What Is a Strain?
Strains are a type of muscle or tendon injury that occurs when the tissue is stretched beyond its normal range. Also called a pulled muscle, a strain is a painful injury that can be caused by an accident, overusing a muscle or using a muscle in the wrong way.
Types of Strains
Strains are categorized according to the location and the severity of the injury. Strains typically affect the calf, hamstring, quadricep, groin or shoulder. They can be acute, suddenly caused by a trauma or overstretching, or chronic, developing over time from overuse.
- Grade one (mild): Muscles are overstretched, resulting in swelling, reduced range of motion and moderate pain.
- Grade two (moderate): Muscles are partially torn, causing moderate pain, swelling and reduced range of motion.
- Grade three (severe): Muscle fibers or tendons are completely ruptured, causing severe pain, swelling and loss of function.
Other types of injuries that cause muscle strain include contusions, spasms and myositis. Contusions are bruises or injuries to the muscle tissue by direct impact. Muscle spasms are involuntary contractions of the muscle tissue causing acute and sudden pain. Myositis is inflammation of the muscle tissue.
Causes of Strains
Sudden movements, overuse, incorrect posture or trauma can cause strains. A strain may result from too much physical activity or effort, failing to warm up properly before a physical activity and poor flexibility. Falls or direct injury may cause trauma to the muscle and result in a severe sprain.
Risk Factors for Strains
Most often, risk factors for strains include previous injuries, fatigue, poor flexibility and overexertion. Weakness or imbalances in muscle groups can also lead to strains, as can a lack of regular physical activity.
Screening for & Preventing Strains
The key to preventing strains is having strong muscles, along with engaging in proper warm-up and stretching before exercise. Additionally, using correct lifting techniques and avoiding activities that could cause further injury can help reduce the risk of strains.
Signs & Symptoms of Strains
Symptoms of a muscle strain include pain and swelling in the affected area, along with a limited range of motion. Most injuries result in pain, difficulty moving the injured muscle, swelling and sometimes discolored and bruised skin. Some may experience sudden contractions or muscle spasms, tenderness and weakness.
Diagnosing Strains
To accurately assess the extent of an injury, your doctor may perform a physical examination, including inspecting the affected area for signs such as swelling or bruising. Your range of motion and any areas with tenderness or pain will also be tested through specific movements. Questions regarding when and how the injury occurred will likely be asked to provide further insight into their medical history. In some cases, imaging tests such as X-rays may need to be carried out in addition to allowing your doctor to rule out other potential causes of symptoms before making a diagnosis.
Treating Strains
Many minor strains can be treated at home with rest and ice to reduce swelling. If you are experiencing a severe strain that does not improve, the Montefiore Einstein team of rehabilitation medicine experts can recommend physical therapy, an individualized home exercise program or short-term bracing as needed.
Living with Strains
Take the following first-aid steps to treat a strain:
- Apply ice right away to reduce swelling. Do not place the ice directly on the skin; instead, wrap the ice in cloth and apply for 10 to 15 minutes every hour for the first day and every three to four hours after that.
- Use ice for the first three days. After three days, either heat or ice may be helpful if you still have pain.
- Rest the pulled muscle for at least a day. If possible, keep the pulled muscle raised above your heart.
- Try not to use a strained muscle while it is still painful. When the pain starts to go away, you can slowly increase activity by gently stretching the injured muscle.