A muscle strain is the stretching or tearing of muscle fibers. Most muscle strains happen for one of two reasons: either the muscle has been stretched beyond its limits or it has been forced to contract too strongly.
In mild cases, only a few muscle fibers are stretched or torn, and the muscle remains intact and strong. In severe cases, however, the strained muscle may be torn and unable to function properly. To help simplify diagnosis and treatment, doctors often classify muscle strains into three grades, depending on the severity of muscle fiber damage:
- Grade I strain. In this mild strain, only a few muscle fibers are stretched or torn. Although the injured muscle is tender and painful, it has normal strength.
- Grade II strain. This is a moderate strain, with a greater number of injured fibers and more severe muscle pain and tenderness. There is also mild swelling, noticeable loss of strength and sometimes a bruise.
- Grade III strain. This strain tears the muscle all the way through, sometimes causing a “pop” sensation as the muscle rips into two separate pieces or shears away from its tendon. Grade III strains are serious injuries that cause complete loss of muscle function, as well as considerable pain, swelling, tenderness and discoloration. Because Grade III strains usually cause a sharp break in the normal outline of the muscle, there may be an obvious “dent” or “gap” under the skin where the ripped pieces of muscle have come apart.
Symptoms of a Muscle strain
- Especially after a movement that stretches or violently contracts the muscle
- Pain gets worse during movement, and eases with keeping it still.
- Stiffness and tightness after rest
- Dull pain when stretched
- Pain only at the end of range (when stretched)
- Muscle swelling, discoloration (bruising under skin) or both
- Loss of muscle strength
- Unable to continue playing
- Muscle cramp or spasms
- Hear a pop in the muscle at the time of injury
Our Physiotherapist are experts at detecting a muscle strain because we spend 11 hours a day working on soft tissue, forgive us to say “we just have the feeling for it”.
Your Physio will want to know what type of activity triggered your muscle pain and whether there was a pop in the muscle at the time of injury. The Physio will ask about your symptoms, especially any decrease in muscle strength or any difficulty moving.
After noting your symptoms and past medical history, your physio will examine you, checking for muscle tenderness, spasm, weakness and decreased muscle movement. If this exam points to a mild or moderate muscle strain, you may not need any additional testing.
In some cases we may refer you for an X-ray to exclude any bone pathology or abnormality, but this is rare.
Any MRI will be very excessive,and is definitely not necessary to confirm a torn muscle, its way too expensive.
Sonar (Diagnostic Ultrasound)
The best way to confirm a muscle strain is to see it live. This is done using a Sonar or Ultrasound (Diagnostic Sonar). We are able to measure the width, depth and length of the tear, exclude or include any surrounding muscles that may also be involved. We’ll compare the painful muscle to the opposite side, and compare it to your own ‘normal’.
The Sonar will be very helpful and show which of the muscles are affected (location) and how bad (degree) the sprain is.
X-rays are unnecessary and ineffective in detecting a muscle strain, cramp or spasm. X-rays do not show soft tissue and so, any pathology in soft tissue (which includes the muscles and tendons) will not be detected by an X-ray.
MRI and/ CT scans
MRI and CT scans are not necessary to detect a muscle strain, as the imaging by sonar is sufficient to pick up the extent of the damage. An MRI might be redundant and also deemed unnecessary.
What you shouldn’t do
- Don’t apply any heat
Heat will dilate the small arteries in the muscle causing blood to bleed out into the tissue, which will make the situation worse.
- Don’t stretch the muscle
The first reaction that people have is to stretch the muscle due to the tight or stiff feeling. If you understand the mechanism of the injury you will realize that the last thing you want to do is to pull on the muscle even more. You will end up making it worse by tearing even more strands.
The muscle will be activated by your bodies normal protective mechanisms and contract the muscle. The more you stretch it, the more your body will try to counteract against it and try to keep the muscle in a shortened position. If you stretch through the pain, you will probably only tear more fibers.
Anti-inflammatory medications are not recommended, especially in the first 48 hours as they are thought to delay healing
If you contract or shorten the muscle while putting load on it you will feel a sharp pain, that is the muscle tearing even more.
- Do not ignore muscle pain that gets worse
It can be a sign of a bigger problem, Contact us A.S.A.P. The faster we have a look at it before the swelling and bleeding gets too much, we can determine where the tear is and distinguish which of the muscles are torn.