A muscle strain is a very common injury to muscle tissue that is often caused by overuse/fatigue or excessive tension put on the muscle.
What is actually happening in a muscle strain?
When you strain a muscle, you are essentially overloading the muscle cells capability to provide the force necessary to perform a certain movement. When this happens, the tiny muscle cells tear apart. There is also connective tissue in between the muscle cells that often gets torn as well.
Muscle Strain: Grades
If you keep up with sports or have had a strain yourself you may be familiar with the grading system used when your doctor diagnoses a muscle strain. The grades are essentially telling you the severity of the injury.
They are as follows:
- Grade 1: A grade one strain is the most mild. Only a small amount of muscle cells have been torn. You will often have:
- mild-moderate pain,
- some swelling,
- very mild or no bruising.
- Grade 2: A moderate amount of muscle cells have been damaged in this case and your symptoms will be more severe.
- You will likely see more bruising,
- more swelling
- and moderate or even more severe pain especially when you are trying to use that muscle.
- Grade 3: this is the worst case scenario. In a grade 3, the muscle has fully torn.
- You will likely hear or feel a pop in the muscle and notice a dent in the area where the muscle was.
- You might also notice a bulge on either side of the dent where the torn muscle coiled up after tearing.
- You will also feel a lot of weakness. For example, if you tore your biceps muscle, bending your elbow will be significantly harder to do as it is the main muscle which performs that movement.
What do I do if I strained a muscle?
If you notice any of the symptoms mentioned above and you know that the pain was from use of that muscle, your next course of action is to:
- Ice and elevate the injured body part.
- Next, avoid use of the injured body part as much as possible for the first 7-10 days. If you have access to crutches that would be great to use in the first week at least if the muscle in question is in your leg.
- Lastly, do not go back to normal quickly. Strains can take weeks to heal depending on the severity!
Should I go to physical therapy?
A visit to your physical therapist after a strain is not a bad idea. However, it may be more beneficial to go straight to your doctor first as they can provide medications for the pain and get you into surgery faster if you’ve had a severe grade 3 tear (more about that below).
A physical therapist can be helpful after you’ve let the muscle rest and swelling has gone down (usually after the first 1-2 weeks), and will be necessary after surgical repair of a grade 3 tear. We can help you progressively improve the strength of that muscle and avoid further injury. Going back to normal quickly after a strain is not a good idea.
When to see a doctor:
I would recommend seeing your primary care, urgent care or orthopedic practitioner if you notice considerable bruising, and especially if you are concerned about a grade 3 tear. Grade 3 tears require surgery ASAP for optimal results, the longer you wait past the first 1-2 days of injury the more likely it cannot be appropriately fixed. This is due to shortening and stiffening of the muscle and connective tissue in the muscle that happens with disuse (and you can’t use a fully torn muscle!).
In conclusion, if you’re a bit concerned don’t hesitate to call your doctor, visit the urgent care or see your physical therapist!
