Cookies on the Bupa website

We use cookies to help us understand ease of use and relevance of content. This ensures that we can give you the best experience on our website. If you continue, we'll assume that you are happy to receive cookies for this purpose. Find out more about cookies



Muscle strain

A muscle strain (pulled muscle) is a stretch or tear in your muscle that can happen if you stretch your muscle more than it can stand or you put too much force on it. You’re more likely to tear your muscles if you don’t warm up or your muscles are tired or weakened. It can also happen if they’re stretched beyond their normal comfortable range, or made to work too hard or too fast. The most common muscles to strain are those in your legs and back.

Running feet on tarmac

About muscle strain

Muscles are made up of a band of fibres, which relax and tighten to make you move. Muscle strain – or a pulled muscle – happens when one of your muscles is over-stretched or torn. The main muscles that people tend to strain are: 

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

You can also strain muscles in the lower part of your back, which is called your lumbar spine. 

Physiotherapists grade muscle strains, depending on how severe they are.

  • A grade one strain is minor damage to your muscle fibres.
  • A grade two strain is a partial tear of your muscle.
  • A grade three strain is a full tear of your muscle.

This grading can help your physiotherapist choose the right treatment for you.

Symptoms of muscle strain

The main symptoms of a muscle 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, and you might have a bit of swelling and a bruise. But you should still be able to move normally and carry on with your activities as normal.
  • If you have a grade two muscle strain, it’s likely to be more painful. You may also have a bruise and more swelling over the affected area. You’ll probably lose some strength in the muscle so might not be able to carry on with your usual activities.
  • A grade three strain is usually really painful, and you’ll have a lot of swelling and bruising. You might have a lump at either end of the muscle. You might feel a popping sensation when you injure your muscle. You can lose all strength in it, which means you won’t be able to put any weight on it. So, you won’t be able to carry on with your usual activities.

Diagnosis of muscle strain

Usually, it’ll be obvious if you strain a muscle after doing a particular activity as you may feel pain either immediately, or shortly afterwards. Because of this, you might not need to see a health professional to get a diagnosis. But if you're unsure, or your symptoms are severe or persistent, contact a physiotherapist or your GP.

They’ll ask you about your symptoms and medical history, and will examine you and ask about how your injury happened.

Your physiotherapist or GP will usually be able to diagnose a muscle strain just by examining you and asking questions. But they might arrange for you to have an ultrasound or a magnetic resonance imaging (MRI) scan if your injury is severe, or to confirm your diagnosis. An ultrasound uses sound waves to produce an image of the inside of your body and an MRI scan uses magnets and radio waves.

Treatment of muscle strain

Treating a muscle strain involves reducing your pain and any swelling, and keeping up movement and strength in your muscle. It aims 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. Usually, you can manage grades one and two strains at home. If you have a more severe strain, you may need treatment in hospital.


It’s important to allow your muscle to 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. If you’ve pulled a muscle in your leg, use a support like a walking stick, for example.
  • Rest for the first two to three days, and then slowly start moving again 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 your pain. Don’t apply ice directly to your skin as you might injure your skin. Don’t leave it on while you sleep either.
  • Compress the area by bandaging it to support the injury and help reduce swelling. The bandage should fit snugly but not be too tight. Take it off each night before you go to sleep.
  • Elevate the injured area above the level of your heart (if possible) to control swelling. Keep the area supported on a pillow for example, and try to keep it elevated as much as possible until the swelling goes down.

As soon as you feel able to, you can start to move around gently and build up your activity slowly. But be careful. For information on how to protect your muscle while it’s healing, see our FAQ: How to help yourself.

If your muscle doesn't start to get better and you can’t put weight on it after about a week, contact a physiotherapist or your GP. They’ll give you some advice on what to do.


If you need pain relief, you can take over-the-counter (OTC) painkillers, such as paracetamol or ibuprofen. You can take ibuprofen as tablets or a cream or gel that you rub on your skin where the injury is. You can use the cream or gel straightaway, but wait a couple of days after you get a strain to take ibuprofen tablets. This is because they can delay healing. You can take paracetamol straightaway. Always read the patient information leaflet that comes with your medicine and, if you have any questions, ask your pharmacist for advice.


If your injury is severe or you find that it keeps coming back, physiotherapy may help you to strengthen your damaged muscle.

Your GP may refer you to a physiotherapist or you can book an appointment with a physiotherapist yourself. You can also choose to see a physiotherapist privately.

They’ll develop a programme of exercises to gradually strengthen and stretch your muscles and strengthen them. 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 process.

It’s important that 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.


If your muscle strain is severe, or your muscle has completely torn, you may need an operation to repair it. The type of operation you have will depend on which muscle you have torn. Your GP will refer you to see an orthopaedic surgeon who will explain what type of procedure you need. You’ll probably need a course of physiotherapy after your surgery to get back to normal.

