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Muscle Strain


Presentation

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
Localized Edema
  • This study investigated if using a shock-control hammer reduces forearm muscle strain by observing adverse physiological responses (i.e. inflammation and localized edema) after use.[ncbi.nlm.nih.gov]
Localized Edema
  • This study investigated if using a shock-control hammer reduces forearm muscle strain by observing adverse physiological responses (i.e. inflammation and localized edema) after use.[ncbi.nlm.nih.gov]
Asymptomatic
  • We compared the MRI characteristics of symptomatic cases before and after healing and with asymptomatic controls.[ncbi.nlm.nih.gov]
Prolonged Immobilization
  • Another important aim of early mobilization, especially in clinical sports medicine, is to minimize inactivity-induced atrophy as well as loss of strength and extensibility, which are rapidly appearing adverse sequelae of prolonged immobilization.[ncbi.nlm.nih.gov]
Painter
  • However, further research in larger groups of house painters is needed to be able to recommend this technique for a wider use.[ncbi.nlm.nih.gov]
Low Back Pain
  • Most episodes of low back pain are caused by damage to the soft tissues supporting the lower spine, including muscles, tendons, and ligaments.[spine-health.com]
  • (If you have low back pain, stop reading this article right now and head on over to Save Yourself from Low Back Pain![painscience.com]
  • Heat and ice treatment are indicated on an "as needed" basis at home to treat sudden flare-ups of low back pain, along with anti-inflammatory medications.[aans.org]
  • Antidepressant medicines are sometimes offered for low back pain, in the belief that they can work as painkillers for this condition. The latest expert guidelines do not recommend using these medicines for low back pain.[bupa.co.uk]
Neck Pain
  • INTRODUCTION: Flight-induced neck pain is common in high performance jet pilots, with incidents frequently attributed to high G z flight maneuvers.[ncbi.nlm.nih.gov]
  • Thus, some, but not all, acute inflight neck pain and related problems might be avoided by using lighter flight helmets.[ncbi.nlm.nih.gov]
  • Back and neck pain are among the most common conditions people suffer from. For some, back and neck pain is an annoyance or inconvenience; for others, it can be debilitating.[northwell.edu]
  • Closeup portrait, really stressed, unhappy young handsome man with really bad neck pain, after long hours of work, studying, isolated white background.[shutterstock.com]
  • Although soft tissues such as muscles, tendons, and ligaments do not show up on X-ray, doctors often order X-rays when you have back or neck pain to rule out the possibility that a spinal fracture, tumor, or degenerative joint disease could be causing[depuysynthes.com]
Thigh Pain
  • Symptoms and Diagnosis Severe thigh pain is one of the most common symptoms of this condition. Other symptoms may include bruising, swelling, weakness, and in severe cases, loss of mobility.[boneandjointreading.com]
  • Posterior thigh pain. In: Brukner P and Khan K, eds. Clinical sports medicine. London: McGrawHill, 1993. Ekstrand J, Gillquist J. The frequency of muscle tightness and injuries in soccer players. Am J Sports Med 1982;10: 75-8. Garrett WE.[physioroom.com]
Muscle Tenderness
  • After noting your symptoms and past medical history, your doctor will examine you, checking for muscle tenderness, spasm, weakness and decreased muscle movement.[drugs.com]
Right Shoulder Pain
  • He complained of right-shoulder pain just after he forcefully hit his right hand against the fence in an attempt to jump and catch a flying ball with a glove on the left hand during a baseball game.[ncbi.nlm.nih.gov]
Headache
  • Strain (Abdominal) Thigh Strain Common Ligament Injuries AC Joint Injury ACL Injury Back Muscle Pain Cramps Dislocated Shoulder High Ankle Sprain Knee Ligament Injuries Lateral Collateral Ligament Medial Collateral Ligament Sprain Muscle Strain Neck Headache[physioworks.com.au]
  • He has worked with patients exhibiting symptoms such as whiplash, headaches, wrist and shoulder sprains, disk bulges, hip and knee pain, numbness, tingling, back pain, and more. Call the office at (615)953-7544 to schedule your appointment today.[artofhealthchiro.com]
  • Next to headaches, back problems are the most common complaint to healthcare professionals. What causes a back strain or sprain? Twisting or pulling a muscle or tendon can result in a strain.[my.clevelandclinic.org]

Workup

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

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].

Prognosis

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:

Etiology

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 

Epidemiology

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.

Sex distribution
Age distribution

Pathophysiology

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.

Prevention

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.

Summary

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.

Patient Information

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

References

Article

  1. Opar DA, Williams MD, Shield AJ. Hamstring strain injuries: factors that lead to injury and re-injury. Sports Med. Mar 1 2012; 42(3):209-26.
  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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Last updated: 2019-07-11 22:16