Muscle strain, muscle pull, or even a muscle tear refers to damage to a muscle or its attaching tendons. Muscle injuries are mainly due to overload and overstretch. You can put undue pressure on muscles during the course of normal daily activities, with sudden heavy lifting, during sports, or while performing work tasks.

Muscle damage can be in the form of tearing (part or all) of the muscle fibers and the tendons attached to the muscle. The tearing of the muscle can also damage small blood vessels, causing local bleeding, or bruising, and pain caused by irritation of the nerve endings in the area.

Muscle Conditions

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.

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Muscle Spasm and Cramps   Torn Muscle   Calf muscle tear or strain   Muscle Pain   Tendinopathy, Tendinosis, Tendinitis

Muscle Strain

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

  • Pain, especially after a movement that stretches or violently contracts the muscle
  • Stiffness and tightness after rest
  • Pain gets worse during movement, and eases with keeping it still.
  • 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

When to Seek Medical Care

If you have a significant muscle injury or if home remedies doesn’t relieve your pain in 24 hours), call us immediately.
If you hear a “popping” sound with the injury, cannot walk, or there is significant swelling & weakness.

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Exams & Tests

The Physiotherapist will take a medical history and perform a physical exam. During the exam, it’s important to establish whether the muscle is partially or completely torn, which can involve a much longer healing process and a more complicated recovery.

X-rays or lab tests are often not necessary, unless there was a history of trauma or evidence of infection.

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Diagnosis

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 asking about your symptoms and past medical history, your physio will examine you, checking for muscle damage by testing its tenderness, spasm, weakness and decreased muscle movement. If this exam points to a mild or moderate muscle injury, 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. Even an 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 muscle injury, 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 muscle damage is.

X-Rays

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.

  • Medication.
    Anti-inflammatory medications are not recommended, especially in the first 48 hours as they are thought to delay healing. Only if the swelling is excessive, you can resort to anti-inflammatory meds.

  • Don’t do any resistance training (weights).
    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. Its important to know the extent of your muscle injury before re-introducing contractions, if you fail to do this you may damage the muscle even more.

Renier Cilliers Physiotherapist & Medical professional at Well Health Pro

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Muscle Strain Treatment Self-Care at Home

The amount of swelling or local bleeding into the muscle (from torn blood vessels) can best be managed early by applying ice packs and maintaining the strained muscle in a stretched position. Heat can be applied when the swelling has lessened. However, the early application of heat can make the situation even worse by increasing swelling and pain.

Note: Ice or heat should not be applied to bare skin. Always use a protective covering such as a towel between the ice or heat and the skin.

Protection, rest, ice, compression, and elevation (known as the PRICE formula) can help the muscle injury. Here’s how: First, remove all constrictive clothing, including jewelry, in the area of muscle strain. Then:

  • Protect the strained muscle from further injury.
  • Rest the strained muscle. Avoid the activities that caused the strain and other activities that are painful.
  • Ice the muscle area (20 minutes every hour while awake). Ice is a very effective anti-inflammatory and pain-reliever. Small ice packs, such as packages of frozen vegetables or water frozen in foam coffee cups, applied to the area may help decrease inflammation.
  • Compression can be gently applied with an elastic bandage, which can both provide support and decrease swelling. Do not wrap too tightly.
  • Elevate the injured area to decrease swelling.
  • Activities that increase muscle pain or work the injured muscle are not recommended until the pain has significantly improved.

PRICE protocol for a Muscle injury

P

Protect.

We have found that patients tend to continue walking on the injured leg with a limp. The muscle still contracts every time that your weight is put onto the leg. It’s better to get crutches and keep the load off the muscle. The main concern is to prevent the muscle from tearing even further.

Rest.

No weight on the injured leg. Use crutches to take the load off the muscle.

I

Ice.

Ice cubes warped in a towel, tied around the calf reduces pain & inflammation and speeds up the healing process. For at least the first 3 days or until the swelling goes down, apply an ice pack for 20 minutes every two hours. Always keep a towel between the ice and your skin (to prevent a clod burn), and press the ice pack firmly against all the curves of your calf.

C

Compress.

Use strapping (Leukotake S) or elastic compression bandage to keep the muscle supported and prevent blood pooling in your calf. This can be done either with taping or tube grip bandage and helps to control swelling.

E

Elevate.

Lying on your back with your foot on a chair (your calf must be higher than your heart to allow gravity to assist in draining the pooled blood in your leg.) Raise your calf for 15 minute intervals during the day.

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Torn Muscle, Muscle tear, Muscle strain, Muscle injury, Pulled muscle

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