What is a muscle strain?
Muscle strains are a common injury, especially in sports where they account for up to half of all injuries at the elite level. Strains occur when muscles are subjected to excessive tensile forces, which causes the muscle tissue to fail. This generally occurs during high-speed activities, such as sprinting, kicking or stretching out to retrieve a ball. The hamstrings, quadriceps, and the gastrocnemius (calf) are the most common muscles where strains are likely to occur due to their high load requirements.
Muscle strains may also occur secondary to fatigue in muscles which are responsible for sustained postures. This can occur in muscles in the neck, shoulders and back and is often associated with poor posture. An example of this is prolonged computer or mobile phone use, which results in the head being in a forward and downward position, putting tension on the shoulders and neck muscles
Signs of a muscle strain
- Pain and tenderness
- Reduced muscle strength
- Muscle spasm
- Reduced joint range of motion
- Walking or jogging with a limp
- Bruising (with more severe strains)
Grades of muscle strains
Muscle strains are generally placed into three grades based on their severity.
Grade 1: Mild damage to individual muscle fibres that causes minimal loss of strength, range of motion and function.
Grade 2: More extensive damage with more muscle fibres involved, however not a complete rupture of the muscle. Significant loss of strength, range of motion and typically affects daily activities.
Grade 3: A complete rupture of a muscle, with significant pain, swelling and loss of function. These injuries sometimes require surgery to reattach the damaged muscle.
Treatment
The traditional approach to treating acute muscle injuries was the use of the acronym RICE- Rest, Ice, Compression and Elevation. This has evolved as our understanding of muscle injury management has developed, and we now use the acronym PEACE & LOVE, which encompasses the whole recovery processes, from the initial injury to return to activity.
(Dubios and Francois Esculier, 2019)
PEACE
- Protection - Avoid activities and movements that increase pain during the first few days after injury
- Elevation - Elevate the injured limb higher than the heart as often as possible
- Avoid Anti inflammatories - Avoid taking anti-inflammatory medications as they reduce tissue healing. Avoid icing.
- Compression - Use elastic bandage or taping to reduce swelling
- Education - Your body knows best. Avoid unnecessary passive treatments and medical investigations and let nature play its role.
LOVE
- Load - Let pain guide your gradual return to normal activities. Your body will tell you when it's safe to increase load
- Optimism - Condition your brain for optimal recovery by being confident and positive
- Vascularisation - Choose pain-free cardiovascular activities to increase blood flow to repairing tissues
- Exercise - Restore mobility, strength and proprioception by adopting an active approach to recovery
A physiotherapist can guide you through your recovery by implementing principles of the PEACE & LOVE acronym at the appropriate stage of rehabilitation. They can also compliment your active rehabilitation with manual therapy which will aim to mobilise scar tissue and increase muscle flexibility.
Importantly, a physiotherapist can assess other areas of the body, movement patterns and training loads which may have contributed to the initial injury. By adhering to this process under the guidance of a trained health professional, the high risk of recurrence of muscle injuries can be significantly reduced.
References:
Dubios, B. and Francois Esculier, J., 2019. Soft-tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine, 54(2).