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Muscle Strains: Causes and Treatment


A muscle strain is often referred to as a torn muscle or pulled muscle.

Contents of Article:


What Is A Muscle Strain?

A muscle strain also called a pulled muscle is an injury in which muscle or tendon fibers are torn or stretched past their capacity.

How Do I Know If I Have A Muscle Strain?

You know when a muscle strain happens. There is always a feeling, a weird twinge, sharp pain, a tearing or popping sensation in the muscle, you will always be aware that something has happened. Other signs are:

  • Heat and reddening of the skin over the injury
  • Though it may seem the entire muscle hurts there is one spot that is exceptionally painful
  • Swelling may occur, a bump is felt where the strain occurred
  • The muscle is both weak and painful
  • Moderate and severe strains often cause an indentation  in the muscle that can be felt

You do not have a muscle strain if:

  • You cannot remember a defining moment when the injury occurred (there are exceptions, but they are rare)
  • The pain comes and goes
  • There is not one easily identifiable spot that is painful
  • The pain has developed and increased over time

What Causes A Muscle Strain?

Most muscle strains happen during sports and exercise where muscle strength and flexibility is pushed to the limits. A direct blow to the muscle will also cause fibers to tear.

Strains can also occur during normal everyday activities such as lifting a heavy object, twisting motions of the trunk or a limb, or slipping on a slick surface. Repetitive motion strains happen when a movement is repeated frequently and the muscle becomes fatigued. The muscle fibers weaken which contribute to tearing. Repetitive motions include lifting and moving heavy objects for a job, typing for hours a day, and practicing an activity, over and over, such as throwing or kicking a ball and practicing a golf or tennis swing.

Strains Are Graded By Severity Of Fiber Tears

Grade I is a mild strain. You will usually feel a twinge, pulling sensation, or ache when the injury happens. You may continue to feel some pain or discomfort immediately after the injury. The initial pain will often subside until a few hours later. Sometimes you will not feel pain until the next morning when you get out of bed. Swelling and bruising may occur though it is not common.

Pain caused by a mild strain is more annoying and uncomfortable than it is constant. Certain movements or pushing directly on the injured area may cause pain to increase for the moment but it quickly passes. You will usually notice a reduction in pain and discomfort within 72 hours. The pain does not stop most normal activities though you may be more careful while doing certain movements and you will definitely be careful not to bump it!

Mild strains heal quickly generally within 1-2 weeks. Medical intervention is not needed.

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Grade II is a moderate strain in which many fibers are torn. You will feel pain from the injury immediately. You may feel sharp and stabbing pain, a cramping sensation, or a tearing and/or popping sensation. It will be painful to move the muscle and weight bearing on an affected leg will increase pain. Redness, heat, and swelling will become evident within minutes or a few hours after the injury. Bruising is often seen around the injury within a few days. You will find that pain will affect certain movements and activities. If the injury occurs in the lower back, hip, leg, or foot your gait will be affected and you may limp.

The initial acute pain begins to fade within 3-4 days. It can take 3-12 weeks for a Grade II strain to fully heal. Medical intervention is usually not needed. However, if pain, swelling, and bruising is intense and excessive a visit to a doctor or urgent care is in order.

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Grade III muscle strains are rare and are the most severe, many requiring medical care. With a Grade III strain, most of the fibers in the muscle or tendon are torn. A rupture (avulsion) occurs when the muscle or tendon are ripped in half or are torn away from the bone.

In most instances when a severe muscle strain occurs the pain is immediate and debilitating. If the injury occurs in the hip, leg, or foot, you will often fall to the ground. Redness, heat, and swelling develop quickly. Movement of the muscle will cause intense pain and weight bearing on an affected leg will be limited and may be impossible.

In rare instances, some individuals may not experience intense pain or debilitation if the injury is to a deeper muscle or tendon. There is definite pain and discomfort but it may be days before you realize the injury is more severe than you originally thought. When this happens you should consult your doctor who can ascertain the damage, give you a list of do’s and don’ts to speed healing, and recommend physical therapy to help you regain muscle strength and range of motion.

When To See A Doctor:

  • An open wound requiring stitches
  • High pain levels
  • Rapid and/or excessive swelling and bruising
  • You are not able to move the muscle or limb without extreme pain
  • You may be unable to put weight on the affected leg
  • Swelling, pain, redness, and heat have not begun to subside within 24-48 hours

Begin The P.R.I.C.E Protocol As Soon As Possible

The P.R.I.C.E. protocol is a 5 step treatment used by doctors, physical therapists, and athletic trainers immediately after a strain to reduce pain, swelling, and stabilize the muscle. The steps to the protocol are:

Protect – stabilize the injury with an elastic or Velcro wrap
Rest – limit movement and use of the affected muscle
Ice – apply ice or cold packs to the injury for 20 minutes every 1-2 hours
Compression – use an elastic or Velcro wrap to apply pressure to the muscle
Elevate – use pillows and folded blankets to elevate arm and leg injuries

Doctors recommend NSAIDs medications such as Aleve and Advil to control pain. Use according to package recommendations.

Use the P.R.I.C.E. method during the first 24-72 hours after the initial injury or until the pain and swelling have lessened. The treatment protocol helps to reduce pain, limit swelling, and aid in the healing process. To learn more about the protocol read What Is The PRICE Protocol?


Muscle Strain Recovery

Patience is important, it takes time for muscle strains to heal. If you resume activities that stress the muscle too soon you will reinjure the muscle or tendon which will increase recovery time. It is important to remember that after the pain and swelling are gone the muscle is still in the healing process. Consult a physical therapist or athletic trainer for stretching and strengthing exercises when the time is appropriate. Taking the time now to allow the tissue to fully heal will save you pain and downtime in the future.


Donna Martin

Massage Therapist Owner: thewellnessdigest.com Twelve years of experience working with clients with chronic pain, post injury pain, and post surgery pain. Muscle dysfunction is often overlooked but can hold the key to many pain conditions.