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July 2010
Commonly called “pulled muscles”, strains are defined as a stretch or tear of a muscle or tendon.
Tendons are strong bands of tissue that attach muscles to bones.
This injury frequently occurs in the hamstring, groin, hip flexor, rotator cuff or lower back. These ‘muscle pulls’ are usually caused by a forceful contraction or tightening of the muscle during activity, such as running, throwing, lifting or jumping.
Strains are categorized into three grades depending on the severity of the injury:
- Grade 1: mild pain, swelling, discoloration; minor loss of muscle strength.
- Grade 2: moderate pain, swelling, discoloration; loss of muscle strength.
- Grade 3: severe pain, swelling, discoloration, loss of muscle strength and noticeable knot within the muscle.
Immediate treatment for a strain is similar to that of a sprain. Care for each comes in the acronym R-I-C-E, which stands for Rest, Ice, Compression and Elevation.
- Rest: Discontinue all activities which cause pain.
- Ice: Apply an ice pack to the injured area for 15 to 20 minutes every 3 to 4 hours. You can also perform an ice massage by freezing water in a paper cup and tearing off the top to expose the ice. Rub the injured area with the ice for 10 to 15 minutes. Continue this for 2 to 3 days or until the swelling goes away. This will also help to reduce pain. Do not use heat during this period.
- Compression: Apply an elastic bandage around the injured area to reduce swelling.
- Elevation: Keep injured area elevated as much as possible to help control the swelling.
Your health care professional will examine your injury and may x-ray the injured site to make sure you do not have an avulsion fracture. An avulsion fracture occurs when a tendon or ligament pulls away a small fragment of bone.
Depending on which muscle or tendon you have strained, you may be given crutches, a brace or sling. Anti-inflammatory medication may also be prescribed in order to alleviate both pain and swelling.
A rehabilitation program should be started as soon as tolerated in order to aid the recovery process. A licensed physical therapist (PT) or certified athletic trainer (ATC) can design a complete rehabilitation program that is specific for your injury. Some general rehabilitation techniques may include light stretching of the injured area while progressing to a strengthening phase.
Length of recovery time depends on age, health and severity of the injury. You and your healthcare professional will decide when it is safe to return to physical activity.
A proper warm up along with stretching may prevent strains. An increase in flexibility and strength will certainly decrease the chances of this injury.
Article Written By:
Brian Cox, ATC, CPT
Coordinator, Sports Medicine - Arkansas Children's Hospital
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