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Muscle strains

Muscle strains are some of the most common sporting injuries, making up 10-55% of all sporting injuries (Jarvinen et al., 2007). Muscles are most prone to strain when they are used to rapidly accelerate or decelerate, and are most common in the hamstrings, quadriceps, and gastrocnemius.  Physiotherapists are the best professionals to assist you with a muscle strain.

Muscles are made up of millions of individual fibres. When some of the fibres can’t handle the stress placed on them, they can become torn. This is a muscle strain.

Pivotal Motion Physiotherapy can help speed your recovery, regardless of the location or severity of your muscle strain,  07 3352 5116.

 

What are the grades of muscle strain?

There are 3 grades or severities of muscle strains.

Grade I:

  • A small number of muscle fibres are strained
  • Symptoms: pain, but no loss of strength or movement

Grade II:

  • Up to 50% of muscle fibres are strained
  • Symptoms: pain and swelling, reduced strength, movement is limited by pain

Grade III:

  • 50-100% of muscle fibres are strained
  • Symptoms: severe swelling and pain, complete loss of function

 

What is the healing time for a muscle strain?

Muscle strain recovery is divided into 3 phases based on time since injury. Healing times can vary based on your age and nutrition, the type of injured tissue, and the amount of blood supply or infection in the area.

1. Acute inflammatory phase

When: from the time of the injury, up until 72 hours following the injury.

The body’s first reaction to injury is inflammation, which is a protective response. This is designed to contain the injury, limit further harm, destroy damaged tissue, and provide ideal conditions for healing. Inflammation is characterised by:

  • Swelling
  • Bruising
  • Redness
  • Heat
  • Pain, especially with movement
  • Loss of strength and/or movement

Swelling is very common during this phase and is caused by increased blood flow and protein-rich fluid in the injured area. Blood flow brings nutrients, oxygen, and cells to break down dead or damaged tissues. Protein-rich fluid brings white blood cells into the area to begin healing.

White blood cells clean the wound by killing bacteria, breaking down dead or damaged tissue, and engulfing harmful agents. They also promote the creation of collagen fibres. Collagen is a protein that forms the structure for skin, bone, muscle, and blood vessels.

 

2. Repair phase

When: 72 hours to 4-6 weeks following the injury.

Dead or damaged tissue is being broken down, and new blood vessels are forming in the injured area. Collagen producing cells are also migrating to the area to form a scar matrix which helps close the wound and protect the new blood vessels. Collagen fibres are laid down very quickly and randomly, making the injured area weak and prone to re-injury.

During this phase pain tends to decrease substantially, so many people believe the injury is healed. It is not! The injury is at it’s most vulnerable here, so heavy loads through the injured area should still be avoided.

 

3. Remodelling phase

When: 6 weeks to 12 months following the injury.

Scar tissue is being strengthened and reorganised. Stronger collagen fibres replace the random arrangement of original collagen fibres, strengthening the injured area. To promote a more organised and strong pattern of fibres we start to put more load through the injured area

Physiotherapists will tailor this loading to the activities and positions you require for sport, work, or everyday life. But, it can take 12 month to achieve full tissue strength and maturity.

 

How do physiotherapist treat muscle strains?

Physiotherapy treatment depends on the phase of healing. Physio treatment for muscle strains can vary from load management advice, taping, dry needling and to hands on soft tissue treatment.

 

Acute inflammatory phase

Physiotherapy treatment involves letting the inflammatory process proceed. Treatment consists of education on the principles RICER and HARM, pain management, and maintaining strength and movement in areas surrounding the injury. Physiotherapists will wait 72 hours prior to beginning intensive treatment of the injured area however in the first 24 hours can give appropriate advice about the acute management of the injury such as crutches, bracing or pain relief strategies.

 

Repair phase

Physiotherapy treatment involves continuing to protect the area from re-injury and putting more load through the injured area. Physiotherapists will prescribe exercises and use hands on techniques to maintain muscle strength and joint range of motion.

 

Remodelling phase

Physiotherapy treatment involves retraining your proprioception, addressing strength or joint range of motion deficits, and prescribing exercises specific to your sport or activities.

 

When can I go back to sport or work?

The severity of muscle strain, muscle group involved, and demands of the sport will determine the return to activity timeline. Re-injury can happen when people return to activity before healing is complete, or before full strength and joint range is achieved.

Physiotherapists give recovery time frame based on the extent of the injury and optimal healing time frames.  This is your return to activity time.

 

How can physiotherapy help avoid muscle strains?

  • Prescribing a proper warm-up and cool-down
  • Ensuring full joint range of motion
  • Easing muscle tightness and fatigue
  • Addressing muscle strength imbalances
  • Ensuring previous injuries are healed
  • Correcting faulty biomechanics

 

If you think you have a muscle strain, no matter what grade, please do not hesitate to call 07 3352 5116 to book a consultation, and we will help get you back on track.

 

 

References

Brukner B, Khan K (2007) Clinical Sports Medicine: Third Edition, McGraw Hill, Australia Pty, Ltd.

Damjanov, I. (2006). Pathology for the health professions: Elsevier Saunders.

Hertling, D., & Kessler, R.M. (2006). Management of common musculoskeletal disorders: physical therapy principles and methods: Lippincott Williams & Wilkins.

Jarvinen, T.A., Jarvinen, T.L., Kaariainen, M., Aarimaa, V., Vaittinen, S., Kalimo, H., & Jarvinen, M. (2007). Muscle injuries: optimising recovery. Best Practice & Research: Clinical Rheumatology, 21(2): 317-331.

Orchard, I.W., Best, T.M., Mueller-Wohlfahrt, H,W., Hunter, G., Hamilton, B.H., Webborn, N., Jaques, R., Kenneally, D., Budgett, R., Phillips, N., Becker, C., & Glasgow, P. (2008). The early management of muscle strains in the elite athlete: best practice in a world with limited evidence basis. British Journal of Sports Medicine, 42(3): 158-159.

Tiidus, P.M. (2008). Skeletal muscle damage and repair: Human Kinetics Publishers.