Disclaimer: This article is not meant to diagnose or treat your injuries. If you are in pain, please seek medical advice for risk of further damaging yourself.
It’s that time of the year again when the weather starts getting nicer (at least up here in Seattle), flowers and trees have blossomed, and everyone seems to have quadrupled their activity level overnight…Unfortunately, there seems to be an increase in injury rate, as well.
Most of us have had this feeling in the past, so it’s usually really easy to shrug it off and say “ehh, it’ll heal on its own. I’ll just throw some ice on it and stretch it out.”
Whoa, not so fast turbo.
Muscle strains suck. And they are usually painful. You want to be careful shrugging this one off, because if it doesn’t heal properly, you could be dealing with Pandora’s Box later.
So, for you independent people out there, the following is a short, informative guide to help you understand what you’re up against and what to do about it.
For starters, let’s identify what we are talking about here; in general when you really feel like you tweaked something, the most common injury is a muscle strain. This is more commonly called: a pulled muscle, a tweaked muscle, or maybe even a torn muscle (I hear this all the time when people are referring to their rotator cuff- which I will address in a different post and I’ll try not to roll my eyes too hard, either).
When you pull a muscle, a doctor (MD, PT, DC, etc) should be able to provide you with a fairly accurate diagnosis that has at least two to three components: what muscle, how severe, and what stage (the stage of an injury isn’t always super useful, but it can very helpful to other healthcare professionals when we are dealing with something that is more of chronic issue).
Here is an example that I used in my clinic this week: chronic, grade 1 muscle strain of the short head of the biceps femoris.
Let’s break each component down:
Location is probably the easiest to understand, but it can be VERY difficult to accurately determine. For the most accurate diagnosis, it’s best to leave this part up to your healthcare professional. In my personal experience, Sports Chiropractors and Physical Therapists tend to be the best at this. But, as I say in the clinic almost every day, “if it looks like a duck and quacks like a duck, it’s probably a duck.” In general, it can be pretty easy to locate the source of pain and weakness on your own terms. Combine that information with the mechanism of injury, and you should have a pretty good idea of which muscle(s) are damaged.
Severity is pretty easy to understand and determine, but seems to have nondescript boundaries between the different grades. Grading a muscle strain can usually be done with observation of the area, manual muscle testing, palpation, and orthopedic testing (to rule out other stuff). There are 3 different grades of a muscle strain:
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Grade 1: This used to be called mild. It is usually described as minimal damage to the muscle itself. It usually only involves pain and some inflammation. Most of the time it takes about 2-3 weeks to heal.
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Grade 2: This used to be called moderate. It is a partial tear of the musculotendinous junction. It generally involves pain, weakness and usually some bruising. It will usually take about 2-3 months to heal.
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Grade 3: This used to be called severe. It is a full length tear of the musculotendinous junction. This involves weakness and loss of function, but isn’t always painful. There is generally a significant amount of bruising and swelling with this. Surgery is generally needed for this to heal properly, so timing is a bit more difficult to predict. Also, this severe of a muscle strain will usually require an MRI.
Deciding the stage of an injury is important for two major reasons; to determine when you can expect to heal, and to understand to complexity of the injury. This is pretty easy for acute muscle strains, but get’s trickier with something more chronic.
I highlight the depth of this subject for one reason: to show you how much more information needs to be considered with a ‘pulled muscle’.
Here’s the bottom line: if you think you might have injured a muscle and your workouts or daily actives have been limited because of it, I suggest having it evaluated properly by someone is trained to handle the diagnosis AND TREATMENT for that injury.
The best advice I can give for a possible muscle strain is: stay active (REST IS NOT THE ANSWER), avoid painful motions/activities, ice as needed (for pain only- this doesn’t actually help an injury heal), and try to keep the inured area moving within it’s pain-free range of motion.
