What Does a Pulled Muscle Really Mean?
A very common injury that physical therapists encounter in the clinic, or on the field, are pulled muscles, also called muscle strains. A pulled muscle, or a strained muscle, is an injury that is similar in nature to a sprained ligament. Essentially the muscle, or tendon of the muscle, cannot tolerate that force or demand placed on it causing it to tear. A pulled muscle or strained muscle is another way of saying that the muscle or tendon has torn.
Since muscles are contractile tissues, meaning they can shorten and create a pulling force, the injury often occurs during a powerful contraction or an excessive lengthening of the muscle. Therefore these injuries can occur in a non-contact fashion such as sprinting, changing directions, quickly decelerating, or jumping (1). Decelerating during the eccentric phase of a muscle contraction is more often the type of contraction involved.
There are several different grades or classifications of a pulled muscle that can occur, meaning not all muscle strains are the same. The injury is graded based on the amount of fiber disruption, or the amount of fibers torn (2).
Grade I injuries are considered mild. The muscle or tendon tissue has impacted only a small number of muscle fibers. Grade I injuries see no decrease in strength and full range of motion is maintained. Soreness may not present itself until the following day (3).
Grade II injuries are more severe and nearly half of the muscle fibers are involved. Unlike grade I injuries, grade II injuries can be felt immediately with swelling, weakness, and pain (3).
Grade III injuries are the most severe and indicate a complete rupture of the muscle or tendon. Significant pain, swelling, bruising, and loss of strength are indicated with this type of injury (3). Oftentimes you may feel a pop and immediately reach for the injured area.
Groin strains, calf strains, quadricep strains, and hamstring strains are some of the common muscles that are involved with these types of injuries. Activities that require acceleration and deceleration as well as directional changes often see a higher rate of injuries. Therefore, soccer, basketball, and hockey are some of the sports that may see the athletes experience these injuries more often. While athletes are more at risk, muscle strains can occur during everyday activities.
Following the initial injury, the recovery begins. Depending on the grade of the injury, there will be different timelines on when to return to sport. In some cases surgical intervention may be required when there is a complete rupture of the muscle, but not always. Grade I and II injuries can typically be managed conservatively allowing for a full recovery and return to prior level of function. Grade I injury can take 1 to 4 weeks while a grade II injury can take 3 to 6 weeks.
The rehabilitation of a muscle strain initially starts with ice and compression of the injured tissue. Gentle mobility is introduced focusing more on active movements instead of static stretching. Then gradual muscle strengthening is allowed. As the injury continues to heal, more aggressive activities are performed such as plyometrics, agility, and power type exercises with the goal of a full return to prior level of function.
If you or a loved one has experienced a pulled muscle, or muscle strain, reach out to TFI Physical Therapy and Sports Performance today!
- Garrett WE. Muscle strain injuries. Am J Sports Med. 1996; 24:S2-88
- Järvinen M, Tero AH. Muscle strain injuries. Rheumatology. 2010(2); 12: 155-161
- https://www.physio-pedia.com/Muscle_Strain#cite_note-Six-2