Causes of muscle strain

If you over-stretch a muscle, or your muscle is forced to contract against a force that's too strong for it, you can strain the muscle. This can happen when you’re exercising or playing sport, have a heavy blow to your muscle, or lift something heavy, for example.

You're more likely to develop a muscle strain in certain situations, such as if you:

  • don’t warm up your muscles properly before exercise and cool them down afterwards
  • don’t take enough time off to recover between training sessions and have tired or overused muscles
  • have tight or stiff muscles
  • have injured your muscle before
  • have weak muscles, which can happen if you don’t exercise often
  • lift heavy objects incorrectly, or have a poor technique in a sport and put too much strain on your muscles
  • don't use the right sports gear – if you wear poorly fitting shoes, for example
  • are overweight – this can put pressure on your muscles

Prevention of muscle strain

You can reduce your risk of straining a muscle by doing a thorough warm-up before you exercise. Here are some tips to stretch the muscles that support your knee; for example, Exercises to prevent knee injury. Ask your physiotherapist about exercises for other muscle groups.

It’s also important to make sure your muscles are strong and flexible enough and you’re fit enough for the activity you’re doing. Build up your activities so you don’t push yourself too hard too soon. Eccentric (lengthening) strength training has been shown to prevent muscle strains.

If you have any minor injuries, make sure you take some time off to let them heal too.

FAQ: Can stretching prevent muscle strains?

At the moment, there isn’t any scientific proof to show that doing stretches before you exercise prevents getting an injury, or any muscle soreness. But it’s probably still worth doing a gentle warm-up to prepare your body for activity. It will also help to build some flexibility into your muscles to prepare you for sport.

Warming up before you exercise can prepare you both physically and mentally for the activity you’re about to do. You can warm up using the same activity as the one you have planned but at a gentle level. For example, if you’re planning to run, you can warm up by walking. As your muscles warm up, they’ll work better so won’t be as prone to injury. Start slowly, and then move slightly faster until you’re moving at the speed you need for whatever activity you’re about to do. So, you should be full speed at the end of your warm-up. If you’re unsure, ask a physiotherapist for advice about suitable warm-up exercises before you start your main activity.

It might help to do some gentle stretching afterwards to cool down too.

FAQ: I have muscle strain – should I see my GP?

You can treat most muscles strains yourself at home and don’t need to see your GP. But get some medical help if:

  • your symptoms get worse – you get more swelling and pain
  • your movement doesn’t get better so if you have a muscle strain in your leg for example, you have difficulty walking

If you have a severe muscle strain and your muscle has completely torn, it's important to get immediate medical help. Go to the accident and emergency department of your local hospital. If you have a severe strain, you may have felt a popping or tearing sensation as your muscle was torn. You’ll also likely be in a lot of pain and have some swelling and won’t be able to move the muscle.

FAQ: What can I do to help a muscle heal?

A strained muscle should heal well if it’s protected from further injury, rested and rehabilitated quickly.

The most important way to help your injury to heal is to follow the PRICE method immediately after you injure your muscle. See ‘Self-help for a muscle strain’ above for information on PRICE. There are also some things to avoid doing in the first few days after an injury that could make your injury worse. It can help to remember these by using the HARM principle.

  • Heat. Don’t use heat packs, hot water bottles or heat rubs on the affected area, or go in a sauna or hot bath. Heat encourages blood to flow to the area, the opposite effect of using ice.
  • Alcohol. Don’t drink alcohol because it can increase bleeding and swelling to the area, which will slow down the healing process.
  • Running (or any other form of exercise). Don’t do this for the first couple of days as it could cause more damage. After that, you can start moving around more as it will help your muscle to heal – but take it slowly. Gradually increase how much exercise you do over the next days and weeks.
  • Massage. Although it’s tempting, hold off for a few days as it can increase bleeding and swelling.

It’s important to rest your muscle as much as you can for a few days. After this, you can start to move around gently and slowly, gradually building up your activity until your muscle returns to normal. If you’d like advice about building up your muscle strength, ask a physiotherapist.


  • Physiotherapy

    At our Health Centres, we offer self-pay health services for a wide range of conditions, including physiotherapy.

