What Is Muscle Strain?
A muscle strain, or pulled muscle, can be described as an injury to a muscle or tendon caused by overstretching, which is the equivalent of a sprain to the ligaments. Most muscle strains occur by twisting or pulling a muscle beyond your limits, which would cause a partial or complete tear in the tissue.
Strains can happen in any muscle in the body, but are most common in the hamstrings, shoulders, neck and lower back. While it is common knowledge that athletes and seniors are most susceptible to muscle strains, anyone can experience a strain as long as your muscle has been overstretched or torn.
Depending on the extremity of the injury, these strains can cause pain and may limit some of your movement within the affected area.
Causes of Muscle Strain
Overstretching & Poor Conditioning
Overstretching is one of the most known causes of muscle strain. Although it is recommended to stretch regularly before engaging in any intense physical activity, too much stretching may result in a strain. When you overstretch, you are causing your muscles to go into an extreme stretch that is way beyond its physical capabilities. In the worst-case scenario, this may even cause instability issues within a joint and have adverse effects on your ability to move altogether.
Participation in Contact Sports
High-contact or high-impact sports can put you at risk of strained muscles due to the motions involved in the activity. When it comes to sports, our muscles provide the force required for all forms of movement. However, during activities that require sudden and explosive movements, such as pushing off during a sprint or changing directions, the force across the musculotendinous unit, which connects the muscle and tendon can be so intense, causing the muscle tissues to tear. Contact sports such as wrestling, boxing, soccer, football, and hockey put people at a higher risk for strains.
Repetitive Movement & Lack of Motion
Repetitive injuries and movements may cause chronic muscle strains, which can be harmful in the long run. If you have suffered from a pulled muscle in the past, ensure that your strain has fully healed before returning to your regular activities. Failure to do so may cause your strain to worsen over time. In the same way, lack of movement can also have the same effect. Such activities include working at your desk and holding your back or neck in uncomfortable positions for extended periods of time. Do a few neck and back stretches from time to time to relieve stress on your back and neck muscles.
While less common in countries like Malaysia, cold weather can also cause acute muscle strains as our muscles tend to get stiffer in lower temperatures. Your muscles are then forced to work much harder in completing the same tasks that would be easily completed in milder weather, possibly causing muscle tissue damage and soreness. If you happen to be visiting a cold country, be sure to keep yourself warm to prevent sore muscles.
Grades of Muscle Strains
Based on the severity, muscle strains can be categorised into three different grades: Grade 1, Grade 2 and Grade 3.
- Grade 1: These muscle strains are considered to be the mildest and most minor cases, where only a few muscle fibres are stretched or torn. At this stage, Grade 1 strains only cause minimal loss of strength and motion, and will not affect the individual’s physical ability greatly.
- Grade 2: This is considered a moderate strain, with a greater number of muscle fibres affected, causing more muscle pain than Grade 1 strains. Apart from aching sensations and tenderness, there is also mild swelling and a noticeable loss of strength on the individual’s part.
- Grade 3: At this point, the muscle has been completely torn or ruptured and is considered a serious injury that can cause immense pain, complete loss of muscle function, swelling, tenderness, and even discolouration. In most occasions, surgery is required to reattach the damaged muscle or tendon.
Symptoms of Muscle Strain
Some signs and symptoms of muscle strain or a pulled muscle include:
- Considerable pain
- Sudden onset of pain that intensifies while contracting the strained muscle
- Swelling or bruising
- Redness or discolouration
- Limited range of movement
- Muscle weakness
- Muscle spasms
Once you begin to feel any of these symptoms, continue to monitor yourself and check if these signs persist.
Diagnosing a Pulled Muscle
The process of diagnosis for a muscle strain typically includes a consultation, where the doctor will examine the cause of your injury, medical history as well as your symptoms. If the assessment points to a Grade 2 or 3 muscle strain, further examinations need to be conducted to confirm the severity of the injury. However, for mild to moderate strains, patients may be instructed to conduct self-treatment at home instead.
A series of imaging studies, such as x-rays and magnetic resonance imaging (MRI), may be ordered to ensure that the bone is not broken and to determine the appropriate treatment for the patient.
By getting a clear diagnosis of your injury, patients can finally receive proper treatment that will help alleviate the pain and reduce the risk of further injury.
