Have you ever experienced a muscle strain? Actually, what IS a muscle strain anyway?
A muscle strain is an injury or trauma to the belly of a muscle. Minor strains often result in a stretch to the muscle, like pulling a rubber band. More severe strains overstretch the muscle to the point where the muscle can have a partial or even a complete tear if it's bad enough. Strains most often occur in places like the low back or hamstrings, but any muscle in the body has the possibility to experience a strain injury.
Strain injuries don't discriminate; athletes with active lifestyles and sedentary individuals can all suffer from muscular strains. The scenarios that a strain can happen in range from repetitive or overuse injuries like running or throwing a baseball, to sudden onset situations like lifting a heavy box while moving or pulling a tough weed while gardening. Most people often describe a muscle strain as feeling like they “pulled” a muscle, and they're not wrong! A muscle strain often results from a muscle being pulled too hard.
While strains happen to muscles, they have a sibling you might also be familiar with: the sprain. Sprains have a similar mechanism of injury, with the difference being that sprains happen to ligaments instead of muscles. For the sake of simplicity, we're only going to discuss strains in this blog; however, I bring up sprains because it's very common that people experience a ligament sprain along with a muscle strain at the same time, resulting in a "sprain/strain" diagnosis.
Muscular strains can be put into two categories: chronic overuse strains and acute traumatic strains.
An overuse strain can be a confusing concept at first because there is no single “event” that can be pinpointed that caused the injury to start. A traumatic strain injury, on the other hand, almost always has a moment where you you notice the injury starting; think of lifting a TV and suddenly, your low back spasms and the pain comes on.
Over-Use Strain (Chronic)
The Cumulative Injury Cycle
The Cumulative Injury Cycle represents the process in which over-use injuries and pain can occur. This cycle isn't limited to just one activity, but can be anything you do repetitively.
The chronic injury cycle begins with Overwork. Overwork can be anything from a long span of sitting or longer-distance running. You read that right; even long periods of sitting can overwork muscle groups, especially in the low back, in addition to increasing your chances of developing deep vein thromboses, diabetes, and undoing the benefits of exercise. The engagement of muscle groups in the same activity – day in, day out – may lead to muscular imbalances and Weak, Tight, and Tense soft tissues, like muscle.
These weak/tight muscles lead to excess tension, friction and pressure to the muscles, ligaments, tendons, and fascia in that area. In turn, this then results in reduced circulation, swelling and hypoxia (lack of oxygen) to the area. The lack of adequate oxygenation to our soft tissues results in the formation of Adhesions and/or Scar Tissue to the area, further decreasing the function of the local structures.
Think of these adhesions like a tube of superglue that leaks out and gets into the carpet. The nice fibers of the carpet are no longer smooth, and the carpet is not as effective in cushioning your feet due to gluing the synthetic fibers together.
Overworked, weakened muscles, coupled with excessive friction and tension and decreased circulation, result in a vicious cycle that both weakens and tenses muscles and soft tissue. The cycle will continue to repeat until the body sends off the alarm system that something is wrong.
At some point in your life, you probably stepped on something painful. You may not have known it was even on the ground, waiting to ambush the bottom of your foot, until you stepped directly on it. Our bodies act very similarly. Our body doesn't let us know something isn’t working correctly us until our internal alarm system goes off. That alarm system comes in the form of pain!
Now that we know how chronic and repetitive injuries can occur with strains, what about severe episodes?
The dreaded acute or traumatic strain. It will have a sudden onset of extreme discomfort or pain, and can be life-altering for a stretch of time depending on the “grade” of your strain. Strains come at different levels, known as Grades. In particular, Grades I, II, and III.
Read on to learn more about the different grades or levels of injuries for strains:
Grade I Muscle Strain In a Grade I muscle strain, the muscle or tendon is overstretched and may have small tears to the muscle, like papercuts. You may have mild pain with or without swelling. Grade I strain is also called mild muscle strain. For Grade I muscle strain, simple home remedies, such as applying RICE (rest, ice, compression, elevation) therapy may be just enough to manage symptoms. These are usually self-resolving in a small time frame, although can be uncomfortable during the healing process. Grade II Muscle Strain Also called moderate muscle strain, Grade II strain occurs when the muscle or its tendon is overstretched with more of the fibers torn. Symptoms may include marked pain with swelling. The area of injury is tender and uncomfortable to the touch and may include bruising. Movement can be difficult to perform because of the level of discomfort and muscle involvement. Grade III Muscle Strain Grade III strain, or severe muscle strain, is the most serious among the three grades of muscle strains. Most of the muscle fibers are torn! In some cases, the muscle is completely torn or ruptured, resulting in a potential loss of function. Pain, swelling, tenderness, and bruising are usually present. Movement is usually difficult. Moderate and severe muscle strains should be seen by a qualified health care provider, such as a chiropractor, for a thorough evaluation!
Now that you know about the different levels of muscle strains, what can be done to help prevent this kind of injury in the first place?
Here are some preventative strategies to reduce the chances of an over-use strain or acute traumatic strain injuries.
Keep in mind, even if everything is perfect, you can still end up with strains and/or sprains if your sport or activity is strenuous in nature. Even the best preparation can't fully prevent injury, but it can definitely decrease the chances of it happening! Some the things you can do are:
Corrective exercises: These will help combat any muscular imbalances that cause biomechanical issues and increase strain on your body.
Micro-breaks: Break up the repetitions of your activity or sport.
Ergonomics: Well-fitted sporting equipment, changes in exercise gear, or alterations to a work environment may be needed to reduce the likelihood of injury.
Proper Technique: Decreases strain on the body with more efficient movement and performance.
Rest and Recovery: Helps to get the body back to a steady state and prevent excessive fatigue.
Equipment: The right equipment can be key to performance, efficiency, and reduction of strain on the body.
Should injury occur regardless of these factors, there are things you can do to ensure your body heals. Anyone can get a strained muscle, and the amount of time you need to fully heal depends on the individual and the type of injury.
If a strain injury does occur, there are many treatment options one can consider. In our office, we typically utilize traditional therapeutic modalities such as electrical muscle stimulation, taping, ice, etc. In addition, we provide 3 key treatment options that not all clinics do, and they are as follows.
Trigger Point Therapy (similar to Active Release Technique)
It is important to see a doctor if you have experience a painful sprain or strain to get the appropriate evaluation and treatment. Your knowledgeable chiropractor can also suggest changes to your exercise routine, sport habits, computer or desk setup, or other lifestyle factors to help improve your recovery.
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Leahy, P.M. Cumulative trauma disorder defined. Retrieved from http://www.sportdc.com/art/leahy_art.shtml. Accessed October 2020.
Mangusan, D. “Back muscle strains.” Retrieved from http://www.physiotherapynotes.com. Accessed October 2020.
“Sprains and strains.” National Institute of Arthritis and and Musculoskeletal and Skin Diseases. Retrieved October 2020 from: https://www.niams.nih.gov/health-topics/sprains-and-strains
Sprains, strains and other soft-tissue injuries. American Academy of Orthopaedic Surgeons. Retrieved from https://orthoinfo.aaos.org/en/diseases--conditions/sprains-strains-and-other-soft-tissue-injuries. Accessed October 2020