About Muscle Pulls

A pulled muscle is another way of describing a muscle strain, which occurs when the fibers in a muscle are stretched too far. This can lead to swelling, pain and muscle cramps or weakness. Muscle strains, while not often serious, should be treated immediately.

Features of Pulled Muscles

• While anyone can pull a muscle, this injury is generally associated with overuse, often by an athlete or someone working in a job that requires heavy lifting. They can also occur via overstretching or by direct injury to the area.
  The most common areas of muscle strain are the back and the hamstrings---the muscles on the back of the thigh. Age, fatigue, nerve impingement in the lower lumbar spine, lack of strength and flexibility contribute to muscle pulls, especially those in the back and hamstrings.

Identifying the Severity of a Muscle Strain

• Muscle strains are assigned to one of three categories, depending on their severity.
  *Grade 1: Mild discomfort, maybe a little tenderness where the pull occurred, but without noticeable swelling.
  *Grade 2: More discomfort, some swelling and possibly some bruising. You may need to briefly stop activities like running.
  *Grade 3: Painful when walking. You may also experience muscle spasms, swelling and significant bruising. If you suspect you have a Grade 3 muscle strain, you should call your doctor.

Acute Treatment

• You can usually treat a Grade 1 muscle injury at home. For a Grade 2 strain, a physical therapist can design an exercise program to help with your recovery. If you suspect a Grade 3 tear, see your physician, as you may need a surgical repair.
  No matter which category you experience, start treatment immediately. Remember the mnemonic PRICE---Protection, Rest, Ice, Compression, Elevation. Lie down and keep an icepack on the spot where you feel the pain for 15 to 20 minutes several times each day for the first 48 to 72 hours. For muscle strains in your limbs, use a lightweight compression bandage, but be careful that it's not too tight. If it's painful to walk, use crutches. Get plenty of rest, but don't stop all activity. Movement can be helpful. If your pain and swelling don't improve, call your doctor.

Rehab Considerations

• Begin gentle muscle stretching exercises immediately, as long as they don't increase your pain. It's not uncommon to get immediate relief followed by an increase in pain. This should go away after you repeat the stretching exercises. As your pain and swelling decreases, slowly add strengthening exercises to your program.
  To avoid a chronic problem, be sure to fully recover before resuming the activity that caused the damage in the first place.

Prevention/Solution:

• Age, fatigue, gender and lifestyle can make you more vulnerable to chronic muscle strains. You can't change some of those factors, but you can get adequate rest and maintain strength and flexibility through a regular program of stretching and strengthening. Always warm up before starting an activity; if you're new to an activity, start slow. Don't overdo---that becomes a muscle pull just waiting to happen.