How to heal a pulled muscle

There is a lot of controversy regarding the proper way to manage a muscle strain after an injury. Wherever you are, there are always individuals surrounding you recommending what they think are the tried and true methods of healing from a muscle injury. I have heard many different methods being recommended, making it difficult to select which is the most appropriate. So, what is the best method: Icing? Heating? Stretching? Massaging? Running it off? All of the above?

How muscle strains occur

There are a variety of mechanisms that can cause a muscle strain. Muscle strains occur when the muscle is overstressed and resulting tears arise in the muscle fibers. A muscle strain can take place at the junction between the muscle and the muscle tendon or in the muscle belly.  Muscle strains are commonly called pulled muscles due to the overstretching mechanism that can lead to muscle strains. The most common mechanism of injury is during an eccentric contraction. An eccentric contraction is a type of muscle contraction where the muscle lengthens while placed under tension. Activities such as lowering objects against the force of gravity are considered eccentric contractions. A muscle strain can also occur during abrupt forceful motions such as accelerating, decelerating, or cutting activities.

Strains are classified into categories based on the severity of the injury. A grade 1 muscle strain is a mild strain with damage to less than 5% of the muscle fibers. A grade 2 strain is considered a moderate strain with a greater amount of fibers involved but less than half of the muscle tissue is damage. A grade 3 strain occurs when greater than half of the muscle fibers are torn. Finally, a grade 4 strain is the complete tearing of the muscle.

Symptoms of a muscle strain involve sudden pain during activity. A popping sensation is commonly reported during muscle strain injuries. The involved muscle may be tender to touch and bruising can often be observed over injured tissue. The severity of symptoms vary based upon the grade of muscle injury. Lower grade injuries may have symptoms of a knot in the muscle while higher grades may produce symptoms of extreme pain or inability to use the involved musculature.

Treating muscle strains

The treatment of muscle strains begins right after the injury occurs. Termination of the harmful activity should be completed in order to decrease the damage to the involved tissues. Icing and gentle massage should be performed to decrease inflammation and to decrease the tensing up of the muscle fibers. Icing should be performed for 20 minutes every hour initially after the injury. The muscle should not be stretched immediately after the injury. Stretching the already overstressed muscle can cause more damage to the tissue. Over the counter anti-inflammatory medication can be used during this time to decrease inflammation and pain. The injured extremity should also be elevated to decrease inflammation. Once symptoms have alleviated and the muscle is healed, a program focusing on strengthening, increasing flexibility, and decreasing muscle spasms should be initiated. Muscle strains can become chronic injuries if the underlying deficits that caused the muscle strain initially are not addressed.

Prevention of muscle strains

There are numerous activities that can aid in the prevention of muscle strains as well as overall injuries. By engaging in a stretching program muscle flexibility can improve to decrease the risk of overstretching a muscle that is shortened and not at an optimal length. Muscle imbalances can cause muscle strains so addressing these imbalances is imperative to the prevention of muscle injuries. Muscle imbalances occur when a muscle group on one side of a joint is stronger than the opposing muscle group. For example, the quadriceps muscle group is stronger than the hamstrings, which leaves your hamstrings more prone to injury. By strengthening the weaker muscle group you can prevent the over stressing of that muscle group that will eventually lead to tears. Lastly, a proper warm up can decrease the risk of a muscle strain by allowing the gradual increase of blood delivery to muscle tissues. This allows muscles to be more pliable and decreases injury.

When a muscle strain does arise physical therapy can help get you back into your favorite activities. Through physical therapy patients are evaluated to determine underlying mechanisms that have caused the injury to occur. During therapy muscles will be strengthened and biomechanics will be corrected to rehabilitate the current injury and prevent future injuries from arising.  For more information on physical therapy visit

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