Muscle strain treatment and progression

Muscle strainMuscle strain is one of the most common sports injuries. In this case, overstretching of the muscle leads to pulling pain and muscle hardening. The thighs, back or neck are often affected. Read here what can be done about it.

At a glance

– A muscle strain is usually contracted during sporting activities. – It is an overstretching of the musculature, causing tiny damages to muscle structures. – Typical symptoms are sudden, pulling pain and hardening of the muscle. – Muscle strains usually heal on their own. However, it can take days to weeks for the affected muscle to regain full strength. – The pulled muscle should be kept immobilized for the first few days. Cooling, an elastic bandage and elevation reduce swelling and help with pain.

What is a muscle strain?

In a strain, a muscle is overstretched by a heavy load. A muscle strain is therefore also called muscle overstretching. It often occurs in sports that involve sprinting, quick stops or changes of direction, such as soccer.

The overstretching (distension) causes tiny damage to the myofibrils. Myofibrils are small units in the muscle fibers that are responsible for actively shortening the muscle.

If the muscle is overstretched even more than in the case of a pulled muscle, individual or several muscle fibers can tear. Then one speaks of a muscle fiber tear. In a muscle tear, an entire muscle tears.

What symptoms occur with a muscle strain? Sudden pulling pains are typical for a muscle strain. A hardening of the muscles – usually happens during sports or other physical exertion. The thighs, back or neck are often affected.

– muscle cramp – swelling – bruising – weakness of the muscle – restricted mobility

A muscle strain can be very painful. Often there is a bruise. It can take up to 24 hours for the swelling and bruising to reach their full extent.

What causes a muscle strain?

A pulled muscle usually occurs when a strained muscle is stretched excessively. This is often the case in sports such as soccer, basketball or tennis, where sprints, jumps, quick changes of direction or stops are required. Most often, strains occur in the thighs or calves.

Muscle strains can also occur in long-distance runners, then mainly in the calf. Especially when running uphill or downhill, muscles can be overstretched.

Important to know: Muscle fatigue plays a major role in a pulled muscle injury. Injuries often occur toward the end of a game or a run.

What factors favor a muscle strain?

When muscles are not properly warmed up before major exertion and sports, injuries often occur.

Muscle strains become more common with age, especially with insufficient training. Strains of the calf muscles, for example, often occur in people over 40 years of age who have trained little before major exertion.

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

How often does a muscle strain occur??

Muscle strain is one of the most common sports injuries – in both professional and recreational sports. More than 90 percent of sports injuries are either strains or sprains.

What is the course of a muscle strain??

Muscle strains usually heal on their own, but it can take days to weeks for the muscle to fully recover.

A special exercise program or physical therapy can shorten the recovery time.

After 4 to 8 weeks, people can usually return to their usual activities after a muscle strain, and athletes can begin their usual workouts.

How to prevent a muscle strain?

It is especially important to warm up the muscles well before exercising.

Targeted training can reduce the risk of injury. This is how fitness training prevents rapid muscle fatigue. Strength training and stretching exercises increase muscle strength and flexibility.

How is a muscle strain diagnosed?

The doctor makes the diagnosis on the basis of the symptoms and physical examination. The affected area is palpated, muscle strength and range of motion are checked.

Imaging procedures such as an x-ray or magnetic resonance imaging (MRI) are usually not necessary. For severe strains, however, they can help rule out other injuries – for example, a broken bone or torn muscle.

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

How to treat a pulled muscle?

In the first 48 hours, muscle strains are treated according to the so-called PECH rule. PECH stands for rest, ice, compression, and elevation. Meaning:

– The affected area should be immobilized. Cooling reduces the pain. Inhibits swelling. Ice or a cold pack can be applied several times a day for this purpose, for example every 2 hours for 10 to 20 minutes. It is important to let the muscles warm up in between. A thin cloth between ice. Skin protects against cold damage. – An elastic bandage or elastic bandage inhibits the spread of swelling. The bandage should not be too tight, however, so as not to impede blood flow. – The injured muscle should be elevated. This helps against the swelling.

If the pain is severe, you can also take painkillers such as ibuprofen for a few days.

Important to know: After resting for the first 2 days, you should start a careful exercise program. The sooner you start moving again, the sooner you can avoid muscle stiffness and restricted movement.

How long does rehabilitation take for a muscle strain?

As soon as pain allows, begin light pain-free activities and exercises. This should improve mobility. At the same time, protect the muscles that are still healing.

A health care professional, physical therapist, or physician can assist in selecting appropriate exercises.

Light training is usually possible again after 2 to 6 weeks. When a full range of motion is achieved without pain, one can begin to use greater loads again.

Important to know: The muscle should heal completely before you put full weight on it again and play sports. If the strain is not completely healed, there is an increased risk of re-injury.


– BMJ Best Practice. Musculoskeletal sprains and strains. Update from 05.03.2021. Retrieved on 20.04.2021. – DynaMed (Internet), Ipswich (MA). Hamstring Strain. EBSCO Information Services. 2018 (1995). Record No. T116919. Called on 20.04.2021. – UpToDate (Internet). Calf injuries not involving the Achilles tendon. Wolters Kluwer 2019. Retrieved 20.04.2021. – UpToDate (Internet). Quadriceps muscle and tendon injuries. Wolters Kluwer 2021. Retrieved 20.04.2021. – UpToDate (Internet). Patient education: Muscle strain (The Basics). Wolters Kluwer 2021.

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