What is a muscle strain?
The amount of time it takes to heal from a muscle strain depends on severity. Grade I strains heal within a few weeks. Grade II strains can take up to 3 months or longer. Grade III strains may require surgery and months of rehabilitation.
A strain, or pulled muscle, is an injury to your muscle or tendon. It occurs when these fibers are overstretched or torn. A muscle strain can occur because of an accident, misusing a muscle, or simply because a muscle is overworked.
Signs and symptoms of muscle strain
After straining a muscle, you may experience muscle spasms, weakness, and pain. Sometimes, the area surrounding the muscle will cramp and swell, and you’ll struggle to move a muscle or won’t be able to use it at all. Severe strains, like a partial or complete tear, are very painful.
Types of muscle strain
Doctors assess the severity of a strain based on the strength or range of motion you have after the injury. There are three grades of muscle strain:
- Grade I: A mild strain that damages less than 5% of individual muscle fibers
- Grade II: Significant loss of motion and strength. It involves more muscle fibers, but the muscle hasn’t ruptured. This type of strain takes around two months to heal
- Grade III: The muscle or tendon ruptures, causing swelling and severe pain. This level of injury may require surgery to reattach the damaged muscle or tendon
Causes of muscle strain
Muscles insert into bones and provide the force that helps you move. If you misuse a muscle or overload it, the resulting force is so great that it causes the tissue to tear. Tears happen in three specific places:
- In the myotendinous junction, which connects muscles and tendons
- At the tendon, where it attaches to the bone
- Inside the muscle
Injuries happen when you overload a muscle, which means it’s contracting and elongating at the same time. Certain factors that predispose you to a muscle strain injury include:
- Previous injuries
- Weak muscles
- Older age
Strains and injuries often occur when you’re starting a new exercise program or physical activity.
When to see the doctor for muscle strain
Not all strains require a visit to your doctor. Moderate or severe injuries need prompt attention. Call your doctor if:
- You feel or hear your muscles pop
- You are in pain and your muscle is swollen or discolored
- You can’t move the injured muscle
- You suffered an injury that isn’t improving after 48 hours
- You hurt your back previously and your symptoms are the same or getting worse
- You have severe back pain
Back pain, especially if it gets worse, is a cause for concern. Pay attention and call your doctor if you notice the following symptoms:
- A burning sensation when you urinate
- Sudden tingling or weakness in one leg
- Numbness in your rectum or groin
- Problems controlling your bladder or bowels
Back pain can indicate other health issues, including a urinary tract infection (UTI) or a possible injury to your vertebrae, vertebral disks, or spinal cord.
Diagnosis for muscle strain
Most of the time, a doctor can diagnose a muscle strain with a physical exam. They will ask you to describe your symptoms and past medical history, then check for:
- Muscle tenderness
- Range of motion and signs of decreased movement
If the exam doesn’t provide an accurate diagnosis, your doctor may order additional testing, including X-rays or a magnetic resonance imaging (MRI) scan.
Treatments for muscle strain
The amount of time it takes to heal from a muscle strain depends on your injury’s severity. Grade I strains heal within a few weeks. Grade II tears can take up to 3 months or longer. If you’ve had surgery from a Grade III strain, gaining normal muscle function will require months of rehabilitation.
If you suspect a muscle strain but didn’t hear a “pop” that would require a visit to a healthcare provider, the RICE rule can help. Doctors suggest:
- Rest to avoid further injury
- Ice to reduce swelling
- Compression with an elastic bandage for support
- Elevation to allow fluid to drain away
Over-the-counter painkillers like acetaminophen and ibuprofen can relieve muscle pain and swelling. Your doctor may suggest you see an orthopedic specialist for further treatment if you have a severe strain. Trying to return to normal daily activity too soon may lead to another injury.
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How can you tell a sprain from a strain?
You can tell the difference between a sprain and a strain due to the location of the injury, the anatomical structures involved, and the symptoms.
Ligaments are tissues near joints in the body that connect two or more bones. When one or more of these ligaments is stretched or torn, the resulting injury is called a sprain.
