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Muscle injury, when to seek help!
What is a muscle strain:
A muscle strain (often called a ‘pulled muscle’) is the stretching or tearing of muscle fibres. It can be mild or severe and generally occurs if a muscle has been stretched beyond its limits or it has been forced to contract too strongly. Severe injuries may involve partial or complete tears. Acute strains may be caused by a single event such as using poor body mechanics to lift something heavy. Repetitive muscle strains can result from repeatedly injuring a muscle whilst doing the same motion over and over.
Grade I (Mild) Grade II (Moderate) Grade III (Severe)
Symptoms can include:
Muscle pain and tenderness to touch, especially after an activity that stretches or violently contracts the muscle. Pain usually increases with movement and is relieved by rest
A ‘pop’ in the muscle at the time of injury
Muscle swelling, discoloration and or bruising
Muscle spasm or cramp
Restricted movement of the affected joint
Decrease or loss of muscle strength (weakness) or function (loss of movement)
A gap, dent or change in the structure of the normal outline of the muscle
Diagnosis:
Some of the key questions your practitioner will want to know:
Details around how the injury occurred
The symptoms that you are experiencing
Are there any restrictions to movement?
Are you able to weight bear?
Is there muscle weakness?
Examining for the extent of injury, your osteopath will:
Observe and palpate the tissues to determine the changes that have occurred due to injury
Assess the range of movement in the joint(s) to acknowledge any changes due to pain and/or injury
Assess the surrounding tissues for evidence of changes
Perform tests to determine the extent of loss of movement
Perform special and significant tests to assist diagnosis and grade the level of injury
Once the diagnosis is confirmed, a tailored treatment plan can be designed to promote your recovery
When to call a professional:
If you hear or feel a ‘pop’ in your muscle at the time of injury
You have mild muscle symptoms that do not improve after 48 hours
You have mild back pain that worsens after a few days
You have numbness in any part of the injured area
You have severe pain, swelling or discoloration in the injured muscle
You have severe back pain that makes normal daily tasks impossible
There is evidence of weakness or difficulty in moving the muscle in comparison to prior to the injury or the opposite limb
Your symptoms do not start to improve within two weeks
Attend A&E (Accident and Emergency) immediately if you have associated symptoms, e.g:
o Fever or chills
o Pain or a burning sensation when you urinate
o Sudden weakness, numbness or tingling in a leg
o Numbness in your groin or rectum
o Difficulty controlling your bladder or bowel function
What can your osteopath do to help:
Assess, and diagnose the extent of the injury e.g. severity of the injury, presence of inflammation and/or swelling, the extent of loss of movement and/or muscle weakness
Check for related injuries e.g. damage to local nerves or joints as a result of the muscle strain
Determine if there are other factors involved in the injury e.g. severe strains or tears may need referral for orthopaedic specialist investigations
Determine the best course of action for short-, mid- and long-term optimal recovery
Provide bespoke advice for the injury that you have sustained
Suggest supports, strapping or other aids if necessary
Provide a prognosis specific to your injury
Refer for scanning if necessary, such as x-ray, ultrasound or MRI (Magnetic resonance imaging)
Treatment options:
What you can do immediately at home, for mild strains:
Avoid harm. In the first 72 hours, avoid doing anything that will make your injury worse, such as using heat, having a bath, exercising or drinking alcohol
POLICE (https://www.bupa.co.uk/health-information/muscles-bones-joints/muscle-strain)
Mild strains may heal quickly on their own
(Excerpt from: https://www.bupa.co.uk/health-information/muscles-bones-joints/muscle-strain)
P – Protect your injury from further harm by resting it immediately and using a brace if necessary
OL – Optimal loading. Start moving your muscle again sooner rather than later, if possible. Only do what is comfortable and pain free
I – Ice. Use a covered ice pack or ice (frozen peas is a good option) wrapped in a tea towel over your injury for 20 minutes maximum and repeat this process every 2 hours
C – Compress. Wrap a bandage on your injury, but not too tightly. Remove this before going to bed
E – Elevate the limb. Raise your injured muscle above the level of your heart (if possible) – if you strained a calf muscle, for example, elevate it on a stool whilst lying down
If you need further assistance or if the symptoms persist beyond 48 hours
Call your osteopath or other professional for advice, treatment, prognosis and plan
More severe strains may require a rehabilitation programme
With severe muscle strains, you may need referral to an orthopaedic specialist for specialist care, such as casts or supports to avoid movement until the muscle repairs, or it may need surgery in very severe cases
You may also require pain relief medications or anti-inflammatories (this must be guided b your GP)
Expected duration of recovery:
This depends on the location and severity of the injury.
It is important that you see a musculoskeletal trained medical professional to diagnose and advise your best course of action
For mild back strains, there could be improvement in 1-2 weeks and full recovery within 4- 10 weeks
Severe strains may persist until the torn muscle is surgically repaired
Prevention:
To prevent muscle strains:
Warm up before taking part in activities and sports and cool down afterwards
Stretch and strengthen your muscles with an exercise programme
Increase the intensity of your training programme gradually. Never push too hard, too soon!
Ensure you have days off from doing intense exercise
Maintain a healthy body weight as this prevents increased pressures and stresses on the muscles
Practice good posture when you sit, stand, work and exercise
Practice sound manual handling techniques when lifting items
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