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 consist 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.
What are the grades of muscle strain?
There are 3 grades or severities of muscle strains.
A small number of muscle fibres are strained
Symptoms: pain, but no loss of strength or movement
Up to 50% of muscle fibres are strained$
Symptoms: pain and swelling, reduced strength, movement is limited by pain
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 how long it has been since your 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. Inflammation helps to contain the injury, limit further harm, destroy damaged tissue, and provide ideal conditions for healing. Common signs of inflammation is include:
Pain, especially with movement
Loss of strength and/or movement
Swelling is very common during this phase. Swelling is caused by blood flow and protein-rich fluid rushing to 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.
Here, the body is breaking down dead or damaged tissue, 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. Your body is laying down collagen fibres very quickly and randomly, making the injured area weak and prone to re-injury.
Typically, pain is less during this phase, so many people believe the injury is healed. It is not! The injury is at it’s most vulnerable here, so you should avoid applying heavy loads through the injured area (e.g. weights, jumping, running) should still be avoided.
3. Remodelling phase
When: 6 weeks to 12 months following the injury.
During this time, your body is working to strengthen and reorganise the scar tissue. 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.
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.
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.
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. If you return to activity before your injury is healed and you have returned to full strength and mobility, you run the risk of becoming re-injured.
Physiotherapists give recovery time frame based on the extent of the injury and optimal healing time frames. This is your return to activity time.
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