A muscle strain, or a pulled muscle, is among the most common injuries affecting people of all ages, particularly those engaging in physical activity or sports.
A muscle strain, or a pulled muscle, is among the most common injuries affecting people of all ages, particularly those engaging in physical activity or sports. A muscle strain occurs when your muscle fibers overstretch or even tear, leading to damage to the muscle and characteristic symptoms such as:
Pain
Weakness
Swelling
Muscle strains range in severity from more mild strains with minimal muscle fiber damage to severe injuries involving a complete tear of your muscle. Most mild strains can be treated with home remedies like rest and nonsteroidal anti-inflammatory drugs (NSAIDs).
Read on to learn more about muscle strains, including why they occur, how you can treat them, and what steps to take to prevent them.
Muscle strains are the result of muscle tissue or its attaching tendons overstretching or tearing. Strains often occur at the musculoskeletal junction where your muscle and a tendon meet.
Muscle tissue makes up about 40% of the mass of the human body and contains 50% to 75% of all proteins in the body. Your muscles play the important role of helping your body move, but they are also prone to injury from sudden force or chronic stress.
Your muscles are made up of overlying filaments. If you imagine these filaments as your fingers when your hands are interlocked, they move closer together when your muscles shorten and further apart as your muscles lengthen.
The muscles that help you move your body are called skeletal muscles. Cardiac muscles in your heart and smooth muscles inside your organs are classified separately.
Skeletal muscles allow you to produce the force needed to move your body or resist outward impacts, such as when landing from a jump. Each muscle is attached to your bones with thick fibrous pieces of tissue called tendons.
Muscle strains are grouped into one of three categories, depending on the severity of the strain:
Grade 1: Grade 1 strains are the mildest types and result in minimal structural damage. They often heal within one to three weeks with at-home treatments like rest and the application of ice.
Grade 2: Grade 2 strains are more serious and involve more extensive damage to muscle fibers though not complete rupture. They often result in the loss of strength and motion but only require at-home treatment rather than surgery.
Grade 3: Grade 3 strains are the most serious. They involve a complete tear of the muscle away from a connecting tendon and generally require surgical treatment to ensure the muscle is properly reattached to the bone.
A muscle strain is sometimes mistaken for a sprain. Although the terms sound similar, these two injuries involve different types of tissue.
Sprains are a type of injury that involves ligaments. Ligaments are bands of connective tissue that attach two bones together. Like muscle strains, muscle sprains can range from mild to severe. They often occur in the ankles after an injury where your foot rolls outwardly or inwardly beyond its limits.
Muscle strains, in contrast, affect muscle tissue. Strains can occur in various muscle groups but are especially common in the hamstring and back muscles, often as a result of overuse, overstretching, or improper technique.
The terms torn muscle and pulled muscle both refer to muscle strains. Some people use the phrase torn muscle to refer to more serious strains involving a partial or complete tearing of a muscle away from a tendon.
Muscle strains often lead to symptoms like pain and swelling in the affected muscle.
The main symptoms of muscle strains are pain and swelling. The degree of these symptoms can vary depending on the severity of your injuries. Minor strains might only cause discomfort for a couple of days, whereas more severe injuries may lead to pain for weeks to months.
Pain may onset rapidly after a sudden injury, or it might develop slowly over time from chronic stress.
Other symptoms of muscle strains can include:
Tenderness when touching the injured area.
Discoloration, such as redness or bruising
Muscle cramping or spasms
Muscle weakness
Limited motion
Some moderate or severe tears may cause a popping sensation that may be audible. This commonly occurs with hamstring injuries, for example.
Some of the more common locations to develop a muscle strain include your:
Back
Neck
Shoulders
Hamstrings
Groin
A muscle spasm is an involuntary and painful contraction of your muscle. Muscle spasms can be a symptom of a muscle strain.
Muscle strains are caused by damage to the muscle fibers, which allow your muscles to shorten and lengthen.
You can think of your muscles as a series of ropes. If you want to pick up an object with a rope, you need to pull on it until it becomes taut and eventually shortens. If you want to lower an object with a rope, the rope needs to be relaxed lengthened out. The force in the rope in these situations is called tension.
Muscles also produce and resist force with tension. And like a rope, if the tension in your muscle exceeds what it can handle, it will tear. This can happen during activities that expose your muscle to high amounts of sudden force, such as those that involve jumping.
Chronic stress on your muscles can cause weakness similar to the fraying of a rope, making the muscle more prone to injury.
Certain factors can make your muscles more prone to injury. These can include:
Insufficient warm-up prior to exercise or physical activity
Cold weather or environment
Overuse and fatigue
Poor technique or biomechanics
Muscle imbalances
Many muscular ruptures happen at the musculotendinous junction, which is where your muscle and its tendon meet. In about 90% of cases, the injury occurs either in this location or in the layer of connective tissue surrounding your muscle called fascia.
Certain movements can make your muscles more prone to injury. For example, most hamstring injuries are caused by hip flexion with an extending knee. This movement is seen in sprinting when your knee is lifted and your foot begins to lower toward the ground.
