Muscle Strains

A strain is the tearing of muscle fibers. Muscle fibers are the individual units that make up your muscles. Muscle strains can be caused by strong or repeated contractions. Muscle strains are categorized as: mild (grade I), moderate (grade II) and severe (grade III).

Grade 1 Muscle Strain
Grade 2 Muscle Strain
Grade 3 Muscle Strain
  1. A grade I strain is a mild disruption of the muscle fibers. There may be mild swelling and tenderness. It may also be painful to stretch and use the injured muscle.
  2. A grade II strain indicates moderate muscle fiber damage. The pain is moderate to severe, it definitely hurts to use and stretch the injured muscle, and ecchymosis may be present. Ecchymosis (commonly called bruising) indicates that there was internal damage to blood vessels that resulted in bleeding within and around the muscle. This bleeding is often visible under the skin as purple, blue, red, yellow, and even green in color.
  3. A grade III strain is the most severe. It is the complete tearing of a muscle into two pieces, or separation of the muscle from its associated tendon. There is severe pain, complete loss of muscle strength, swelling is normally present with ecchymosis, and there may be a palpable "indentation" where the muscle is torn. Medical intervention is usually necessary. Typically, an orthopaedist (musculoskeletal specialist) will evaluate your condition and surgical repair may be necessary.

Treatment for Strains

Directly after a strain, control the swelling with RICE for 24 to 48 hours:

  • Rest the injured joint/extremity and use a sling for an arm or shoulder injury or crutches for a leg or foot injury.
  • Ice for 20 minutes every hour.
  • Compress with an elastic Ace bandage or brace for an ankle or knee, a splint for an injured finger or buddy-taping for an injured toe.
  • Elevate above the heart, if possible.

An over-the-counter acetaminophen, such as Tylenol® or non-steroidal anti-inflammatory drug (NSAID), such as Advil® may help with reducing the swelling and pain/ pressure relief. After this home treatment, be sure to have the injury evaluated by your doctor to rule out a fracture or a severe strain.

Most mild strains heal with a few days to a week. Seeing a physical therapist can also help you regain range of motion. Your physical therapist can also show you injury prevention techniques to help prevent future strains.

If your symptoms don't improve within a couple of days, or you experience any of the following, see your doctor to have it immediately evaluated:

  • An audible "popping" sound with the injury
  • Pain and swelling that gets worse over time
  • Fever or chills
  • Difficulty standing or walking without pain
  • Limited flexibility and range of movement around the injured joint
  • Numbness or tingling
  • Joint/extremity deformity or signs of instability

Moderate strains may require bracing for a period of time, followed by physical therapy to help regain normal function and range of motion. Severe strains may require surgery to repair the tear, followed by physical therapy to rehabilitate the injury.

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