Muscle Strain: Causes, Symptoms & Treatment

Muscle strain, along with muscle stiffness, is a typical and common sports injury. Just as, as the muscle fiber tear, the muscle strain belongs to the closed muscle injuries, because only the muscle is affected. Externally, however, nothing can be seen that would indicate a strain.

What is a muscle strain?

Athletes are particularly familiar with it: the muscle strain. In this injury, the skin remains intact, so it is a closed muscle injury (see also sports injuries). Depending on which parts of the body are under strain, the strain can occur in any muscle group. While runners are more prone to a pulled muscle in the calf and thigh muscles, basketball players will have particular difficulty with the upper arm or shoulder muscles. Symptoms mainly amount to cramping pain in the affected body part. Depending on the severity of the injury, there may also be a restriction of movement. Nevertheless, in principle, a muscle strain is not an actual injury to the muscle; instead, there is a hardening of the muscle because the muscle tone is disturbed.

Causes

A muscle strain, unlike other sports injuries, is not caused by external damage, but has its causes in the disturbance of muscle function. Excessive strain over a long period of time or, alternatively, a very rapid change in strain can cause a disturbance in muscle tension, which leads to a hardening of the muscle in question. The result is cramp-like pain because the muscle can no longer relax as usual. In addition to excessive strain, there are other risk factors that promote the development of a pulled muscle. In particular, people whose muscles are weakened due to lack of exercise are prone to a pulled muscle if the muscles are suddenly subjected to greater strain. There is also a risk if people do not warm up enough before exercising to stretch the muscles and thus increase their resilience. People who have too few fluids and electrolytes in their bodies or who eat an inadequate diet are also often affected. Illnesses, such as colds, weaken the muscles and can therefore pose an additional risk for muscle strain.

Symptoms, complaints and signs

In the case of a pulled muscle, mild discomfort such as a feeling of tightness or a slight pulling in the affected muscle occurs at first. Usually the tissue is hardened, but this does not yet restrict the ability to move. Those affected often try to relieve this tension with massages or moderate exercise. Over the course of the next few days, pulling pain sets in, which slowly becomes stronger and eventually develops into cramp-like discomfort. Subsequently, the affected limb can no longer be moved without pain. Externally, a muscle strain can only be recognized by the described hardening of the muscles. Bleeding or effusion does not normally occur. If the sporting activity is interrupted and the strain is treated quickly, the symptoms will subside within four to six days. After that, moderate exercise can be resumed. However, if the pulled muscle continues to be subjected to heavy strain, the strain will also increase. This can lead to a muscle fiber tear, which is associated with further complications. Incorrect treatment – such as overly intensive massages – can also aggravate the discomfort. Then the pain can spread to the surrounding regions, and in the worst case a chronic pain syndrome develops.

Disease progression

Unlike other sports injuries, a muscle strain usually develops gradually, while a muscle fiber tear occurs suddenly after a wrong movement. The course of a strain is usually similar. The overstretching of the muscle causes a strong contraction, which in turn leads to hardening. Depending on the healing process, the duration of the strain can also vary. The pain usually subsides after a few days, but nevertheless complete healing usually takes up to three weeks. The sooner the muscle strain is diagnosed and treated, the sooner the affected person is free of symptoms again.

Complications

Of course, various complications can occur when a muscle strain is present. In most cases, a muscle strain is caused by overuse or by external force.The ligaments and tendons are stretched very strongly in such a case, so that a strain occurs. If the affected person continues to put a lot of strain on this part of the body, it may even lead to a muscle tear. This complication must definitely be examined by a doctor or treated accordingly. Otherwise, permanent consequential damage can occur, so that a complete recovery is no longer possible. In other cases, inflammation can also form in the muscle or in individual joints, so that an abscess can even occur. An abscess is an excessive accumulation of pus that requires treatment. In fact, if the bacteria and viruses enter the bloodstream, an infection may result. Nausea, vomiting, fever, aching limbs and headache are the result. Without medical treatment and without taking the appropriate medication, a severe infection can develop, so it is imperative to seek medical treatment. This is the only way to avoid the above-mentioned complications. However, those who opt for timely treatment can expect a quick recovery and no serious complications.

When should you go to the doctor?