Muscle strains commonly occur in both athletes and people who are inactive. For athletes, overtraining is one of the top factors for developing muscle tears.
Overtraining causes the breakdown of muscle fibers to happen more quickly than the rate at which your body can repair them, and they can make your body more vulnerable to injury when tension increases quickly in your muscles. Additionally, overtraining can lead to the breakdown of coordination between muscles, which might shift force to muscles or parts of muscles that are vulnerable to injury.
Muscle strains can occur in anyone, but they are especially common in people engaging in intense physical exercise. Certain risk factors also make people more susceptible.
Some factors can heighten the likelihood of muscle strains, especially during sports and physical activity. Common risk factors for muscle strains include:
Older age: Your muscles lose elasticity and flexibility with age, and they also recover more slowly, especially if you aren’t continuously physically active throughout your life.
Previous injuries: Prior muscle injuries can weaken your muscles and increase re-injury risk. Additionally, previous injuries to other muscles or structures might redistribute force to a certain muscle, making it more prone to injury.
Participation in high-intensity sports: Many types of sports pose a higher risk of muscle strain, including track and field, hockey, and American football. For example, muscle strains make up more than 30% of injuries in soccer, with the hamstring being the most common location.
Poor physical conditioning: Weak muscles, tight muscles, and muscular imbalances all can contribute to soft tissue injuries.
Sedentary lifestyle: Physical inactivity can weaken your muscles, which makes them more prone to injury when they’re faced with a sudden high demand. Additionally, obesity may increase the amount of force on the muscles in the trunk and lower body.
Improper technique: Incorrect technique in lifting, sports activity, and other physical activity can make your muscles more prone to injury.
Biomechanical factors: Some people might be more prone to injury due to biomechanical factors caused or influenced by their genes. For example, a short length of one of the muscles in your hamstring called the biceps femoris long head is linked to an increased risk of a hamstring tear.
Your healthcare provider may be able to diagnose a muscle strain based on your symptoms alone.
Most muscle strains can be diagnosed by a healthcare professional, such as a general doctor or a physiotherapist, without any special tests. They’ll perform a clinical exam where they:
Consider your medical history
Ask you about your symptoms
Perform a physical exam, where they’ll likely:
Touch your muscle
Move your body through particular movements
Check for signs of swelling or discoloration
If your healthcare provider thinks you have a serious strain or additional injuries, they may order imaging, such as:
X-rays to rule out fractures and bone injuries
Ultrasound
Computed tomography (CT) scans
Magnetic resonance imaging (MRI)
Most muscle strains can be treated conservatively, but some may require more advanced treatment.
Treating a muscle strain typically involves conservative treatment following the RICE protocol. RICE stands for:
Rest: Resting the affected muscle is crucial, particularly for more severe strains. Refraining from activity prevents further muscle fiber damage.
Ice: Applying an ice pack to the affected area for up to 20 minutes every few hours during the initial 48 hours helps reduce inflammation and numb pain.
Compression: Wrapping your injured muscle with an elastic bandage can help control swelling. However, compression should remain loose enough to maintain good blood flow, and it should not hurt.
Elevation: Keeping the injured area elevated above heart level can help reduce swelling.
This acronym is sometimes written as PRICE, with the first P standing for protection, meaning avoiding activities that could cause re-injury until the muscle is healed.
Additionally, many over-the-counter medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may help reduce your pain and swelling. Some options include:
Ibuprofen
Acetaminophen (Tylenol)
Naproxen
Other treatments include:
Physical therapy: A physical therapist can design exercise programs to improve your strength, flexibility, and range of motion, potentially aiding your healing process.
Heat therapy: After the initial inflammation phase subsides, heat application can soothe the strained muscle, relax muscle fibers, and improve blood flow.
Surgery: Surgery may be performed for severe tears if doctors don’t think your muscle will heal properly on its own. Surgery is often performed by an orthopedic surgeon or a sports medicine specialist.
You may be able to minimize your chances of developing a muscle tear by keeping your muscles strong and avoiding quickly increasing exercise intensity or volume.
Some ways you may be able to prevent muscle strains include:
Properly warming up: Engaging in a warm-up involving light aerobic activity, such as jogging and dynamic stretching, before physical activity can potentially decrease your injury risk. Warming up increases blood flow to your muscles and helps prepare them for the activity ahead.
Stretching: Incorporating regular stretching exercises into your weekly schedule helps improve flexibility and muscle elasticity, which can reduce injury risk.
Strength training: Building muscle strength, especially in commonly injured areas like your hamstrings, can potentially protect your muscle from injury.
Avoiding overtraining: Gradually increasing exercise intensity and scheduling recovery periods into athletic training can help reduce injury risk.
Maintaining good technique: Using correct form during exercise and sports minimizes unnecessary strain on muscles.
Listening to your body: If you’re feeling rundown or have muscle soreness, it might be better to take a rest rather than continuing to train.
Muscle strains often reoccur. For example, anywhere from 12% to 63% of people who have had a hamstring injury later develop another one. Taking steps to strengthen your hamstrings can help you prevent re-injury. If you’re unsure of how to build a proper strengthening program, you can consult an expert, like a physiotherapist
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