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Muscle strain

This factsheet is for people who have strained a muscle, or who would like information about it.

A muscle strain is a stretch or tear in your muscle caused by over-stretching or over-tightening of muscle tissue. The muscles in your legs are most commonly affected.

About muscle strain

Muscle strain (also called pulled muscles) happens when one of your muscles is over-stretched or torn. Your muscles are a band of fibres, which relax and tighten to make you move. Muscle strain can happen when you’re exercising or playing sport, or during accidents. Strains can also happen when you’re lifting heavy objects.

The muscles that are most commonly strained are those in your legs. The main muscles affected are listed below.

  • The calf muscles at the back of your lower legs. These muscles help you to raise your heel.
  • The quadriceps muscles at the front of your thigh. These muscles help you to straighten your knee.
  • The hamstring muscles at the back of your thigh. These muscles help you to bend your knee.

Muscles sprains of the lower part of your back, called your lumbar spine, are also common.

Muscles strains can be graded, depending on how severe they are. A grade one strain is minor damage to your muscle fibres, with some pain and swelling. A grade two strain is a partial tear of your muscle, with moderate pain and swelling and a grade three strain is a full tear of your muscle. This grading can help your doctor to choose the right treatment for you.

Symptoms of muscle strain

The main symptoms of muscles strain are pain and tenderness when you touch the affected muscle.

If you have a mild (grade one) muscle strain, the area may feel tender, but you should still be able to move normally and carry on with your activities.

With a grade two muscle strain, your pain is likely to be more severe. You may also have a bruise and some swelling over the affected area. You’re likely to lose some strength in the affected muscle, which may mean you can’t carry on with your usual activities.

A grade three strain causes severe pain and you may feel a popping sensation as the injury happens. This type of strain can cause you to lose any strength in the affected muscle. This means you won’t be able to carry on with your usual activities. 

Causes of muscle strain

A muscle strain can occur when you over-stretch a muscle, or if your muscle is forced to contract against a force that is too strong for it. This can happen when you’re active, playing sport or exercising, or when you’re lifting something.

You're more likely to develop a muscle strain in certain situations. Some of the main ones are listed below.

  • If you don’t warm up your muscles properly before exercise.
  • Your recovery time between training sessions isn't long enough.
  • Your muscles are already tight or stiff.
  • You have previously injured your muscles.
  • Your muscles are tired or overused.
  • You have weak muscles.

Diagnosis of muscle strain

Your GP or physiotherapist (a health professional who specialises in maintaining and improving movement and mobility) will ask you about your symptoms and examine you. He or she may also ask you about your medical history and how your injury happened.

Your GP or physiotherapist will usually be able to diagnose a muscle strain by examining you. However, you may also be asked to have an ultrasound or an MRI scan if the injury is severe, or if you play sport to a high level. An ultrasound uses sound waves to produce an image of the inside of your body, or part of your body. An MRI scan uses magnets and radiowaves to produce images of the inside of the body.

Treatment of muscle strain

The aim of treatment for muscle strain is to reduce your pain and any swelling, make sure the movement and strength of your muscle is maintained and to get you back to your usual activities as soon as possible. The type of treatment you need will depend on how severe your injury is. Many grade one and two strains can be managed by you at home. More severe strains may need treatment in hospital.

Self-help

It’s important to help your injury heal and to protect it from further damage by taking certain steps as soon as you can. Many minor strains will respond to the PRICE procedure.

  • Protect your injury from further harm.
  • Rest your injury for the first two to three days, and then re-introduce movement so you don’t lose too much muscle strength.
  • Ice the injured area using an ice pack or ice wrapped in a towel to reduce swelling and bruising. Don’t apply ice directly to your skin as it can damage your skin.
  • Compress the area by bandaging it to support the injury and help reduce swelling. The bandage should fit snugly but not be too tight, and you should remove it before going to sleep.
  • Elevate the injured area above the level of your heart to control swelling. Keep the area supported and try to keep it elevated as much as possible until the swelling goes down.

For the first 72 hours after an injury there are certain things you shouldn’t do to ensure you don’t make the injury worse. See our frequently asked question for more information.

If your injury doesn't improve, it's important to seek advice from your GP or physiotherapist. As soon as you feel able to, you can start to move around gently, building up your activity slowly.

Medicines

If you need pain relief, you can take over-the-counter painkillers, such as paracetamol. This will help to ease mild pain and discomfort. If you have more severe pain, you can take a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen. You can take these as tablets, or as a cream or gel rubbed gently onto your skin where the injury is. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Surgery

If you have a grade three strain and your muscle has completely torn, you may need an operation to repair it. You’re likely to have surgery within the first week after your injury.

Physiotherapy

If your injury is severe or you find that it keeps re-occurring, physiotherapy may help you to strengthen the damaged muscle and return to your usual activities.

Your GP may refer you to a physiotherapist or you can choose to see a physiotherapist privately. He or she will develop a programme of exercises to gradually strengthen and stretch your muscles. These exercises will vary depending on the kind of injury you have and how severe it is. Your physiotherapist may also use various techniques to help speed up the healing of your injury.

It’s important to make sure your injury has fully healed before you start exercising again. If you return to exercise too soon, you’re more likely to have another muscle strain injury.

Prevention of muscle strain

You can reduce your risk of muscle strain by doing a thorough warm-up before exercise. It’s also important that you make sure your muscles are strong enough and you’re fit enough for the activity you’re doing.

 

Produced by Rebecca Canvin, Bupa Health Information Team, March 2012.

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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