Muscle Strain

By: Ehren Allen, DPT, COMT

What are Strained Muscles?

The quick answer is strained muscles are tears to a muscle or tendon.  Muscle strains are tears to the fibers of muscles and tendons.  A tear can occur at any part of a muscle or tendon. A tendon is a fibrous tissue that connects a muscle to a bone. The most common area to strain is at the junction where the muscle and tendon come together.  The image above shows areas of the body where muscle strains can occur.  The low back are is the most common strained muscles.  Other common strains are your hamstring, quad, bicep, triceps, abdominal, pectoralis, calf and trap muscles.

Muscles strains or muscle tearsStrained Muscles

Muscle Strains are graded depending on their severity.  The Hamstring Diagram below explains the grading of muscle strains. 

Muscle strains are graded depending on severity.  JOI explains strains and helps fix themImage of Hamstring Muscle Strains and Grades

Common muscles that get strained are the:

  • Hamstrings
  • Hip Flexors
  • Hip Adductors
  • Calf muscles (Gastrocnemius and Soleus)

Strained Muscle Rope Analogy

It might be easier to understand the grades of a strained muscle when we use a rope analogy.  Think of your muscle like a the threads of a rope.  

When you have a first degree muscle strain, just some of the fibers of the rope are frayed.  

When you have a second degree muscle strain, a significant amount of the fibers of the rope are frayed and some of the fibers are torn.  

A third degree muscle strain is when their is a major disruption in the fibers of the rope or the rope is completely torn apart.  This is also referred to as a complete tear.  

When the muscle pulls away from its attachment on the bone it is called an avulsion

What Does a Muscle Strain Feel Like? 

The quick answer is a muscle strain can be very painful when it occurs.  Some people report a "pulling" sensation when they strain a muscle.  Others have reported that it felt like they got hit with a sledgehammer.  

Strains are usually painful and can be very sore for several weeks to months depending on severity.  Because tissue is disrupted, there can be bleeding from the muscle when it is strained.  This can lead to bruising at the site of the injury. Bruising can also settle in areas that are lower than the strained area because the fluids may settle with gravity. Bruising may also occur due to hypoxia around the injured area.  Hypoxia is a lack of oxygen to the tissue which can cause temporary damage to surrounding tissue as well. 

With severe strains, there may be a divot in the muscle or tendon. This may also be called a deficit. A deficit is a space where the muscle or tendon has torn.

How Do You Know if You have a Strained Muscle or Tendon?

JOI explains types of strains and injuries and how to know if you have a strainAchilles tendon injuries and strains

A strained muscle or tendon usually causes some pain.  The pain may be mild or it may be severe, depending on the severity of the strain.  If the strain comes from trauma the pain may be instant.  In mild cases, the pain of a strain may occur later or after an activity.  

It is important to recognize the difference between pain and soreness in a muscle.  After a tough workout or long run, it is typical to have soreness. Sometimes, the soreness will occur a couple of days after the activity. This is called Delayed Onset Muscle Soreness or "DOMS".  DOMS can be very uncomfortable but it should resolve in a few days.  

Sharp pain, deep ache, or loss of strength or control of a muscle are not typical symptoms of DOMS.  These symptoms may indicate a strain.  

What is the Difference Between a Strain and a Sprain?

The quick answer is a Sprain is damage to a ligament and a Strain is damage to a muscle or tendon.  Ligaments connect bone to bone and help to hold joints together in the body.  When they are damaged, there can be pain and less stability in a joint. Ligaments do not have a lot of blood supply so they can take a long time to heal.  Sprains usually occur from some sort of quick trauma where the joint is forced into a position outside its normal movement.

Muscle and tendon strains can occur with trauma as well, but they may also occur when the muscle is forcefully or quickly stretched beyond its normal length.  

To learn more about strains vs. sprains, this article may help.

Can You Strain a Muscle in Your Back?

A pulled muscle in the low back or strain can happen but this is rare.  The muscles of the low back are rich in blood supply and are used to working all the time so they can handle a lot of force and activity.  The muscles in the low back can have spasms which can seem like a strain.  The muscle anatomy in the low back is complex but other structures in the low back are more common to become painful or injured. These include:

  • Intervertebral Disc
  • Facet joints
  • Sacroiliac Joints

How Do You Prevent a Muscle Strain?

Stretching can help prevent muscle strain.Image of a couple stretching

With muscle strains, prevention is the best medicine.  Regular stretching can help to lengthen tight muscles and tendons.  Increased flexibility allows the muscles and tendons to adapt better to the new activity.  

Warming up before exercises such as running, dancing, climbing, or any other physical activity can help decrease the risk of a strain.  Warm muscles tend to stretch and move better.  

Remaining hydrated can help to keep the muscles pliable and mobile as well.

How Do You Fix A Strain in a Muscle?

If you have a strained muscle or tendon, the first line of treatment is Ice and rest for a few days.  For mild strains, gentle movement and massage can be helpful to decrease swelling and pain after a few days of rest. Light stretching can help to stimulate the muscle after about a week of gentle treatment, but if it hurts, stop!

Physical therapy can help you recover from a muscle strain.Image of a patient with a physical therapist

For more severe strains, it is best to see a doctor and go to physical therapy. Physical therapists specialize in treating muscle strains.  Treatment may include:

If the Strain is severe, or there is a loss of muscle control, an Orthopedic Surgeon may order an MRI to determine whether a surgical repair is needed.  This is rare though.

If you have a muscle or tendon strain, the Jacksonville Orthopaedic Institute is here to help. Our Orthopedic Doctors and Therapists are experts in treating strains and getting you back to the activity that you love!

JOI offers ASAP Fracture and Injury Service so that you can be seen quickly, without a trip to the Emergency Room.  We also offer Telemedicine visits.  These options are great for those who are concerned about exposure to COVID-19.  

Our Medical and Rehabilitation Offices are sanitized and all patients and staff are screened daily so that we can make sure you have the safest environment possible.

To schedule a virtual or in-office appointment, Call JOI-2000, schedule online or click the link below.

Ehren Allen, DPT is a medical content writer for JOIEhren Allen, DPT, COMT -  Content Writer

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