Muscle Strain

The signs and symptoms of muscle strain are varied and include:

• Inflammation and bruising at the site of injury
• Pain when the area is at rest and in motion
• Weakening of the muscles of the affected area and the neighboring tendons
• Failure to use the muscles
• Individuals may also hear the sound of “pop” in the joint at the time of injury
• Numbness in the affected area

A proper physical examination followed by X-ray is done to diagnose the condition. In physical examination the joints of the affected area are examined to understand the mobility and also identify the exact site of the tendon and ligament that is injured.

Post this; an X-ray may be done to confirm the finding. These are also done to rule out the possibility of fracture or injury to any bone. When physical examination and X-rays do not draw any appropriate finding, then magnetic resonance imaging (MRI) scan may also have to be carried out to for differential diagnosis. Magnetic resonance imaging may also be needed to identify the specific muscles that was injured during the strain [5].

Treatment regime largely depends on the extent of severity of the injury. In some cases, medications may do the needful, whereas in some cases, a blend of medications, therapy and surgery may be required to correct the strain. 

1. Medications: Mild anti–inflammatory medications may be prescribed for decreasing the inflammation and treating the pain in the affected area. These mediations also have pain relieving properties and include either ibuprofen or acetaminophen. Anti-fibrotic medications like suramin has been very promising in preventing scars after muscular strains [6].
2. Therapies: Certain therapies need to be carried out as soon as possible after the strain has occurred. These would help relieve the pain and arrest any further damage to the affected area. Application of ice to the area of strain helps in a great deal to reduce both pain and inflammation [7]. The affected area is put to rest and it should remain in that state until the diagnosis is made. Depending on severity of the injury immobilisation of the area with the help of splint or brace may be necessary. Warm compress using methyl salicylate patches on the affected muscles reduces pain and discomfort of the muscle strain [8].
3. Surgery: This is often the last resort and is considered when the strain cannot be healed through medications and therapies. Surgery is considered, when the muscles have ruptured or there is a torn ligament [9].

Muscle strains can be characterized under 3 different categories: grade I, grade II and grade III. In the initial stages – grade I, the individual may experience a sense of extreme pain in the affected area accompanied by inflammation. For grade I injuries, the patient is expected to recover within few weeks.

Whereas, grade II muscle strains may take longer duration to heal and the recovery period may be as long as 2 - 3 months. After proper treatment regime and physiotherapy the patient can regain his normal activities. Muscle strains pose no mortality but may cause significant morbidity if physical therapy of the affected muscle is delayed [3].

Patients suffering grade III type of muscle strain often have to undergo surgical procedures to regain normal mobility and activity. Post-operative care is of utmost importance in such cases and after rigorous treatment regime for several months the patient can gradually come back to normal life.

Complications

Complications can set in if timely treatment is not initiated. In addition, failure to appropriately diagnose the type of strain and its associated treatment regime can also call for complications to develop. The following is a list explaining the complications of muscle strains:

• Muscle pain that turns chronic in nature
• Muscular rupture
• The muscles of the affected area tighten
• Decreased mobility
• Muscle rupture
• Fluid accumulation in between affected muscles [4]

Causes of muscle strain are many and can be summarized as follows:

• A sudden jerk in an awkward position
• Lifting heavy objects in an incorrect posture
• Not warming up and stretching out properly before carrying out daily tasks [1]
• Fatigue
• Undue pressure on a particular muscle area which causes the muscle tendons to undergo wear and tear
• Playing sports such as tennis, golf and rowing
• Activities such as jumping, running and throwing
• Long hours of sitting posture which exerts strain on back muscle 

Muscle strain is a common phenomenon affecting many sportsperson and the common population. Statistics indicate that about 30% of all injuries are related to muscular injuries and strains.

Overuse or excessive pressure on a particular area can be a significant factor contributing to muscle strains. A strain usually occurs when the muscle tendons which are essentially fibrous tissues that connect the muscles to the bones experience wear and tear.

