Muscle strain

Expert reviewer, Declan Leonard, Physiotherapist
Next review due August 2022

A muscle strain (pulled muscle) is an overstretch or tear in your muscle fibres. It can happen if you overstretch your muscle or you put too much force on it. You’re most likely to strain a muscle in your legs or back.

Man tying laces

About muscle strain

Your muscles are made up of a band of fibres, which relax and tighten to make you move. You may strain a muscle if you stretch it beyond its normal comfortable range, or make it work too hard or too fast.

You’re most likely to have a muscle strain (pulled muscle):

  • in your lower leg – your calf muscles, which help you to raise your heel
  • at the back of your thigh – your hamstring muscles, which helps you to bend your knee

You can also get:

  • a muscle strain in your back – your lumbar spine
  • a muscle strain in your neck
  • a muscle strain in your arm
  • a muscle strain in other parts of your leg such as at the front of your thigh – your quadriceps muscles, which help you to straighten your knee

Symptoms of muscle strain

Muscle strain symptoms vary, depending on how bad your injury is, but may include:

  • pain
  • tenderness when you touch the muscle
  • swelling
  • bruising – it can take up to 24 hours before the full bruise is visible
  • weakness
  • loss of movement

Your symptoms should ease in a few days. The longer your symptoms last, the worse your injury is likely to be. See our section: Grading of muscle strain, below for more information.

If you hear a popping or snapping sound when you hurt yourself, this may be caused by a torn ligament or broken bone. So, go to your local hospital’s accident and emergency (A&E). You should also seek medical help immediately if you have symptoms of a grade three strain.

Grading of muscle strains

Physiotherapists grade muscle strains depending on how bad they are. Strains within each grade may also vary in how mild or severe they are.

Grade one strain

This causes slight damage to your muscle fibres.

  • Your muscle may feel tender.
  • You may have a bit of pain too.
  • You should still have normal strength in your muscle, but you may find it too painful to carry on with your usual activities.

Grade two strain

This is a partial tear of your muscle (part of the way through it). Grade two strains can also vary from milder strains to more severe ones.

  • Your muscle is likely to be painful.
  • You may have a noticeable bruise and swelling over the affected area.
  • You’ll probably lose some strength in the muscle too, stopping you from carrying on with your usual activities.

Grade three strain

This is a full tear of your muscle (all the way through it).

  • Your muscle is usually really painful.
  • You’ll have a lot of swelling and bruising.
  • You may have a lump at either end of your muscle.
  • You may feel a popping sensation when you hurt your muscle.
  • You may lose all strength in your muscle so you can’t use it – if it’s a leg muscle, you probably won’t be able to walk on it.
  • You won’t be able to carry on with your usual activities.

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

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Diagnosis of muscle strain

You’ll usually know if you’ve strained a muscle after an activity, as you’ll feel pain straightaway or shortly afterwards. If so, you probably don’t need to see a healthcare professional and you can manage your symptoms at home yourself. But if you’re not sure what’s caused your symptoms, or they’re very bad or not getting better, contact a physiotherapist or your GP. There are lots of different ways to access physiotherapy – you may be able to refer yourself directly.

A physiotherapist or GP will usually be able to diagnose a muscle strain (pulled muscle) just by examining you and asking questions. They’ll ask you about your symptoms and medical history. They’ll also ask how you hurt yourself.

Not everyone will have further tests, but if your injury is very bad or the cause isn’t clear, you may need to have some. Your physiotherapist or GP may arrange for you to have an ultrasound or a magnetic resonance imaging (MRI) scan. An ultrasound uses sound waves to create an image of the inside of your body and an MRI scan uses magnets and radio waves.

If you have symptoms of a grade three strain, you should go to your local accident and emergency (A&E) immediately.

Self-help for muscle strain

If your muscle strain (pulled muscle) isn’t a bad one, there are several things you can do at home to ease your symptoms and speed up your recovery.


You should follow the POLICE procedure as soon as possible after you’ve hurt yourself. This will give your muscle a chance to heal and to protect it from any more damage.

  • Protect your injury from further harm, for example by using a support.
  • Optimal Loading. It’s important to start moving the muscle again sooner rather than later. Remember to only do what feels comfortable and speak to a physiotherapist for further advice.
  • Ice. Apply an ice pack or ice (or frozen peas) wrapped in a towel. Use for around 20 minutes roughly every two hours. But not while you’re asleep.
  • Compression. Bandage your injury, but not too tightly. Take the bandage off before going to sleep.
  • Elevation. Keep your injured muscle raised above the level of your heart.

For more information, click to open our POLICE infographic.

An image describing the acronym POLICE

Avoiding HARM

In the first 72 hours, you also need to avoid anything that could make your injury worse. It can help to remember these by using the HARM principle.

  • Heat. This includes heat packs, hot water bottles and heat rubs, and saunas and hot baths.
  • Alcohol.
  • Running (or any other form of exercise).
  • Massage.

For more information, click to open our HARM infographic.

An image describing the acronym HARM

It’s important to rest your muscle immediately after an injury. After this, you can start to move around gently and slowly, as long as this doesn’t cause any pain. Then gradually building up your activity until your muscle feels like it’s back to normal. If you’d like advice on building up your muscle strength, ask a physiotherapist.