A tendon is a fibrous cord of tissue that connects a bone to a muscle. When the tendon or attached muscle is stretched or torn, the resulting injury is called a strain.
There are several ways you can get a sprain. Getting hit, twisting, or falling can make your joint move to an abnormal position. This can cause the ligaments near the joint to stretch or tear.
Sprains occur in different ways depending on their location in the body. Different locations of sprains include:
- Knee joint — typically caused by activity that causes you to pivot
- Ankle — typically caused by awkward landing from a jump or other mobile activity on an uneven surface
- Thumb — typically caused by overextension while playing sports
- Wrist — typically caused by falling and landing on an outstretched hand
Strains can occur when you pull or twist a tendon or muscle. They can occur suddenly or develop over time. Causes of strains include:
- Lifting heavy objects
- Too much stress on muscles
- Current injury in the area
- Movement of the tendons or muscles in the same way repetitively over time.
What are the symptoms of a sprain or strain?
In a minor sprain, stretching occurs in the ligaments, but the joint is still stable. In a moderate sprain, the ligament may partially tear, and the joint loses stability. If the sprain is severe, the ligament can be completely torn and separated from the joint.
Sprain symptoms include:
- Inability of the affected joint to function
When an injury occurs to the ligament, the joint stability decreases, and you may feel a pop or tear. The ankle is the most commonly sprained joint. Continuous straining can lead to arthritis.
Strains are caused by stretching, pulling, or overuse of muscles or tendons. Common symptoms of a strain include:
- Muscle spasm
- Muscle weakness
With a mild strain, the tendon or muscle is stretched mildly. A moderate strain results in overstretched muscles or a partial tear. If the muscle or tendon is ruptured, some function of the muscle will be lost. This is a severe strain.
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How is a sprain vs. a strain diagnosed?
To determine if you have a sprain or a strain, you will have to see a doctor. Your doctor will examine you and look for pain and swelling in the affected area. The extent of pain with both a sprain and strain can be about the same.
Imaging such as an x-ray or MRI may be ordered. They can rule out fractures and bone injury and determine the extent of your injury.
Severe sprains and strains could result in a bone fracture. Fractures are breaks or chips in the bone, many times resulting from sports injuries, accidents, or weak bones.
How are sprains and strains treated?
Treatment for sprains and strains is about the same. To minimize symptoms like pain and swelling from your injury, you should initiate RICE treatment.
- Rest your injury. This may include the use of a cane or crutches.
- Ice your injury. Apply cold compresses for twenty minutes several times a day.
- Compress your injury. Splints, bandages, and other devices will hold the injury still and reduce pain and swelling.
- Elevate your injury. Prop the injured area up on a pillow to reduce swelling.
Your doctor may recommend that you use over-the-counter medicines such as Motrin.
An extreme sprain or strain may need to be immobilized. In extreme cases, you may need surgery. Both may need to be followed by physical therapy.
How can sprains and strains be prevented?
Whether you are sedentary or an athlete, you or anyone else can get a sprain or a strain. There are things you can do to limit your risk of getting an injury, though.
- Stretch your body by exercising every day.
- Wear supportive shoes that fit properly.
- Support strong, healthy muscles by eating a nutritious diet.
- If you play sports or participate in organized physical activities, warm up beforehand.
- Always wear protective equipment that is made for your physical activity.
- Post-injury, participate in conditioning activities to build muscle strength.
Medically Reviewed on 4/11/2022
American Academy of Orthopaedic Surgeons: “Sprains, Strains and Other Soft Tissue Injuries.”
Harvard Medical School: “Muscle Strain.”
HSS: “Muscle Strain: “Causes, Symptoms, Treatment.”
Mount Sinai: “Strains.”
National Institute of Arthritis and Musculoskeletal and Skin Diseases: “Sprain vs. Strain.”
The Journal of the American Academy of Orthopaedic Surgeons: “Muscle strain injury: diagnosis and treatment.”
Mayo Clinic: “Sprain.”
National Institute of Arthritis and Musculoskeletal and Skin Diseases: “Sprains and Strains.”
University of Rochester Medical Center: “Sprains, Strains, Breaks: What’s the Difference?”