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Muscle Strain

By: Robert H. Sheinberg, D.P.M., D.A.B.F.A.S., F.A.C.F.A.S.


An injury to the muscle that has occurred most commonly following an athletic activity. The muscle has stretched to its elastic limit but has not torn. 


Strains are more common when a person has done an activity without proper warming up. The warm up should include light exercises simulating the activity and muscle stretching. Muscle strains are usually caused by poor muscle flexibility. During loading of the muscle tendon unit powerful eccentric contraction (muscle lengthening contraction) can cause a strain to the muscle due to the increased tension generated by the muscle during this type of contraction. Usually less common during the concentric contraction (shortening of the muscle). Excessive stress to a muscle in a person or athlete doing an exercise or activity that they are unaccustomed to (i.e. strain of the lower back caused by excessive lifting, strain of the calf, excessively jumping when unaccustomed to it). 


Soreness to the muscle usually develops within 24 hours of the activity. Depending on the severity of the condition a partial loss of function and strength are usually seen in the affected muscle group. There is a slight loss of muscle strength. Tightness to the affected muscle is felt. Difficulty walking may accompany it. Rarely is there any swelling or discoloration associated with these injuries.


Treatment is usually aimed at resting the muscle. Ice to the affected area (20 minutes on, 40 minutes off) for the first 48 hours may provide benefit. This will lessen the inflammation to the muscle region. The application of the heat 3 or more days later is beneficial before an activity to warm up the muscle. The muscle should then be lightly stretched to improve its flexibility. If there is pain associated with using the body part, rest is necessary until full range of motion is felt. This is followed by stretching the muscle to resume the muscle tendon length and strengthening the muscle to prevent recurrence. It is importance to focus on concentric and eccentric muscle contractions. 


Prognosis is excellent if the muscle has healed completely. Incomplete healing of a muscle followed by concentric or eccentric activity may predispose the muscle to a complete muscle tear and a more serious problem.