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Experiencing a muscle pull is unpleasant, and determining whether it’s a serious strain requiring medical attention can be even more daunting. Many of us have encountered muscle strains, cramps, soreness, and tightness, but the challenge lies in the fact that these issues often produce similar levels of discomfort. Here’s how to identify a true muscle strain and the steps you can take to address it.
Sharp pain is usually a clear sign of something serious, but it can also be quite complicated. You might find yourself questioning whether you should continue exercising later that day or in the following days. Therefore, it’s crucial to confirm that you’re dealing with a muscle strain and not another type of pain, such as delayed-onset muscle soreness (DOMS). This is a common error, but fortunately, there are specific signs to watch for.
Is It Actually a Muscle Strain?
To clarify, a pulled muscle is the informal term for a muscle strain. A strain refers to the traumatic tearing of muscle tissue, though “pulled muscle” is often used to describe less severe (yet still painful) cases—all of which involve some degree of tearing. The severity of the strain and the level of pain you experience typically depend on the number of muscle fibers torn (though pain can sometimes develop gradually). In rare instances, the muscle may completely rupture, resulting in a muscle rupture, which is a far more severe injury.
A muscle pull typically occurs abruptly, and you’ll immediately sense that something has gone terribly wrong. Since a pulled muscle can often be mistaken for other injuries like sprains or hernias, a key distinction, as noted by Paul Ingraham, a science writer at PainScience.com, is that a muscle strain causes weakness in a single muscle or muscle group and makes muscle contractions painful.
According to Justin Kobbe Solace, a board-certified massage therapist and pain management expert at Hybrid Health, you’re likely to experience more pain during the eccentric (lengthening) phase of movement and during resistance tests. In severe cases, symptoms like swelling, redness, skin warmth, and bruising may appear. If this happens, don’t hesitate to seek medical attention.
How Muscle Strains Occur
The frustrating part about muscle strains is that they don’t require extreme activities. For instance, a family member of mine injured his back simply by lifting his dog. Strains often occur when muscles are pushed beyond their limits, whether from excessive stretching, sudden movements (like slipping or falling), or lifting heavy objects (such as a 60-pound Golden Retriever, as in my cousin’s case) in an awkward position.
Although any muscle can be strained, larger muscles like the hamstrings, calves, quads, biceps, and back are more prone to injury. Sports such as basketball, football, and track are particularly known for increasing the risk of strains. From my own track and field experience, I’ve witnessed and experienced numerous hamstring strains.
Essentially, explosive movements—such as quick directional changes, sudden sprints, or high jumps—increase the risk of overstretching and tearing muscles, particularly if you haven’t warmed up properly, have generally weak muscles, or are fatigued. However, muscle strains can also result from repetitive motions or overuse, such as in rowing, golfing, running, or assembly line work, which can cause gradual wear and eventual tearing.
On the flip side, if you wake up with stiffness and pain in certain areas, it’s likely just soreness. While it might be uncomfortable for a day or two, take comfort in the fact that your muscles might be growing stronger.
Stretching Can Worsen the Injury
Your initial reaction might be to stretch the strained muscle, but consider this: if the strain resulted from overstretching, further stretching it to its full range of motion won’t help. Instead, the best approach is to avoid activities that irritate the injured muscle and allow it sufficient time to heal.
The standard initial treatment for muscle strains is R.I.C.E.—rest, ice, compression, and elevation. This approach is widely recommended for various soft-tissue injuries. However, as noted in a paper from the Journal of the American Academy of Orthopaedic Surgeons and another in the Journal of Athletic Training, the effectiveness of the I.C.E. components in R.I.C.E. for muscle strains hasn’t been thoroughly studied. Despite this, their use remains widely advised.
In other words, icing, compression, and elevation may not directly treat the muscle strain itself, but they can at least help alleviate the pain temporarily.
Pushing through the pain and exercising too soon can exacerbate the injury, potentially leading to re-injury or chronic issues, according to Solace. For minor strains, gently moving the muscle through its range of motion after a few days of rest can be beneficial. However, stop immediately if pain occurs. Solace emphasizes that this approach promotes blood flow, which aids in the healing process.
While many minor strains heal with time and adequate rest, worsening pain or a lack of improvement after several days signals the need for medical attention. A specialist in musculoskeletal medicine is ideal, as not all general practitioners are equipped to accurately diagnose muscle-related injuries.
Consult your insurance provider or primary care physician for a referral to a specialist in muscular or sports injuries. If you’re uncertain about the nature of your injury, seek out a doctor or physical therapist who focuses on the specific area of discomfort. For instance, if your lower back is affected, a spine specialist would be the best choice.
Tips to Avoid Future Muscle Strains
You’ve likely been told to stretch and stay “flexible” to avoid muscle strains. However, a review of research on the topic reveals that regular stretching doesn’t prevent muscle pulls or injuries in general. So, what actually works? A proper warm-up, though it’s worth noting that an effective warm-up doesn’t always involve static stretching.
Instead, concentrate on moving your muscles and joints through a full range of motion using “dynamic stretching”. Prepare for your workout by performing lighter versions of your planned exercises. For instance, if you’re warming up for squats, start with bodyweight squats and gradually progress to your actual workout sets. In colder weather, dedicate extra time to warming up. Here are additional tips to consider:
Determine when you’re ready to resume: Returning to your regular routine should depend on the restoration of your strength and range of motion, not a fixed recovery timeline. This varies based on the strain’s severity, but the goal is to avoid pain. When you restart, increase intensity gradually each week, paying attention to how your injury responds.
Avoid intense activity when fatigued: Fatigue increases your risk of injury, so avoid pushing through workouts if your form, focus, or technique begins to suffer.
Ease into new activities: When starting a new program, exercise, or sport, take it slow to learn when to push harder or hold back.
The encouraging news is that our bodies are incredibly resilient and can grow stronger with effort. For recovery from serious injuries, professional guidance from a physical therapist, trainer, or doctor is essential to ensure proper execution of exercises and stretches, helping to strengthen and maintain the health of the injured muscle.
Illustration by Fruzsina Kuhari.
