A strain is an injury to a muscle or tendon in which the muscle fibers tear. Acute muscle strain injuries are quiet common in athletes and lead to significant pain, disability and time away from work and athletic pursuits.
The most important factors leading to muscle strain are over-training, strenuous exercise, lack of recovery, previous injuries and poor nutrition.
It usually involves bi-articular muscles (muscles that cross two joints) such as hamstrings and rectus femoris. Hamstring injuries are common in runners, footballers and rugby players. For example lumbar flexion with a straight leg as happens when a player attempts to pick up the ball whilst on the run is a common action for hamstring injury as places excessive tensional load while the hamstring is under an eccentric contraction, thereby causing an indirect overload injury of the msk unit. Furthermore restricted ankle dorsiflexion, bio-mechanical anomalies at the lumbopelvic, thigh or leg region,restrictions in the spine, muscle imbalance may increase the risk of hamstring injuries.
Muscle strain are categorized in three distinct categories:
1) Grade 1: Mild strain, few fibers have been damaged. Minor swelling and discomfort with minimal or no loss of strength function. Healing within 2-3 weeks.
2) Grade 2: Moderate strain, extensive damage to muscle fibers. Mild swelling and discomfort with moderate loss of strength and function. Healing occurs within 3-6 weeks.
3) Grade 3: Sever strain, complete rupture of a muscle. Loss of strength with total loss of function. May require surgery. Healing can be up to 3 months.
Swelling, bruising or redness, or open cuts due to the injury.
Pain at rest.
Pain when the specific muscle or the joint in relation to that muscle is used.
Weakness of the muscle or tendons (A sprain, in contrast, is an injury to a joint and its ligaments.)
Inability to use the muscle at all.
For Grade 1, Grade 2 and Grade 3 strains the immediate treatment plan will comprise of the RICE protocol (Rest, Ice, Compression,Elevation) which has the aim to avoid further muscle damage and minimizing the bleeding, preventing formation of a large hematoma which has an impact on the size of the scar tissue at the end of the regeneration and accelerating regeneration.
After the RICE protocol, early mobilization is advised to improve the healing process. Controlled exercise after 72hours can be initiated, such as isometric training, later introducing some load within the limits of pain and finally controlled isotonic training using high repetition and low resistance.
Stretching exercises will help the alignment of the scar tissue and his extensibility, moreover improving the flexibility of the muscle.
Isokinetic exercises are excellent in the early phases of muscle healing, helping strengthen without full weight-bearing for the first 6/8 weeks.
Resistance bands can be used once the muscle has healed and gains its strength. The number of sets and repetitions should be increased progressively.
Warm up before participating to any activity.
Cool down and stretch after the performance.This will help prevent DOMS (Delayed Onset of Muscle Soreness) due to the inability of removing muscle lactic acid as well as aid in preventing overuse injuries.
Maintain good muscle strength and flexibility will prevent further damage
Improve your diet.
Dott. Emanuele Luciani
Osteopath, physiotherapist, hatha yoga teacher
Osteopath registered with the General Osteopathic Council (GOsC)
"Centro Studi Tre Fontane"
Via Luigi Perna 51, Rome