Tears to the muscles are usually found in the distal end because sarcomeres are less elastic in the ends than those in the central part [2]. The muscles of the lower back and the hamstring muscles of the thigh region are important areas for muscular strain.

An active lifestyle is the key to stay healthy and prevent unwanted muscle strains. Indulging in regular exercises such as stretching and muscle strengthening shall go a long way in preventing muscle strains [10]. In addition, selection of right footwear that would provide support and conditioning to the body muscles is a must.

Muscle strain is a common complaint experienced by millions of individuals across the globe. It is also referred to as “pulled muscle” which occurs due to damage to the muscle and its neighboring tendons.

The excessive pressure exerted while carrying out daily routine tasks results in muscle strain which can also cause local bleeding and inflammation of the affected area. Muscle strain occurs as a result of tearing of the fibers of the muscle along with its tendons.

This condition results in pain, irritation and bruising of the affected area. Muscle strains should not be ignored and be attended to as soon as possible to prevent further damage to the affected muscle area.

Definition

A muscle strain occurs when undue pressure is exerted on a specific area resulting into a damaged muscle.

Cause

This causes the affected area to swell and cause pain. There are various causes that give rise to muscle strain. These consist of sudden jerk, incorrect posture while lifting heavy object, long hours of sitting in a particular fashion and fatigue. All these activities or situations can cause muscle strain.

Symptoms

Symptoms of muscle strain include pain in the affected area when at rest and even at motion. The area is painful and gets inflamed. The individual is unable to use that part at all and there is generalized weakening of the muscles of that area.

Diagnosis

A muscle strain is usually diagnosed by a thorough physical examination accompanied by X-rays to rule out the possibility of any fracture of neighboring bone.

Treatment

Treatment regime generally includes rest along with therapies and medications. In case of severe or grade III type of muscle strains the doctors usually advice surgical procedures. 

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2. LeCroy CM, Reedy MK, Seaber AV. Limited sarcomere extensibility and strain injury in rabbit skeletal muscle. Trans Orthop Res Soc. 1989; 14:316.
3. Silder A, Thelen DG, Heiderscheit BC. Effects of prior hamstring strain injury on strength, flexibility, and running mechanics. Clin Biomech (Bristol, Avon). Aug 2010; 25(7):681-6.
4. Yilmaz C, Orgenc Y, Ergenc R, Erkan N. Rupture of the medial gastrocnemius muscle during namaz praying: an unusual cause of tennis leg. Comput Med Imaging Graph. Dec 2008; 32(8):728-31.
5. Koulouris G, Ting AY, Jhamb A, Connell D, Kavanagh EC. Magnetic resonance imaging findings of injuries to the calf muscle complex. Skeletal Radiol. Oct 2007; 36(10):921-7.
6. Chan YS, Li Y, Foster W, Fu FH, Huard J. The use of suramin, an antifibrotic agent, to improve muscle recovery after strain injury. Am J Sports Med. 2005; 33(1):43-51
7. Carvalho N, Puntel G, Correa P, Gubert P, Amaral G, Morais J, Royes L, da Rocha J, Soares F. Protective effects of therapeutic cold and heat against the oxidative damage induced by a muscle strain injury in rats.J Sports Sci. 2010; 28(9):923-35 
8. Higashi Y, Kiuchi T, Furuta K. Efficacy and safety profile of a topical methyl salicylate and menthol patch in adult patients with mild to moderate muscle strain: a randomized, double-blind, parallel-group, placebo-controlled, multicenter study. Clin Ther. 2010; 32(1):34-43 
9. Sallay PI, Ballard G, Hamersly S, et al. Subjective and functional outcomes following surgical repair of complete ruptures of the proximal hamstring complex. Orthopedics. Nov 2008;31(11):
10. Alonso JM, Edouard P, Fischetto G, Adams B, Depiesse F, Mountjoy M. Determination of future prevention strategies in elite track and field: analysis of Daegu 2011 IAAF Championships injuries and illnesses surveillance. Br J Sports Med. Jun 2012;46(7):505-14

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