Muscle strain

A strain occurs when a muscle has been overstretched. Another word for muscle strain is pulled muscle. It often occurs during sport activities such as soccer, which involves sprints, fast stops, or changes in direction. 

The myofibrils incur tiny injuries through overstretching (distension). Myofibrils are small structures in the muscle fibers that are responsible for the active shortening of the muscle.

If the muscle is overstretched even more than in a muscle strain, one or multiple muscle fibers can tear. This is referred to as a torn muscle fiber. A torn muscle is when an entire muscle tears.

Typical symptoms of a muscle strain are pain that appears suddenly and a hardening of the muscle. It occurs most often during sport activities or other physically strenuous activities. The thigh, back or neck are most often affected.

Other possible symptoms are:

• muscle cramp
• swelling
• bruising
• muscle weakness
• reduction in ability to move

A muscle strain can become very painful quickly. Bruising often occurs. It can take up to 24 hours until the swelling and bruising reach their full extent. 

A muscle strain most often occurs when a stressed muscle is overstretched. It occurs during sport activities such as soccer, basketball, or tennis where sprints, jumps, sudden changes in direction or stops are required. Strains occur most often in the thigh or calf.

Even distance runners can experience muscle strains; typically in the calf. In particular, muscles can be strained when running up or down a hill.

Injuries often occur when muscles are not properly warmed up before they are heavily strained or before sport activities.

Muscle strains occur more often in older people, especially those who are out of shape. Strains in the calf muscle often occur in people over 40 who have not trained sufficiently before participating in strenuous activities.

A prior injury also increases the risk of a muscle strain.

A muscle strain is one of the most common sport injuries experienced by professionals and amateurs. More than 90 percent of sport injuries are either muscle strains or compressions.

Muscle strains usually heal by themselves, but it may take days or weeks before the muscle can work to full capacity.

A special exercise program or physical therapy can shorten the time it takes to heal. 

It is usually possible to return to daily activities 4 to 8 weeks after a muscle strain, at which time athletes can return to their typical training routine.

It is especially important to warm up muscles before playing sports. 

Special training can lower the risk of injury. Fitness training prevents muscles from becoming fatigued too quickly. Weight training and stretching increase the strength and flexibility of the muscles. 

Doctors make the diagnosis based on symptoms and a physical examination. The affected area is palpitated and the muscle strength and range of movement is examined.

Imaging techniques, such as an x-ray or magnetic resonance imaging (MRI) are typically not necessary. 
In the case of serious strains, however, they can be helpful in ruling out other injuries, for instance a broken bone or torn muscle. 

Sometimes an ultrasound is performed to confirm the diagnosis and determine the severity of the injury.

The RICE rule is used to treat a muscle strain within the first 48 hours of injury. RICE stands for rest, ice, compression (compression bandage), and elevation. This means:

• The affected area should be kept still.
• Cooling reduces the pain and prevents further swelling. A cold compress can be used multiple times a day, for example, every 2 hours for 10 to 20 minutes. It is important that the muscles are given the chance to warm up again in between applications. A thin cloth placed between the ice and the skin protects from frostbite.
• An elastic bandage prevents the spreading of the swelling. However, the bandage must not be too tight, otherwise the flow of blood will be restricted.
• The injured muscle should be elevated. This helps prevent swelling.

If pain is intense, pain medication such as ibuprofen can be taken for a few days.

As soon as the pain allows, it is possible to start with easy, pain-free activities and exercises. They should improve movement and simultaneously protect the healing muscles.

A doctor or physical therapist can offer support in selecting suitable exercises. 

Light training is usually possible again after 2 to 6 weeks. Once complete range of motion without pain is achieved, it is possible to resume with more strenuous activities.