What Is Muscle Strain?
A muscle strain is an injury that happens when you overstretch or tear a muscle or a tendon, the strong, flexible tissue that attaches your muscles to your bones.
You can get these injuries to any muscle in your body if you push it beyond its normal limit, whether you're doing regular daily activities like lifting something heavy, working out, or playing sports. Back, calf, and hamstring strains are among the most common types of muscle strains.
Muscle strain vs. pulled muscle
A muscle strain is the same as a pulled muscle or a muscle tear. Since it’s an identical injury, there are no differences in symptoms or treatments. All three terms are used interchangeably.
Muscle Strain Symptoms
When you tear or strain a muscle, it can damage small blood vessels, causing local bleeding or bruising. It also can cause pain due to irritation of nerve endings in the muscles.
Symptoms of a muscle strain include:
- Swelling, bruising, or redness
- Pain while your muscle is at rest
- Pain when you're using the muscle or related joint
- Weakness of the muscle or tendons
- Inability to use the muscle in any way
- Muscle spasms
Grades and Severity of Muscle Strains
While all muscle strains hurt, some are more serious than others. Here's a quick look at the grades of muscle strains:
Grade 1 muscle strain: This is a mild strain with minimal impact on your muscle's strength or motion.
Grade 2 muscle strain: While this is more serious than a grade 1 muscle strain, your muscle hasn't completely torn. Still, you'll have less strength and motion in that muscle, and maybe some swelling and bruising. It may take 2-3 months to recover.
Grade 3 muscle strain: This is a serious injury where your muscle tears into two pieces or shears away from the tendon. You won't be able to use the muscle and will have significant pain, swelling, and bruising. This type of injury might need to be repaired with surgery.
Causes of Muscle Strains
Healthy muscle fibers work like elastic bands that stretch and contract every time you move. When you overuse your muscles by doing the same motions over and over, those bands can stretch beyond their limits and tear. The same thing can happen from quick and unexpected movements, like if you slip or when you lift something heavy.
These types of tears are more likely to happen when:
- You don't warm up before physical activity.
- You're not flexible.
- Your muscle is tired.
Tight muscles aren’t very stretchy, which means they tear more easily under pressure.
When to Seek Medical Care
Call your doctor if you have a major muscle injury or any numbness or tingling (and don't get relief from over-the-counter pain relievers or home remedies within 24 hours).
Seek emergency treatment if:
- You heard a popping sound at the time of the injury.
- You can't walk or lift your arm.
- You have lots of swelling or pain.
- You have a fever.
- You have an open wound.
Exams and Tests
Your doctor will ask you about what caused the injury and your medical history. They'll also give you a physical exam. They'll check whether your muscle is partially or completely torn. A complete tear can involve a much longer healing process and a more complicated recovery.
You may not need X-rays or lab tests unless trauma is involved or there are signs of infection.
For a more serious muscle strain, your doctor may do an ultrasound to check for tears or fluid, or an MRI to check for blood clots or internal bleeding.
Muscle Strain Treatment
Muscle strains are common injuries, and you can treat most at home.
First aid for muscle strains
- Rest. If you think you’ve pulled a muscle, stop moving the affected area or you might make the problem worse. Rest the muscle until the pain improves. When you start to feel better, you can try some light stretches and easy activities. It’s important not to overdo it, but resting for too long can make you feel stiff and weak.
- Ice. Apply ice to the injury as soon as possible to help reduce swelling or local bleeding into the muscle (from torn blood vessels). Start with 10 to 15 minutes each hour for the first day, then every 3 to 4 hours on the following days. Wrap your ice pack in a towel to protect your skin. If you still have pain after the first few days, you can switch to a heat compress to increase blood flow to the area.
- Elevate. Try to keep the pulled muscle elevated -- ideally, above your heart -- when you’re sitting or lying down. This can help with swelling. You can use pillows to prop up the injured area.
- Pain relievers. Take nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen or ibuprofen to reduce pain and improve your mobility. Don't take NSAIDs if you have kidney disease, a history of gastrointestinal bleeding, or are taking a blood thinner like warfarin (Coumadin, Jantoven) without talking to your doctor. In this case, it's safer to take acetaminophen, which lessens pain but doesn't reduce inflammation.
Your doctor might also suggest you do stretching exercises or change the way you sit or move at work.
Assuming that you don't have a serious muscle injury that needs surgery, medical treatment is similar to treatment at home. But a doctor can give you valuable information, such as:
- The extent of damage to your muscle and tendon
- If you need crutches or a brace to help healing
- Whether you need to restrict your activity or take days off work
- Whether rehabilitation exercises or physical therapy might help you recover and prevent reinjury
Your doctor might also refer you for alternative treatments, including chiropractic or osteopathic manipulation, acupuncture, or myofascial release, which is a type of massage that focuses on releasing tightness in your muscles.
Depending on what how seriously you're injured, surgery may help, too.
Some activities you can do daily can help avoid injury and reduce your risk of muscle strain at work or while exercising or playing sports include:
Regular stretching: When you stretch, you loosen up your muscles, which makes them more flexible and less likely to tear. For the best results, you should stretch two to three times each week for at least 5 minutes, and especially before and after you exercise.
Warm-ups: Warming up before you exercise with light aerobics, like walking or jogging or squats, is one of the best ways to avoid muscle strain. When you increase your heart rate, you also increase the blood flow to your muscles, which helps them move better.
Strength training: Weak muscles are more prone to injury, but strengthening them through activities like weight lifting, yoga, or cycling makes them more resilient to stress. It’s best to do strength training at least twice a week for 20 minutes or more. Talk to your doctor before you start a new exercise program.
Good ergonomics at work: Ergonomics is the practice of fitting a job to a person. According to the Occupational Safety and Health Administration (OSHA), good ergonomics helps reduce tired muscles, increases how productive workers can be, and decreases not only the number of work-related musculoskeletal conditions workers develop but also how bad they can be.
Bad ergonomics can lead to muscle strains. Some ergonomic risks include:
- Using a great amount of force
- Keeping the same posture or staying in the same position, which limits blood flow
- Not taking enough breaks and not working on different tasks
Preventing injuries such as musculoskeletal disorders at work is required by federal law (the General Duty Clause of the Occupational Safety and Health Act, section 5). Any employer with an employee who reports a work-related musculoskeletal disorder falls under this rule.
OSHA can cite employers and/or send hazard alert letters for ergonomic risk under this act, which holds employers responsible for meeting certain safety standards. If an employer gets a letter, OSHA may follow up to see what the company has done to solve ergonomic risks.
Although 60% of all work-related musculoskeletal disorders occur in manufacturing and so-called manual-handling jobs, OSHA requirements for workplace safety apply to all jobs.
In most cases, people recover completely from muscle strain with proper treatment. More complicated cases should be handled by a doctor.