I’ve pulled a muscle…. What now?

By Daniel Graham – Podiatrist, Quay Health Sydney

Did you know that muscle strains are the most common injuries in athletes and can comprise of up to 55% of all sports related injuries?

A muscle strain is a soft tissue injury occurring in the muscle belly, muscle tendon or more commonly the junction between the two. The two most common areas to have a muscle strain are the lower back and the hamstrings however this can be heavily influenced by what activities are being performed.

Classification of severity

There are three grades of muscle strains dependent on the severity of the injury.

Grade 1 – Mild strain; stretch possibly with small fibre ruptures, minor swelling, usually felt as a sharp pain at the time of injury but does not cause a loss of function and activity can usually continue.

Grade 2 – Moderate strain; mild fibre ruptures, increased swelling, reduced strength of the musculotendinous unit and usually unable to continue with activity.

Grade 3 – Severe strain; complete rupture, significant swelling and pain and loss of muscle function.

All three grades of muscle strain are associated with significant risk factors. The two most common risk factors for a muscle strain are a recent history and a past history of the same injury. Additionally, having one type of muscle strain also increases the risk for other certain types of muscle strains.

What’s the difference between a sprain and a strain?

Terminology regarding sprains and strains can often get confused but sprains and strains are different injuries. As mentioned previously strains involve muscles, tendons and where the two join to bone. Whereas, sprains refer to ligament injuries in which the tissue that connects bone to bone is affected. The grading system is very similar between these two injuries however treatment varies largely.

Signs and symptoms of muscle strain:

Signs and symptoms vary depending on the severity of the injury, however generally there will be:

  • Pain and tenderness
  • Swelling
  • Bruising
  • Limited movement
  • Weakness
  • Spasm

Treatment for muscle strain:

Traditionally, recovery for muscle strains have followed the R.I.C.E. principals; rest, ice, compress and elevate. However, a problem with R.I.C.E. is that it does not take you through the recovery process or introduce you back into activity safe. Recently there has been a shift towards a new acronym for soft tissue injuries that is better arranged to help with the initial stages of recovery as well as return to activity; P.E.A.C.E. & L.O.V.E.

P- Protection; avoid activities and movements that increase pain during the first few days after injury

E- Elevation; Elevate the injured limb higher than the heart as often as possible

A- Avoid anti-inflammatories; Avoid taking anti-inflammatory medications as they reduce tissue healing. Avoid icing

C- Compression; Use elastic bandage or taping to reduce swelling

E- Education; Your body knows best. Avoid unnecessary passive treatments and medical investigations and let nature play its role

&

L- Load; Let pain guide your gradual return to normal activities. Your body will tell you when it’s safe to increase load

O- Optimism; Condition your brain for optimal recovery by being confident and positive

V- Vascularisation; Choose pain-free cardiovascular activities to increase blood flow to repairing tissues

E- Exercise; Restore mobility, strength and proprioception by adopting an active approach to recovery

The acronym P.E.A.C.E. & L.O.V.E. is a much better step by step approach to dealing with soft tissue injuries. However, if the injury is serious or not getting better you should always have it assessed by a health professional. The appropriate diagnosis and early intervention can reduce the risk of the injury progressing into something more serious and an appropriate treatment plan can ensure optimal recovery.

What are the causes of muscle strains?

Muscle strains commonly occur when:

  •  Abnormal loads are being put through normal structures; lifting something to heavy

  • Normal loads are being put through abnormal structures; lifting an everyday object with poor back alignment or fatigued muscles

Or

  • Abnormal loads through abnormal structures; lifting a heavy object with poor back alignment or fatigued muscles

These however, are examples of acute muscle strains. Chronic muscle strains occur as a result of overuse or repetitive stress that can occur over time.

How to Prevent a Muscle Strains:

A great way to prevent muscle strains is by being prepared for the activity you wish to perform. If you play a sport, ensure that you are conditioned to play that sport; instead of playing a sport to get fit, be fit enough to perform that sport.  Making sure that you are conditioned appropriately for your specific activity is a great way to ensure you don’t overload yourself and suffer from injury while performing those sport specific activities. This can be done through designing a training program consisting of stretching, strengthening and load management specific to your needs.

Having a biomechanical assessment is always a great idea before commencing activity to ensure you are safe to do so, especially if you have suffered from previous injuries or general aches and pains. Having the appropriate screening to highlight and address any kind of biomechanical abnormalities can be instrumental in ensuring that you don’t break down.

If you do generally suffer from aches or pains, if you have suffered from muscle strains in the past, if you are looking at beginning a new activity or have felt a pinch lately, Quay Health has multiple health professionals that perform full body biomechanical assessments and create specialised training programs on a daily basis.