Ultimately whether you call it a ‘strain’, ‘pull’ or ‘tear’ it all means the same thing, a percentage of muscle fibres have been damaged either from over-stretching or over-tightening and less commonly direct trauma (contact / kick to the muscle).
Physiotherapists can grade your muscle strain from the symptoms reported and through assessment. This then can give a guide to how long the injury is likely to keep you from your sport or activity if the optimal rehabilitation and loading is applied. There are variables that must be considered: the muscle injured and its level of involvement of regaining full function or the persons sport / activity, the health of the individual (other health issues / healing issues), previous injury, biomechanical issues etc.
- A grade one strain is minor damage to your muscle fibres, with some pain and swelling.
- A grade two strain is a partial tear of your muscle, with moderate pain and swelling.
- A grade three strain is a full tear of your muscle.
The main symptoms of a muscle strain are pain and tenderness when you touch the affected muscle.
- If you have a mild (grade one) muscle strain, the area may feel tender. You should still be able to move normally and carry on with your activities as normal. I often describe this as a very few fibres damaged (10%) and return to full function could be as quick as two weeks.
- If you have a grade two muscle strain, your pain is likely to be more severe. You may also have a bruise and some swelling over the affected area. You’re likely to lose some strength in the affected muscle, which may mean you can’t carry on with your usual activities. This is a huge grade covering 10% to 99% of the muscle fibres damaged; hence the symptoms follow a huge spectrum. Return to function again varies and is best predicted once rehabilitation has started to assess its response but a vague timescale from 6 weeks to 12 weeks would be where many would fall.
- A grade three strain causes severe pain and you may feel a popping sensation when the injury happens. You can lose all strength in the affected muscle so you can't put any weight on it and can't carry on with your usual activities. It is important to remember this is rare and only a definitive diagnosis through imaging / scanning. This would be if conservatively managed a least a 12 week injury if not longer. Surgery may be an option and therefore the rehabilitation would take significantly longer.
Treatment for a muscle strain involves reducing your pain and any swelling, and keeping up movement and strength in your muscle. It aims to get you back to your usual activities as soon as possible. The type of treatment you need will depend on how severe your injury is. The key is regaining the strength within the muscle – this is the part that people can often short cut returning to their sport earlier than anticipated however there is a significant risk of re-injury and further scar tissue developing within the muscle which does not have the same contractile qualities of muscle fibres potentially creating a more significant longer term issue.
It is important to allow your injury to heal and to protect it from further damage by taking certain steps as soon as you can. Many minor strains will respond to the PRICE procedure.
- Protect your injury from further harm.
- Rest your injury for the first two to three days, and then slowly start moving again so you don’t lose too much muscle strength.
- Ice the injured area using an ice pack or ice wrapped in a towel to reduce swelling and bruising. Don’t apply ice directly to your skin as this can damage it.
- Compress the area by bandaging it to support the injury and help reduce swelling. The bandage should fit snugly but not be too tight, and you should remove it before you go to sleep.
- Elevate the injured area above the level of your heart to control swelling. Keep the area supported and try to keep it elevated as much as possible until the swelling goes down.
If your injury is severe or you find that it keeps coming back (re-occurring), physiotherapy can help you to strengthen the damaged muscle and give a clear loading program to return to your activity / sport within the most optimal time frame. It’s important to make sure your injury has fully healed before you start exercising again. If you return to exercise too soon, you’re more likely to have another muscle strain injury.
If your muscle strain is severe, or your muscle has completely torn, you may need an operation to repair it. This would be fully assessed by both a physiotherapist and doctor with imaging (ultrasound and / or MRI scan) prior to the decision being made.
Chartered Physiotherapist MSc, BSc (Hons), MCSP, MHCPC
Owner First Physio
Disclaimer: The opinions expressed are those of First Physio only and do not constitute medical advice.