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Treating Muscle Strains, Pulls, and Tears

DrSugar: Dealing With a Strained Muscle?

DrSugar is in the house! And she's answering your health-related questions.

Dear DrSugar,
I think I strained my hamstring sprinting at the end of a run. I don’t think I pulled or tore it — there was no bruising. I guess I am not as in shape as I used to be. I iced it when it started feeling weird, about an hour to two after my workout, but when do I start heat? How long should I wait to stretch it? Is strength training a good idea?
— Harming the Hammies

Thank you so much for this great question, as I’m sure there are many readers out there who have suffered a muscle strain and had similar questions regarding how to manage the condition. To clarify, I’m sure readers out there are wondering . . . well what’s the difference between a muscle strain and a muscle sprain? A muscle strain is a stretching or tearing of a muscle or tendon and often occurs in the lower back and in the hamstring muscle in the back of your thigh. A muscle sprain is a stretching or tearing of ligaments (tough bands of tissue that connect one bone to another in a joint) — think ankle sprain.

Keep reading for advice on treating a muscle strain.

WebMD describes the symptoms of a muscle strain like this: swelling, bruising or redness, pain in the affected area at rest, pain in the affected muscle when it is used, weakness of the muscle or tendons, and possible inability to use the muscle at all. There are risk factors and causes of muscle strains. The distinction should be made between a chronic and acute muscle strain. According to the Mayo Clinic, an acute strain occurs when a muscle becomes strained or pulled (or possibly even torn), when it stretches abnormally far or suddenly. Acute strains can occur commonly after lifting heavy items or lifting items improperly, running/jumping/throwing, or after slipping and falling. A chronic strain results from prolonged, repetitive movement of a muscle, either from a job or during sports. Other risk factors include working out improperly or too hard when your muscles are not conditioned, improper warm-up and stretching, and fatigue.


In terms of what distinguishes a mild strain from a more serious strain, Mayo Clinic recommends making an appointment with a doctor if you have any of the following symptoms: if you can’t walk more than four steps without serious and debilitating pain, if you can’t move the affected joint/muscle, if you have numbness in any part of the injured area, or if you see redness or red streaks spreading out from the area of injury. According to WebMD, the physician will perform a history and physical exam to determine the extent of the injury (in which determining if a tear is present and if so, the severity of the tear). If the muscle is completely torn, there can be prolonged recovery with a longer healing time and possible need for surgery.

For initial treatment of a muscle strain the Mayo Clinic recommends the P.R.I.C.E. approach: protection, rest, ice, compression, and elevation. Protection involves immobilizing the area using an elastic wrap, splint, or sling. If the strain is severe, protection may be a cast or brace that would be placed by a physician. Rest involves avoiding activities that cause pain, swelling, or discomfort. Mayo Clinic advises that you can likely still exercise other muscles that are not injured to prevent deconditioning. They also recommend icing the area immediately after the injury for 15 to 20 minutes at a time, repeating every 2 to 3 hours for the first few days following the injury. Cold reduces pain, swelling, and inflammation. However, they do report that one should not ice the area without speaking with your doctor if you have vascular disease, diabetes, or decreased sensation. Compression involves using an elastic wrap to reduce swelling, however should not be wrapped too tightly and should be loosened if pain increases, the area becomes numb, or swelling occurs outside of the wrapped area. Finally, elevation will reduce swelling by draining excess fluid.

To answer your question regarding the use of heat, WebMD recommends using heat when the swelling has lessened and advises that early use of heat can actually increase swelling and pain. Finally, both WebMD and Mayo Clinic advise a slow and gradual return to using the injured area, starting about two days after the initial injury. They also recommend not working the affected body part until the pain has significantly gone away. Your physician can also determine your activity restrictions and help facilitate rehabilitation exercises (if required), based on the severity of your strain.

Have a question for DrSugar? You can send it to me via private message here, and I will forward it to the good doctor.

DrSugar's posts are for informational purposes only and should not be considered medical advice, diagnosis, or treatment recommendations. Click here for more details.

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