Muscle Strains: Healing, Prevention, and the Role of Physiotherapy

Have you ever experienced sudden, sharp pain from a muscle strain during physical activities or daily tasks? Muscle strains can unexpectedly disrupt our lives. In this article, we will explore the causes, classification, and healing process of muscle strains. We will also highlight the essential role of physiotherapy in diagnosing, treating, and managing these injuries.

Causes of Muscle Strain

Imagine your muscles as elastic bands. They can normally stretch and contract without issue. However, when a muscle is subjected to excessive force, similar to stretching an elastic band too far, it can lead to tears in the muscle fibers. These tears, known as muscle strains, commonly occur due to sudden, heavy forces or overexertion, particularly near the area where the muscle connects to the tendon.

Classification of Muscle Strains

Muscle strains are classified into three grades based on their severity:

1.Mild (grade 1): In this grade, only a few muscle fibers are torn, causing minor swelling, discomfort, and minimal loss of strength and movement.

2. Moderate (grade 2): This grade involves a greater extent of muscle damage, resulting in a clear loss of function.

3. Severe (grade 3): A severe strain means the tear extends across the entire muscle, causing a complete loss of muscle function.

Understanding the Healing Process

Unlike bones that regenerate, muscles heal through a repair process. Imagine mending a tear in a fabric with a patch – the patch may not be the same as the original, but it helps repair the tear. Muscle healing occurs in three stages:

1. Inflammatory phase: After a strain, the affected muscle fibers become damaged, leading to swelling and inflammation as the body’s initial response to the injury.

2. Repair phase: The body initiates repair by cleaning up the damaged area, building new muscle fibers, and forming a “patch” tissue to mend the tear. Blood supply to the injured area also improves during this phase.

3. Remodeling phase: In this final phase, the newly formed muscle fibers mature, the “patch” tissue settles in, and the muscle gradually regains its strength and functionality.

Importance of Physiotherapy in Diagnosis, Treatment, and Management

Physiotherapists play a vital role in diagnosing and managing muscle strains. They will take a detailed history and conduct a physical examination, including special muscle strength tests, to assess the extent of the injury and help you develop a rehab plan to get you started. 

Following diagnosis, the initial treatment phase sometimes involves a short period of immobilization. This allows the scar tissue connecting the injured muscle ends to gain strength and withstand the forces put on the regenerating tissue without causing re-rupture. It is important to limit immobilization to less than a week to minimize the adverse effects of inactivity. Rehabbing a muscle strain will generally use the following progression:

Immediate Treatment

During the immediate aftermath of the injury, specific measures can be taken to manage pain, swelling, and inflammation. The POLICE approach (Protect, Optimal Loading, Ice, Compression, Elevation) can be applied:

Protect: Supports like crutches may be used for lower body injuries affecting gait.

Optimal Loading: Gradual loading of the injured muscle within pain limits is recommended to enhance the regeneration phase.

Ice: Applying ice packs for 15-20 minutes every 30-60 minutes in the first several hours can help reduce swelling and inflammation.

Compression: Compression of the injured area using elastic bandages or compression garments can minimize bleeding and swelling.

Elevation: Elevating the injured limb above heart level when possible can also assist in reducing swelling.

Treatment after Week One

As the acute phase subsides, a structured exercise program is introduced to promote optimal healing and restore muscle function. Here are two types of exercises commonly included in the rehabilitation plan:

1. Isometric Training:

Isometric exercises involve contracting the muscle without changing its length. It’s like pushing against a wall without actually moving it. These exercises help activate and strengthen the muscle without putting excessive strain on the healing tissue. For example, gently pushing your hands together or pushing your foot against a wall are isometric exercises that can be performed multiple times throughout the day. It’s important to ensure that these exercises are pain-free before progressing to the next stage.

2. Isotonic Training:

Once you can perform the isometric exercises without pain, isotonic exercises are incorporated into the rehabilitation plan. Isotonic exercises involve dynamic movements that cause the muscle to lengthen and contract. For instance, performing bicep curls with weights or doing squats are examples of isotonic exercises. These exercises help improve muscle strength, range of motion, and functional capacity. Start with pain-free movements and gradually increase the intensity and complexity of the exercises under the guidance of a physiotherapist.

3. Return to Activity:

After progressing through isometric and isotonic exercises, the rehabilitation plan may include sport-specific exercises, including eccentric and plyometric exercises. Eccentric exercises involve lengthening the muscle while under tension, such as slowly lowering a weight during a bicep curl. Plyometric exercises involve rapid muscle contractions and explosive movements, like jumping or bounding exercises. These exercises focus on restoring the muscle’s ability to handle the demands of specific activities or sports. The progression to sport-specific exercises should be gradual and tailored to individual needs, guided by a physiotherapist.

Muscle strains can be painful and disruptive, but with the guidance of a physiotherapist and appropriate treatment, the healing process can be optimized. If you experience a muscle strain, seek the help of a qualified professional for an accurate diagnosis and a tailored management plan. At Connect Physiotherapy & Exercise, our team is dedicated to assisting you in your recovery journey, helping you regain strength and return to your activities with confidence.

*Remember, while knowledge is power, self-diagnosis and treatment can be risky. While this blog provides useful information, it’s essential to see a trained professional for proper diagnosis and management. Every person is unique, and so is their recovery journey. At Connect Physiotherapy & Exercise, we’re all about personalized care. Let us help you navigate your path to recovery.

References

Bleakley CM, Glasgow P, MacAuley DCPRICE needs updating, should we call the POLICE?British Journal of Sports Medicine 2012;46:220-221.

Jarvinen T, Jarvinen M, Kalimo H. 2019. Regeneration of injured skeletal muscle after the injury. Muscle Ligaments and Tendons Journal. 03(04):337. 

Järvinen TAH, Järvinen TLN, Kääriäinen M, Äärimaa V, Vaittinen S, Kalimo H, Järvinen M. 2007. Muscle injuries: optimising recovery. Best Practice & Research Clinical Rheumatology. 21(2):317–331.

Lieber RL. 2010. Skeletal muscle structure, function, and plasticity : the physiological basis of rehabilitation. Baltimore: Lippincott Williams & Wilkins.