ability to perform tasks under the required tissue stress or “loads’ for an activity.

Predisposing factors that may increase the risk of muscle strains are:

  • Coordination and balance imbalances between agonist and antagonist muscles.
  • Flexibility imbalances between agonist and antagonist muscles.
  • Previous injury
  • Inadequate rehabilitation from previous injury
  • Inadequate strength, flexibility, and endurance for activity
  • Increased muscle flexibility

When looking at the movement around a joint, the muscle performing the action, the “flexing” on one side of the joint is called the agonist. The muscle on the other side of the joint, with the potential to oppose the action, or control the rate of “flexing”, is called the antagonist.

The most common muscles to suffer a muscle strain in are the quadriceps, hamstrings, and calves. Muscle strains most frequently occur in the superficial muscles that cross over two joints and are a result of high tensile forces exerted on such muscles. The high tensile forces can lead to excessive stretching of the muscle fibres and consequently result in a tear close to the muscle-tendon junction.

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