A muscle strain or pulled muscle occurs when a muscle is overstretched or becomes torn. Depending on the severity of the injury, it may take anywhere from a couple of weeks to several months to fully heal.
Muscles are made up of muscle cells that are bundled together. The bundles form into muscle tissue that is surrounded by fascia. Muscles do attach to bones using tendons. Muscle tissues are fed a supply of blood and nerve vessels. When you think to walk, it is the nerve signals sent to the muscles that exert force on bones via the tendons to create movement.
In the worst cases of muscle strain, there is typically also injury to the tendons which take longer to heal. Made up of collagen fibres, tendons lack the same level of blood supply as muscle tissues.
Recovery Process for Muscle Strains
- Stage 1: Inflammatory stage – This starts from the time the injury occurs, up to 3-5 days thereafter. It is when the injury stops bleeding as blood clots and scar tissue form hence the need to stop physical activity to avoid increasing blood circulation that would dislodge the clots. During the inflammatory process, the body will seek to remove and absorb damaged cells while stabilising bleeding. It is advisable to avoid anti-inflammatory medication at this time to avoid interfering with this important process.
- Stage 2: Proliferation stage – This process will take about 7-21 days after the inflammatory stage is over. During this time, the body will generate new cells that are still weak and will attach to the blood clots. You should start to introduce some gentle movements to help build strength.
- Stage 3: Remodelling stage – This stage can start as soon as new cells begin to form but can take even months to complete. Strength training should be done during this time to help strengthen new cells and align them appropriately with the rest of the uninjured tissues so they can perform the function that the particular muscle or tendon does.
Signs of Muscle Strain
Muscle strain will often be a result of injury or overuse of muscles. When it occurs, you will typically feel some pain, weakness, and possible muscle spasms. You may also experience some cramping and see swelling. If blood vessels have been injured, bruising may also appear. The symptoms will often be more intense the more severe an injury you have, and will thus take longer to heal.
Types of Muscle Strain
Grade I
This is the mildest and most common form of muscle strain that typically involves small tears to the muscle tissues caused by overexerting yourself or minor impact injury. You might feel some mild pain when being physically active or after. You may also feel some soreness or weakness for at least a couple of days when you try to use your muscles. Recovery from this injury can take less than a week.
Grade II
This is when moderate muscle tears occur. It can be characterised by pain while active, aching, or cramping that forces you to stop. Recovery from this injury can take about 3-7 days before you feel comfortable to start being active again. Grade II injuries and higher will often benefit from physical therapy that can be applied for several weeks. As the muscles and tendons heal and new cells fill in the damaged sections, using the scar tissue as scaffolding, osteopathic treatments like gentle stretching, massage, and articulation can help train them back to normal function without pain.
Grade III
This kind of injury involves more severe tears to the muscle that results in more intense and stabbing pain. You may also feel sudden weakness and suffer a limited range of motion. This kind of injury may require some immobilisation and take anywhere from 3-6 months to recover. Once the injured part is no longer immobilised, the patient may be referred to an osteopath to carry out physical therapy that will help to reduce pain, relax the muscles, recover mobility, and articulate the joints. This therapy will typically start with light movements as the muscle strength is built up.
Grade IV
This is the most severe muscle strain that will often involve having the muscle or tendon being seriously torn or ruptured and possibly detached from the bone. There is often severe pain felt and the sensation that there is a big gap in the muscle. Swelling and discolouration will often also appear. This level of injury will often require surgical intervention to reattach. Depending on the location of the injury and severity, recovery may range between 3-9 months or longer for recovery. It may be a few months shorter if not severe enough to require surgery.
Treatment for Muscle Strain
The more severe forms of muscle strain that may require many weeks or months of recovery tend to come with a pop sound from the muscle. For mild cases that come with less pain, the RICE protocol can be effective. This involves:
- Rest to prevent further injury
- Ice application to reduce swelling
- Compression for support
- Elevation to encourage drainage
The use of over the counter pain medications like ibuprofen can also help relieve pain symptoms. Try to take it easy to allow healing to occur. If you return to your normal physical activities too soon could cause further injury.
If you suspect your injury is a Grade II or higher, go see your doctor. You will likely be referred to a physical therapy specialist like an osteopath for rehabilitation. The massage, stretching, and physical manipulation applied will help relieve muscle tension, improve mobility of the joints, reduce pain and promote faster healing of the injury.
