Muscle Strains

A muscle strain, or pulled muscle, is when your muscle is overstretched or torn. This usually occurs as a result of fatigue, overuse, or improper use of a muscle. Strains can happen in any muscle, but are most common in your lower back, neck, shoulder, and hamstring (the muscle behind your thigh).

A muscle strain causes pain and may limit movement within the affected muscle group. Mild to moderate strains can be successfully treated at home with ice, heat, and anti-inflammatory medications. Severe strains or tears may require medical treatment.

Diagnostic imaging may be necessary to learn the extent of the damage to your muscle. Physical therapy may be recommended. In severe cases, surgical repair may be necessary.

Symptoms of mild to moderate muscle strains are usually gone within a few weeks. More severe strains may take months to heal.

You will generally feel a muscle strain as it occurs. Symptoms include:

• sudden onset of pain
• soreness
• limited range of movement
• bruising or discoloration
• swelling
• a "knotted up" feeling
• muscle spasms
• stiffness
• weakness

In the case of a mild strain, a torn muscle may feel slightly stiff, but still flexible enough for use. A severe muscle strain is when the muscle is severely torn, resulting in pain and very limited movement.

An acute muscle strain is when your muscle tears suddenly and unexpectedly. This can be due to:

• not warming up properly before physical activity
• poor flexibility
• poor conditioning
• overexertion and fatigue

An acute strain can happen when you:

• slip or lose your footing
• jump, run, or throw
• lift something heavy
• lift in an awkward position

Chronic muscle strains are the result of repetitive movement. This can be due to:

• sports like rowing, tennis, golf, or baseball
• holding your back or neck in an awkward position for long periods of time, such as when you work at a desk
• poor posture

Most muscle strains can be successfully treated at home. According to the Mayo Clinic, minor muscle strains can be treated with the R.I.C.E. method: rest, ice, compression, and elevation (Mayo Clinic, 2011).

• Rest. Avoid using your muscle for a few days, especially if movement causes an increase in pain. Too much rest can cause muscles to become weak, which can prolong the healing process. After two days, slowly begin using the affected muscle group, taking care not to overdo it.
• Ice. Apply ice immediately after injuring your muscle. This will minimize swelling. Do not put ice directly on your skin—use an ice pack or wrap ice in a towel. Keep the ice on your muscle for about 15 minutes. Repeat every hour on the first day. For the next several days, apply ice about every four hours.
• Compression. To reduce swelling, wrap the affected area with an elastic bandage until swelling comes down. Be careful not to wrap the area too tightly, as this can reduce blood circulation.
• Elevate. Whenever possible, keep the injured muscle raised above the level of your heart.

Other self-care methods include:

• Anti-inflammatory medications. Use an over-the-counter anti-inflammatory medication, such as acetaminophen or ibuprofen. This will help keep pain and swelling down.
• Heat. After three days, apply heat to the muscle several times a day.
• Stretching. Do not rest your muscle for too long. This can cause stiffness and weakness. Begin light stretching as soon as possible. Slowly increase your level of activity.
• Warm up. When you return to normal activity, make sure to stretch and warm up before exercising.
• Stay in shape. You are less likely to suffer a strain if your muscles are strong and healthy.

If your muscle strain is severe, you may need medical attention. Physical therapy may also be recommended.

For mild to moderate strains, home treatment should be enough. Seek medical attention if:

• pain does not subside after a week
• the injured area is numb
• there is blood coming from your injury
• you can’t walk
• you can’t move your arms or legs

A physical examination and imaging tests, such as X-ray and magnetic resonance imaging (MRI) scans, can help your doctor determine the extent of your injury. Treatment may include anti-inflammatory medications and pain relievers to reduce pain and swelling, along with physical therapy to help strengthen the muscle and restore movement.

In very severe cases, surgery may be required to repair the muscle.

Recovery time depends on the severity of the injury. For a mild strain, you may be able to return to normal activities within three to six weeks with basic home care. For more severe strains, recovery can take several months.

With proper treatment, most people experience a complete recovery. Your chances of recovery are much better if you take steps to avoid re-injury. Follow your doctor’s instructions after surgery, and do not engage in strenuous physical activity until your muscles have healed.

You can decrease your chances of straining a muscle if you take some basic precautions.

• Try not to sit in one position for too long. Take frequent breaks to move and change position. Use a chair that provides good support for your lower back or use a pillow for support. Try to keep your knees level with your hips.
• Maintain good posture when standing and sitting. If you spend a long time in one position, try to alternate putting one foot and then the other on a low footstool. This can help decrease stress on your back muscles.
• Lift objects carefully. Keep your back straight, bend at the knees, and always lift with your legs. Hold the weight close to your body. Do not lift and twist at the same time.
• Always stretch and warm up before engaging in physical activity. Similarly, take time to stretch after each workout or session of physical activity to prevent muscle stiffness.
• If you are new to exercising, start slowly and build up your activity a little at a time.
• Exercise regularly to keep your muscles healthy and strong.
• Understand your body’s limitations—don’t overdo it!