Strains

A strain is often referred to as a ‘pulled muscle’.  It is caused by a sudden movement, such as a twist or pull, that the muscle is unprepared for.  This results in an over stretch or tear of the muscle fibres.

There are three grades of strain; Grade 1 - mild, Grade 2 - moderate, and Grade 3 - severe.  

• Grade 1

  Mild Grade 1 strain is when only a few muscle fibres have been torn by the sudden action.  There will be no reduction in strength and there is a full range of motion.  The onset of pain may be delayed until the next day.  This will require two to three weeks rest.

• Grade 2

  Moderate Grade 2 strain is categorised by roughly half of the muscle fibres being torn.  Muscle strength will be reduced.  There will be high amount of pain with swelling of the effected area.  This will require three to six weeks rest.

• Grade 3

  Severe strain Grade 3 is the complete rupture of the muscle; either the tendon is torn from the muscle or the muscle belly is torn in two.  There will be complete loss of function and strength with severe swelling and pain.  Surgery maybe required to repair the muscle and this will require around three months rehabilitation. 

As soon as the strain has occurred the body kicks into healing itself.  There are three phases of injury repair; acute, sub acute and chronic.

• Acute

  This is also known as the protection phase when inflammation and pain is at it’s greatest.  This starts straight after the injury occurs. Inflammatory response is the body’s first response to a muscle strain.  It is the body’s way of trying to protect itself from further damage.  During this time dead muscle fibres are taken away so that the repair process can begin.  This phase lasts around four days, depending on the use of the muscle and whether it is allowed to rest.

• Sub Acute

  The repair phase starts when the body gears up to mend the injured fibres.  As new scar tissue is laid down strength is restored.  Inflammation gradually decreases as the body no longer needs to protect the injury site.  The laying down of this new tissue can take up to six weeks.  Even when the muscle fibres have been repaired the restoration doesn’t stop.  Healing continues as the new tissues are tested for robustness and remodelled to strengthen it if required.  This can take up to three months before the final phase is undertaken. 

• Chronic Phase

  After three months the injury reaches chronic phase.  This phase is about ongoing repair and remodelling as the body remodels scar tissue based on the stresses applied to it.  There may still be pain when the injury is overused, or a dull ache at rest, but there will be full range of movement.  This phase might last years depending on how the injured site is used.

Scar tissues is less flexible and therefore weaker.  It also has a tendency to deform surrounding tissue.  This might mean that the injured muscle may be more prone to re-injury.  A stressed muscle is more likely to form trigger points.