How is the diagnosis made?
The exact determination of the type of muscle injury should be made by a physician even if there are clear signs. Even if the injured person already has a suspicion, an experienced doctor may see some things a little more precisely. The diagnosis is made after a detailed anamnesis, i.e. after a detailed conversation with the patient and some examinations.
The course of the accident, i.e. also the mechanism of the injury, the type and intensity of the pain, but also the training intensity of the patient and his fitness level are important in the discussion. Special attention is also paid to past injuries to muscles, tendons and bones. In addition to a close examination of the injured body part (also in side comparison to the healthy side!)
and careful palpation, the physical examination also includes a rough examination of the reflexes of the potentially damaged muscle. An objective examination of the muscle’s remaining strength by the doctor and an assessment of the patient’s stance and gait are also included. Under certain circumstances, a specific relieving posture during walking may already indicate the exact location of the injury.
After completion of the physical examination, the attending physician can also use sonography, i.e. ultrasound, to confirm his suspicions. Especially in the case of larger tears in the muscle tissue, these are clearly visible in the ultrasound image. If no clear diagnosis can be made even after all these examinations have been completed, magnetic resonance imaging (MRI) may still be considered, with which muscle and soft tissue injuries can be very well depicted. However, this method is generally reserved for more complex, ambiguous cases and professional athletes and is not normally required.
What is the difference in therapy?
The two elementary differences in the therapy of muscle strain and muscle (fiber) tears result from the characteristics of the different injuries mentioned above. Since the basic structure of the muscle is still intact in the case of a pure muscle strain, a slight stretching of the affected muscle can be perceived as pleasant and pain-relieving. Torn muscles are quite the opposite.
Stretching does not usually relieve the pain, but rather intensifies it even more. The actual injury is also made worse with every strain and under every stretch. Muscle tears – no matter of what extent – should never be stretched further under any circumstances.
The cornerstone of therapy should nevertheless continue to be protection, elevation and cooling. Under this form of therapy, the second important difference in the therapy of strains and muscle (fiber) tears arises. Since the injuries are associated with varying degrees of damage, they simply require different lengths of time to heal completely. While a strain already shows improvement after a few days and no further therapy is needed after about a week, therapy for larger muscle tears can take months.