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.

Medicines for muscle strain

If you need pain relief, you can use over-the-counter painkillers.

  • In the first 48 hours, you can take paracetamol tablets or rub an ibuprofen cream or gel into your injured muscle.
  • After the first 48 hours, you can take ibuprofen capsules or tablets. You shouldn’t take these straightaway as they may delay healing.

Always read the patient information leaflet that comes with your medicine and, if you have any questions, ask your pharmacist for advice.

Treatment of muscle strain

You can usually treat mild muscle strains at home. But sometimes you may need to see a physiotherapist or have an operation to repair your damaged muscle.

Your recovery time will depend on how badly you’ve injured yourself and which muscle is involved. It also depends on how active you need to be afterwards. It may take you a few weeks to be able to walk around as normal and it may take even longer for you to go back to sports. With a very bad strain, it may take months for you to recover completely.

It’s important to keep your muscle moving after an injury, but you may need to make some changes to the way you do things. You may be more prone to hurting that muscle again in the first four to six weeks, so you’ll need to take extra care. To prevent another injury, warm up properly before you exercise.

Physiotherapy for muscle strain

If your injury is very bad or it keeps coming back, physiotherapy may help 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.

The physiotherapist will create a programme of exercises to gradually strengthen and stretch your muscles. These exercises will depend on the type of injury you have and how bad it is.

Surgery for muscle strain

If your muscle strain is very bad, or you have a completely torn muscle, you may need an operation to repair it. Your GP will arrange for you to see an orthopaedic surgeon who will explain which type of procedure you need. You’re most likely to be referred if:

  • you’re not recovering as quickly as you should be
  • your symptoms are getting worse
  • you’re getting new symptoms
  • your symptoms are worse than they should be for your type of injury

The type of operation you need will depend on the location of the tear and muscle involved.

You’ll probably need to see a physiotherapist after your surgery to get back to normal.

Causes of muscle strain

Most people strain a muscle when they’re doing exercise. But you may be more likely to have a muscle strain (pulled muscle) if you:

  • have strained a muscle in the past
  • fall
  • twist suddenly
  • have a heavy blow to your muscle
  • are overweight (which puts more stress on your muscles)

You’re also more likely to tear your muscles if you don’t warm up properly before you exercise or if your muscles are tired or weak. This is particularly important as tired muscles are less able to support your joints well. You can read about ways to protect yourself from strains in Prevention of muscle strains below.

Prevention of muscle strain

To prevent muscle strains, take care when you exercise.

  • Warm up your muscles thoroughly first – do some gentle exercise to get your body ready for more vigorous activity.
  • Cool down properly afterwards – gradually decrease your activity levels until your breathing and heart rate return to normal.
  • Do some gentle stretches while your muscles are still warm.
  • Use the correct exercise or sports equipment.
  • Wear properly fitting sports shoes – and the right shoes for your activity.
  • Replace your shoes when they wear out.
  • Avoid exercising when you’re tired or in pain.
  • Have regular days off exercise between training sessions.

To prevent strains when you’re not exercising, take steps to prevent falls, especially if the ground is slippery.

If you don’t exercise very often, your muscles may get weak, which can make them more prone to damage. So, it’s important to keep them as strong and flexible as possible. You can do exercises to strengthen specific muscles in your body. A physiotherapist can give you advice.

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.

Frequently asked questions

  • The time it takes to recover from a muscle strain (pulled muscle) will depend on how bad your injury is and which muscle you have damaged. It also depends on how active you need to be afterwards. Some injuries take a few weeks to heal, while more severe strains may take months to fully heal. Speak to a physiotherapist for advice on how long you may take to recover in your individual circumstances.

  • The symptoms of a muscle strain will depend on how bad your injury is, but you may experience pain, swelling, tenderness or bruising around the affected area. Your muscle may also feel weak or difficult to move. For more information, see our section on Symptoms above.

  • Yes. You should avoid heat packs, hot water bottles, heat rubs, saunas and hot baths for 72 hours after your injury. You should also avoid anything else that could make your injury worse, such as alcohol, exercise or massage. For more information, see our self-help section above.

  • At the moment, experts aren’t sure whether doing stretches before exercise can prevent an injury or any muscle soreness. But it’s worth doing a gentle warm-up to prepare your body for activity.

    Ideally, you should do a dynamic warm-up, which focusses on moving your muscles through their full range of motion for the activity that you’re about to do. Do this for around five to 10 minutes. As your muscles warm up, they’ll work better so you’re less likely to hurt yourself. If you’re not sure about a suitable warming-up routine for you, ask a physiotherapist for advice.

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

    • your pain and swelling get worse
    • your pain and movement don’t get better after around seven days

    If you have a very bad muscle strain, you should see a physiotherapist for advice. If you have a torn muscle, it's important to get immediate medical help. Go to A&E at your local hospital if you:

    • felt a popping or tearing sensation when you pulled your muscle
    • are in a lot of pain
    • have a lot of swelling
    • find it difficult to move the muscle – you may not be able to walk on it

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Related information

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  • Reviewed by Laura Blanks, Specialist Health Editor, Bupa Health Content Team, August 2019
    Exert reviewer Declan Leonard, Physiotherapist
    Next review due August 2022