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Muscle Strains, what are they? How or why did it happened.

Muscle injuries such as strain’s or tears are the most common injury in sports, varying from 10-55% of all injuries sustained in sport [1,2]. Strain’s are especially common in sports that require sprinting or jumping. Muscle tears or strains are often located near the end of a muscle where it meets the tendon (myotendinous junction) of the superficial muscles working across two joints; such as the quadriceps, hamstrings and calf muscles (rectus femoris, semitendinosus, & gastrocnemius muscles) [1].


Eccentric contraction or the deceleration part of a movement has the highest amount of force produced on a muscle; thus tears tend to occur in the bigger and stronger muscle groups producing the largest amount of force during deceleration. Therefore its not uncommon to see muscle strains in muscles of the shoulder with throwing movements, trunk or core with jumping or bowling/throwing actions and or strains in the legs/hip with running or jumping [3].


Diagnosis/Prognosis


IF you’ve gone through the unfortunate experience of a muscle tear you’ll know it is associated with a powerful stretch or contraction during activity where the fibres in a muscle are torn. Depending on the severity of the tear and grade differing characteristics of swelling, redness, tenderness on palpation, resting pain, bruising, restrictions in range, or weakness may occur [4].


Muscle strains are classified in 3 grades according to their severity (Grades 1,2,3):


(G1) Mild: a tear of a few muscle fibres; minor swelling and discomfort with no or only minimal loss of strength and restriction of the range of movements; pain/tenderness and or swelling may be delayed.


(G2) Moderate: a greater damage of muscle with the tear effecting approximately half of the fibres in the muscle with a clear loss of strength; often associated with sharp acute pain, swelling, bruising.


(G3) Severe: a tear extending across the whole muscle belly and complete rupture, resulting in a total loss of muscle function. This will cause significant pain, swelling and bruising [4].


Your recovery times will vary depending on the severity of grade and what level of function your rehabilitation and or return to sport will be required.


Treatment


What’s the immediate care for a muscle strain? Ever heard of the acronym’s RICE, PRICE or POLICE [4,5]; What do they mean?

RICE (Rest, Ice, Compression, Elevation) or PRICE (Protection, Rest, Ice, Compression, Elevation) are likely more well known, however what should be applied is POLICE (Protection, Optimal Loading, Ice, Compression, Elevation).

Too much rest may be harmful and inhibits recovery. The secret is to find optimal loading. Optimal loading means replacing rest with a balanced and incremental rehabilitation program where early activity encourages early recovery. Injuries vary so there is no single one size fits all strategy though, this is where professional advice is encouraged to apply the right principles to be safe and effective towards your rehabilitation [5]. Initial muscle strain management (POLICE) and controlling inflammation may also benefit from NSAIDs (non-steroidal anti-inflammatories) such as ibuprofen to assist with recovery.


Basic rehabilitation of a muscle strain should involve the short term management (POLICE); restoring range of motion; proprioceptive and neuromuscular training; to then build towards a progressive strength and conditioning program tailored to the individuals goals ensuring safe return to activity and decreasing the risk of re-injury.


How Our Physio can help?

  • Diagnosis

  • Whole body assessment and biomechanical analysis to identify contributing causes to your muscle strain

  • Education and advice

  • Structured hands on and exercise therapy to facilitate recovery

  • Return to sport and decreased risk of re-injury

Should you have any further questions or regarding muscle tears or would like to discuss your injury with a physiotherapist, please contact Our Physio Central Coast (02) 4339 4475.

References

[1] Garrett WE: Muscle strain injuries. Am J Sports Med 1996, 24:S2–S8.

[2] Järvinen M, Lehto MUK: The effect of early mobilization and immobilization on the healing process following muscle injuries. Sports Med 1993, 15:78–89.

[3] Garrett WE Jr. Muscle strain injuries. Am J Sports Med 1996; 24:S2-8.

[4]Järvinen, T. A., Järvinen, T. L., Kääriäinen, M., Äärimaa, V., Vaittinen, S., Kalimo, H., & Järvinen, M. (2007). Muscle injuries: optimising recovery. Best practice & research Clinical rheumatology, 21(2), 317-331.

[5] Bleakley, C. M., Glasgow, P., & MacAuley, D. C. (2012). PRICE needs updating, should we call the POLICE?. British journal of sports medicine, 46(4), 220-221.



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