What is muscle strain?

A muscle strain is an injury to a muscle or tendon that often happens at the junction where the muscle and tendon meet. Most people would think of a muscle strain as when the muscle gets stretched beyond its normal range. Like any material, if it’s stretched beyond a certain limit, the substance of that material gives way, causing some damage.  A muscle consists of muscle fibres that cause contraction and relaxation of the muscle, and these fibres are housed in a framework of tissues that do not contract, but which transmit the contraction to the tendons at the ends of the muscle. These tendons pull on the bone, and the limb or body part moves.

What are the signs and symptoms?

A muscle strain is characterised by: 

• Sudden onset of pain
• Soreness
• Limited range of movement
• Swelling
• Stiffness
• Weakness of the muscle or tendons
• Inability to use the muscle at all
• Bruising or redness due to the injury

What are the causes?

The risk factors are multifactorial and there are some muscles more prone to injury; for example the hamstring muscle group is the most injured in football. Having a previous muscle injury predisposes athletes to another injury. Fatigue is also an issue, and with the pandemic having concertinaed match schedules there has been an increase in muscle injuries. Sprinting, or high energy activity, like jumping/landing can cause muscle injury, as can a sudden change of direction, intentional or not. Having a concussion predisposes to musculoskeletal injury, and age can be a factor, with calf injury more common in those over 30. Lumbar spine injury (e.g. stress injuries, disc injuries) can interfere with the normal neural messaging, and cause damage by disco-ordination of muscle contraction.  These issues can also cause muscle pain, but without necessarily involving muscle damage (for example, sciatica).

The most common causes of a muscle strain are:

• Not warming up properly
• Lack of flexibility
• Sprinting
• Sudden movement
• Kicking
• Jumping
• Trauma
• Change of direction either intentional or unintentional
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How is it diagnosed?

Firstly, the doctor will take a medical history and perform a physical exam. During the physical exam, your doctor will check for swelling and points of tenderness. The location and intensity of pain can help determine the extent and nature of the damage, it’s important to establish whether the muscle is partially or completely torn, which can involve a much longer healing process, possible surgery, and a more complicated recovery. X-rays or lab tests are often not necessary, unless there is a history of trauma or evidence of infection.

How is it treated?

Treatment starts with trying to limit further damage to the muscle from bleeding and swelling. For immediate self-care of a muscle strain, try the R.I.C.E. approach — rest, ice, compression, elevation. Physical therapy is often recommended, including strengthening and stabilisation exercises, as well as aiding in return to activity. Muscle stiffness may be able to be treated at home with rest, massage, and the application of heat or cold.

How can it be prevented?

Tips to avoid a muscle strain:

• Flexibility
• Strength
• Rehabilitate properly from previous injury
• Recover from performance adequately (Cold, Eat, Drink, Rest, Compression)
• Try and avoid over-reaching
• Shared decision making
• Need to perform vs susceptibility