If unexpected severe pain of the muscles occurs during sudden movements, due to a heavy physical load or due to sports activities, a doctor should be consulted. After a fall or accident, a visit to the doctor should also be made. Serious injuries or damage to the skeletal system must be ruled out in various tests and through the use of imaging techniques. If the affected person is no longer able to put weight on his body as usual, if there is a sudden decrease in physical performance or if severe pain occurs, he needs help. Self-directed use of a pain medication is not recommended. The risk of possible side effects is high, therefore consultation with a medical professional is recommended to avoid complications before administering medication. Impaired locomotion, disturbances in general movement, or a feeling of illness should be presented to a physician. A pulling sensation in the body during movement, a sensory or perceptual disturbance, and irritability should be investigated and treated. If there is hypersensitivity to touch, pain at rest or pressure, a physician’s evaluation is necessary. A muscle strain must also be differentiated by a physician from a pinched nerve or existing damage to the nerve fibers. In these cases, there is a risk of permanent impairment that should be avoided.

Treatment and therapy

The treatment of a muscle strain is mainly done by alleviating the symptoms and correcting the malfunction of the muscle so that it can be relaxed again. In any case, the strain on the muscle should be stopped so that further injury cannot occur. In addition, the respective muscle should be cooled with ice and elevated to keep the pain as low as possible. Depending on the severity of the strain, it is also often useful to apply a pressure bandage and ideally wrap this in combination with an ice pack. However, care should be taken to avoid frostbite. It is also important that the pressure bandage does not cause any additional pain or even circulatory problems because it was wrapped too tightly. Care should also be taken to ensure that mobility is not restricted. A cooling sports gel can also provide relief for a pulled muscle.

Outlook and prognosis

The prognosis for a pulled muscle depends on how the person deals with the muscle strain as well as the treatment. Ideally treated and spared distensions have a nearly 100% chance of complete recovery. This is usually the case within days or weeks and depends very much on the affected muscle as well as the health condition of the affected person himself. Important for a good chance of uncomplicated healing is the immediate interruption of muscle strain when the strain occurs. If a pulled muscle continues to be stressed, it can lead to a muscle fiber tear, which is more painful and takes longer to treat. For the best prognosis, the affected muscle should be cooled and elevated as soon as possible. This prevents body fluids from seeping in, thus weakening swelling. It also greatly facilitates healing of the affected tissue.In most cases, a pulled muscle heals well within four to six days. However, heavy loading of the muscles should be avoided for a few days. Light training, in which the muscle group is fully stressed (i.e. also stretched), is recommended, however, in order to restore the usual mobility. It can happen that once pulled muscles are pulled again and again. Most often, this is due to chronic overuse.

Aftercare

Aftercare for a pulled muscle focuses on reviewing the course of the condition by the appropriate medical specialist. If the muscle strain does not heal or if rapid healing is desired, measures to promote healing are also available. Stimulation current treatments are possible, for example. In this form of therapy, the pulled muscles are activated with electrical shocks, which is intended to promote muscle healing. Another alternative is enzyme preparations, which are intended to help heal the symptoms completely as part of aftercare. Physical applications such as lymphatic drainage or cold treatments help the still weakened muscle to recover. After the muscle strain has largely healed, the doctor should be consulted again. The physician will palpate the muscle and, if necessary, perform image-diagnostic examinations. For more severe muscle strains, physiotherapy or PNF are then indicated. Active stretching is also part of the aftercare. In the case of severe injuries, surgery is necessary. After surgery and immobilization of the affected limb, which takes between three to five weeks depending on the injury, the physician must be consulted for a follow-up examination. After surgery, muscle toning physiotherapy is often necessary to improve the mobility of the muscles. Follow-up care is provided by the general practitioner, a sports medicine physician or an orthopedic surgeon.

What you can do yourself

In any case, a muscle strain requires medical clarification. Acute discomfort is treated according to the PECH principle: Rest, ice, compression, elevation. If a strain is suspected, sporting activity should be stopped immediately. The affected muscle must not be subjected to further stress and requires rapid cooling, for example in the form of a cooling spray or a cold, moist compress. An elastic pressure bandage must then be applied. Ideally, the ice pack should be integrated into the bandage to ensure long-term cooling. Finally, the injured area must be elevated. The injury must then be examined again by a doctor and treated if necessary. After treatment, rest is indicated. The muscle may be loaded again after two weeks at the earliest, provided that the responsible physician gives his okay. If pain, swelling or other symptoms occur, it is best to consult a doctor. A positive course is ensured, among other things, by massages and further cooling measures. In consultation with the doctor, alternative remedies such as calendula ointment or preparations from natural medicine can also be used. A warm bath or moderate physical exercise also strengthen the cardiovascular system and thus accelerate recovery.