Muscle Strains

By Michelle Duclos, MA, ATC, LAT, CES

Overview of Muscle Strains

A common injury in athletics is a muscle strain, more often known as a pulled muscle. Muscle strains typically occur as a result of one of two reasons: 1) the muscle has been stretched past its limit; 2) the muscle has been forced to contract too strongly. A pulled muscle can vary in terms of severity, ranging from mild to severe.  The most common muscle strains occur in the low back muscles or the hamstring muscle in the back of your leg.  However, any muscle in your body can have a strain. 

Watch this VIDEO on Muscle Strains to learn more. 

Muscle Strain Grades

To help diagnose the severity of the injury, a muscle strain can fall into one of the classifications:

Grade I strain-

The mildest 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

Moderate strain. More injured fibers, with some tearing possible and more severe muscle pain and tenderness. There is also mild swelling, noticeable loss of strength, and sometimes a bruise.

Grade III strain-

Severe strain. The muscle fiber is torn all the way through with this injury.

Muscle strains are categorized by severity with labels of grade 1 through 3. JOI Rehab

Grades of muscle strains by JOI Rehab










The risk of pulling a muscle is typically higher during high-intensity activity, such as athletics or gym workouts.  Contact sports also have an increased risk of muscle strains.  However, muscle strains can occur during any form of activity, including things as simple as walking down the stairs.  Often, doing yardwork on the weekends is a common cause of muscles strains. 

Zoomed in image of the muscles and tendons in elbow. This is a common place for a muscle strain to occur also referred to as tennis elbow. JOI Rehab

Muscle Strain in Elbow

Causes of Strains

Here are some of the most common causes of muscle strains.

  • Poor, or complete lack of warm-up before activity
  • Lack of flexibility or stretching before the activity
  • Poor conditioning
  • Overexertion
  • Unusual body movements or doing activities that you have not done before.

How do you know it is a Muscle Strain?

The symptoms of a pulled muscle may vary slightly depending on severity. Symptoms may include:

  • Sharp pain, especially after an activity that stretches or violently contracts the muscle.  
  • Tenderness over the muscle
  • Bruising, redness, or other discoloration
  • Muscle spasm
  • A “popping” sensation
  • Swelling or stiffness
  • Weakness or the inability to contract or use the muscle

Symptoms unique to a more severe strain include:

  • An indent or other defect in the normal outline of the muscle
  • A decrease or complete loss of muscle function

Treatment of Strains

Most muscle strains can be successfully treated by using the RICE Protocol at home.  The most frequently used, and most effective treatment for minor muscle strains is the RICE Protocol. At home you may use the following treatments:

Rest: avoid using your muscle for a few days, especially if movement causes an increase in pain

Ice: will help minimize pain and swelling. Apply a pack for about 20 minutes

Compression: Will help minimize swelling and provide stability to the affected muscle

Elevation: Keep the injured muscle above the level of your heart when possible

Laser or Massage Therapy

laser therapy at JOI Rehab for muscles strains

Laser Therapy for Tennis Elbow

NSAIDs: May help reduce pain and swelling

Heat: May be used after 2-3 days post injury to facilitate circulation to the area and promote healing.

Physical Therapy: Your MD may prescribe formal physical therapy to help your strain heal. 

What Are the Muscles Which Are Strained the Most Often?

The most common form of a muscle strain is a back strain which can occur simply by bending over to lift an object. JOI Rehab

Low back strain

JOI has identified the 3 most common strained muscles.

1)Low Back Strain

The muscles of the low back are often strained while trying to lift objects.  They are also strained when doing yardwork or other activities for too long of a period of time.  To learn more about these strains, please read this article: Dr. Kambach on lower back_strain

Low back muscle strain

Pain in the spine

2) Hamstring Strains

The hamstring muscles are the large muscles in the back of your thigh.  These muscles are often strained while running or sprinting.  In sports the common symptom for a hamstring strain is when the athlete suddenly “pulls up” or has to stop running and they usually grab the back of their leg.  To learn more about this injury, please read this article:  muscle strain

Hamstring Strains are the second most common form of muscle strains. JOI Rehab

Exercise For Legs Hamstrings

3) Neck Strain

The muscles of your neck are often strained while sleeping.  These smaller muscles of the neck when kept in a poor position while sleeping will certainly be sore in the morning.  Often, people state they have a crick in their neck with this injury.  To read more about neck strains, go to: neck sprain.

Neck Musclescan also suffer a strain just like other muscles in the body. JOI Rehab

Neck Muscles are also susceptible to a strain.

4) Quad Strain

The quadriceps muscle or quad, is a group of 4 muscles in the front of the thigh.  The quad muscle is so important to the function of the knee joint especially with injuries.  With an injury to the knee and swelling, often the quad muscle shuts down due to swelling.  The quad muscle is also very important with patello-femoral tracking. This is the tracking of the patella or knee-cap within the knee.  The VMO muscle must be strong enough to keep the knee-cap in the correct position.  A strain to the quad can affect the knee significantly.

Quadriceps Muscle strains are another common strain that occur. JOI Rehab

Man Doing Leg With Machine In Gym – Leg Exercises

When to See a Doctor for a Muscle Strain

For mild to moderate strains, using a home treatment plan should be enough. However, in some cases, a pulled muscle may require extra care. Seek medical attention if you experience one or more of the following complications:

  • Loss of all muscle function
  • Pain does not subside after 48 hours
  • Numbness in the affected area
  • Significant swelling that does not go down
  • Fever
  • Open wounds

Prevention of Strains

By taking some basic precautions, you may decrease your chance of injury. Some prevention strategies include:

  • Proper warmup before participating in sports
  • Correct technique when lifting heavy loads either in the gym or during daily activity
  • Maintain a healthy body weight
  • Stretching before and after a workout may help prevent stiffness
  • Increase intensity slowly so as not to overexert your muscles

Recovery for a Muscle Strain

The amount of time it takes to recover from a muscle strain will depend on the severity of the injury. Mild strains will heal quicker than severe strains. Mild strains may take anywhere from one to four weeks with home care, whereas a severe strain involving a tear may take months to fully heal and may sometimes require physical therapy.

JOI MD Locations Include:

  • Baptist South, Baptist Beaches, Baptist Clay, Nassau, and San Marco

JOI also offers physical therapy in numerous areas in northeast Florida, if your referring MD feels physical therapy would assist you in relieving these symptoms.  We have a team of physicians and therapists who work together for your best outcome.  If you are experiencing any of the symptoms above, you should probably see a physician.  There are so many treatment options available for you to get back to the activities that you love. 

By: Michelle Duclos, MA, ATC, LAT, CES

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JOI Physical Therapy Locations Include:

Arlington, Beaches, Fleming Island, Mandarin, Nassau, Nocatee, North, Point Meadows, San Marco, South, Westside, and World Golf Village.  For appointments, please call 904-858-7045.

Finally, if you feel you need to see one of our Orthopedic Specialists, call 904-JOI-2000 or schedule online by clicking the link below.

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