  • Other helpful websites Other helpful websites

    Further information


    • Musculoskeletal sprains and strains. BMJ Best Practice., last updated 30 December 2016
    • Sprains and strains. NICE Clinical Knowledge Summaries., last revised March 2016
    • Behm DG, Blazevich AJ, Kay AD, et al. Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review. Appl Physiol Nutr Metab 2016; 41(1):1–11. doi: 10.1139/apnm-2015-0235
    • Muscle strains in the thigh. American Academy of Orthopaedic Surgeons., last reviewed March 2014
    • Muscular system anatomy. Medscape., updated 11 September 2015
    • Brukner P, Khan KQC. Brukner & Khan's clinical sports medicine. 4th ed. New York: McGraw-Hill Medical; 2012
    • Medial gastrocnemius strain. Medscape., updated 7 November 2016
    • Lumbosacral spine sprain/strain injuries. Medscape., updated 11 March 2015
    • Ultrasound – musculoskeletal. Radiological Society of North America., reviewed 10 June 2015
    • Magnetic resonance imaging (MRI) – musculoskeletal. Radiological Society of North America., reviewed 25 June 2015
    • Derry S, Moore RA, Gaskell H. Topical NSAIDS for acute musculoskeletal pain in adults. Cochrane Database of Systematic Reviews 2015, Issue 6. doi: 10.1002/14651858.CD007402.pub3
    • Questions and answers about sprains and strains. National Institute of Arthritis and Musculoskeletal and Skin Diseases., published January 2015
    • Find a physio. Chartered Society of Physiotherapy., accessed 8 February 2017
    • Personal communication, Dr Leon Creaney, Consultant in Sport & Exercise Medicine, The Wilmslow Hospital, Spire Manchester and Spire Liverpool, 4 March 2017
    • Hamstring strain. Medscape., updated 2 April 2015
    • Eccentric resistance exercise for health and fitness. American College of Sports Medicine., published 2013
    • Herbert RD, de Noronha M, Kamper SJ. Stretching to prevent or reduce muscle soreness after exercise. Cochrane Database of Systematic Reviews 2011, Issue 7. doi: 10.1002/14651858.CD004577.pub3
    • Yeung SS, Yeung EW, Gillespie LD. Interventions for preventing lower limb soft-tissue running injuries. Cochrane Database of Systematic Reviews 2011, Issue 7. doi: 10.1002/14651858.CD001256.pub2
  • Has our information helped you? Tell us what you think about this page

    We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.

    Let us know what you think using our short feedback form
  • Related information Related information

  • Tools and calculators Tools and calculators

  • Author information Author information

    Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, March 2017
    Expert reviewer by Dr Leon Creaney, Consultant Sport and Exercise Medicine Physician
    Next review due March 2020

About our health information

At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.

  • Information Standard

    We are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.

    Information standard logo
  • HONcode

    This site complies with the HONcode standard for trustworthy health information:
    verify here.

    This website is certified by Health On the Net Foundation. Click to verify.

What our readers say about us

But don't just take our word for it; here's some feedback from our readers.

Simple and easy to use website - not alarming, just helpful.

It’s informative but not too detailed. I like that it’s factual and realistic about the conditions and the procedures involved. It’s also easy to navigate to areas that you specifically want without having to read all the information.

Good information, easy to find, trustworthy.

Meet the team

Nick Ridgman

Nick Ridgman
Head of Health Content

  • Dylan Merkett – Lead Editor
  • Graham Pembrey - Lead Editor
  • Laura Blanks – Specialist Editor, Quality
  • Michelle Harrison – Specialist Editor, Insights
  • Natalie Heaton – Specialist Editor, User Experience
  • Fay Jeffery – Web Editor
  • Marcella McEvoy – Specialist Editor, Content Portfolio
  • Alice Rossiter – Specialist Editor (on Maternity Leave)

Our core principles

All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.

An image showing or editorial principals

                  Click to open full-size image

The ‘3Rs’ encompass everything we believe good health information should be. From tweets to in-depth reports, videos to quizzes, every piece of content we produce has these as its foundation.


In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.


We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.


We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.

Our accreditation

Here are just a few of the ways in which the quality of our information has been recognised.

  • The Information Standard certification scheme

    You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.

    It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.

    Certified by the Information Standard as a quality provider of health and social care information. Bupa shall hold responsibility for the accuracy of the information they publish and neither the Scheme Operator nor the Scheme Owner shall have any responsibility whatsoever for costs, losses or direct or indirect damages or costs arising from inaccuracy of information or omissions in information published on the website on behalf of Bupa.

  • British Medical Association (BMA) patient information awards

    We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.

Contact us

If you have any feedback on our health information, we would love to hear from you. Please contact us via email: Or you can write to us:

Health Content Team
Battle Bridge House
300 Grays Inn Road

Find out more Close

Legal disclaimer

This information was published by Bupa's Health Content 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 information contained on this page and in any third party websites referred to on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them. Bupa is not responsible for the content or availability of these third party websites. We do not accept advertising on this page.

For more details on how we produce our content and its sources, visit the 'About our health information' section.

ˆ We may record or monitor our calls.