Treatment Options for Muscle Strains
Based on the information gathered from the physical tests and examinations, a personalised treatment plan will be specifically created for you according to your needs and symptoms.
Home Remedy & Treatment
Since mild to moderate (Grade 1 and 2) strains can be treated at home, home treatment is commonly recommended to these patients. Most doctors would advise patients to follow the RICE method:
- Rest the injured muscle and take a break from sports and other forms of physical activity
- Ice the affected area to reduce swelling
- Compress the injured muscle with an elastic bandage
- Elevate the injured area above the level of your heart to minimise swelling
Alternatively, patients can also be prescribed with nonsteroidal anti-inflammatory drugs such as ibuprofen to relieve pain and inflammation, which can work hand in hand with their home treatment remedies.
Specialist & Surgical Treatment
For those with Grade 2 or 3 strains, you may be referred to an orthopaedic specialist to conduct further investigation on the injury. Depending on the location and severity of the muscle strain, the orthopedist may suggest the use of a cast to immobilise the injured muscle, rehabilitation programmes, or surgery.
Usually, surgery would be the last resort for most muscle strains and is only conducted on patients suffering from Grade 3 strains—this is when the muscle has completely torn into two. If not treated immediately, severe muscle strains may cause permanent functional impairment. Some effective surgical treatment options include Platelet-Rich Plasma (PRP) therapy, which uses injections to help accelerate the regeneration of damaged muscle tissue.
Depending on the severity of the strain, the length of recovery may differ from person to person. Usually, physical therapy will be recommended post-surgery to speed up recovery and help you regain your full muscle function. You can choose to have a home physiotherapist guide you through these exercises in the comfort of your home too.
Muscle Strain Prevention
Fortunately, there are many ways in which muscle strains can be prevented. You can reduce your risk of straining a muscle with these basic precautionary measures:
Do Your Warm-Up
Warm-up before participating in sports activities, but be mindful about overstretching. Warming up your muscles before engaging in strenuous physical activity gently prepares your body and helps your muscles relax, which can lower your risk of injury.
Get Sufficient Rest
If you are suffering from a recurring muscle strain, give your body enough time to heal from the injury fully. Failure to do so may worsen the existing injury and cause more pain and inflammation to the affected area.
Practice Good Posture
Practice good posture when you sit or stand. Spending too much time in one position may strain your muscles and even compress your nerves. Common issues from sitting too much include sciatica, which refers to back pain caused by a problem with the sciatic nerve.
Don’t underestimate the importance of staying hydrated. Muscle strains are also associated with abnormal muscle contractions, which are typically caused by dehydration and fatigue. In a study highlighted in a National Athletic Trainers Association bulletin, it revealed that 3 to 4 per cent dehydration lowers muscle endurance, which ultimately increases the risk for strains.
Maintain a Healthy Body Weight
Obese individuals are more susceptible to muscle strains in the legs and back, as the bodyweight may result in additional stress on the muscles.
When Should You See a Doctor?
If the symptoms of your strain persist and you continue to experience considerable pain, or if home remedies are deemed ineffective, you should consult a doctor immediately.
Should the pain become unbearable and you start to hear a “popping” sound from the affected area along with significant swelling, you should be assessed in a hospital’s emergency room. However, there is no need to rush to the emergency department if the intensity of the injury is not severe.
Muscle strains in the lower back, legs or feet can cause pain or difficulty walking. Physically seeking help at a clinic or hospital can be a hindrance. Your doctor may also recommend physiotherapy as part of your treatment plan.
- McDermott, B., Anderson, S., Armstrong, L., Casa, D., Cheuvront, S., Cooper, L., . . . Roberts, W. (2017, September). National Athletic Trainers’ Association Position Statement: Fluid Replacement for the Physically Active. Retrieved November 02, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5634236/
- Platelet-Rich Plasma (PRP) Injection: How It Works: HSS. (n.d.). Retrieved November 02, 2020, from https://www.hss.edu/condition-list_prp-injections.asp
- Rest, Ice, Compression, and Elevation (RICE). (n.d.). Retrieved November 02, 2020, from https://www.uofmhealth.org/health-library/tw4354spec
- Stephen Hochschuler, M. (n.d.). What You Need to Know About Sciatica. Retrieved November 02, 2020, from https://www.spine-health.com/conditions/sciatica/what-you-need-know-about-sciatica
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