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Categories: Strength Training

Pulled Muscle Treatment Guide: Recover Fast From Muscle Strain

By Charlie Seltzer, MD / December 13, 2016

You may have been here: you’re lifting a weight you’ve lifted a hundred times before and you feel a tweak. A wave of anxiety rushes over you and you think, “Oh no. I can’t be injured. I am going to lose everything I’ve worked so hard for.”

You move your freshly injured body part around and pray that the twinge goes away. You do another set, but it feels no better.

You may even try to push through the workout, possibly with lighter weights. You change around your exercises. You pray some more. You run through every devastating scenario you can think of in your head as you leave the gym, scared you won’t be able to shake off the injury in the morning.

The good news is, yes, you will be able to lift again. The human body is remarkably resilient, and with proper diagnosis and appropriate treatment, you can minimize your recovery time and get back to making progress sooner.

Soft tissue injuries (injuries to muscles, ligaments and tendons) are the most common type of injury amongst regular exercisers. They can be acute, i.e. occurring at an identifiable point in time, or chronic. Chronic injuries often are the result of overuse and repetitive stress (think shoulder pain in a tennis player). Soft tissue injuries result in pain, swelling, and loss of function. Acute injuries that are not identified and treated properly can easily turn into a chronic injury, which can be very frustrating and mentally challenging.

What Exactly Is A Pulled Muscle?

A pulled muscle is a colloquial term for a muscle strain, which is an injury to a muscle caused by overstretching of the muscle fibers.1 Strains can occur acutely or develop over time from repetitive use. It is important to distinguish strains from the microscopic tears to muscle, which occur as a result of proper weight training. Muscle adaptation to progressive resistance training depends on, to a significant degree, this type of “injury,” which is desired. A strain, on the other hand, is not normal and is most definitely not a desired outcome of exercise.

What’s The Difference Between A Muscle Pull & Tear?

Muscle tears are usually painful and result in swelling and bruising (as blood leaks from torn vessels in the injured area). Depending on the degree of the tear (i.e. partial/minor versus full), there will be varying levels of difficulty in moving the muscle. For example, in a full rotator cuff tear, it is often impossible to raise the arm over the head. If you are in the gym and feel a tweak or a sharp pain followed by swelling and bruising, a muscle tear2 is likely.

Muscle tears are divided into grades based on the degree of injury.3 Grade 1 tears are limited to a few muscle fibers. The sheath that encases the muscle, known as the fascia, remains intact. In Grade 2 tears, more fibers are injured but the fascia remains intact. Grade 3 tears involve still more fibers damaged and the fascia is partially torn. And finally, a Grade 4 tear is defined as a complete tearing of the muscle and fascia.4

What Are The Best Ways To Prevent A Pulled Muscle?

Proper precautions can minimize your chances of injuring a muscle:

  • Warm-up with some type of cardio to increase body temperature. Warmer muscles are more elastic and thus less likely to tear.5
  • Perform several lighter, progressive sets of initial exercise(s). This will further increase temperature and blood flow to the target muscles. It also primes the nervous system for the upcoming work and reduces risk of injury.6
  • Do not perform static, or traditional, stretching prior to resistance training. This has been shown to weaken muscles and likely predispose to injury, and can possibly decrease performance.7
  • Perform flexibility training, but not before resistance training. More flexible muscles are less prone to injury. Stretching after a workout is very helpful in injury prevention over the long run.8
  • Leave your ego at the door. No one knows how much you can bench press when you’re walking down the beach. Lift under control with proper form. Your body will thank you.

Pulled Muscle Treatment

If you believe you have torn a muscle, use the PRICE formula.9

P: Protect the area from further injury. In other words, if you just hurt yourself bench pressing, do not do another set.

R: Rest the affected area. Avoid any pain inducing movements. Rest is important for recovery, but resting too long can result in deconditioning and delayed recovery. For this reason, I think it is a good idea to see a sports medicine physician for any pain lasting more than a day or two.

I: Applying ice to the area immediately will help reduce pain and swelling. 20 minutes of ice every hour while awake for the first day is a common recommendation, though you should never apply ice to bare skin.

C: Compression (using an elastic wrap) can provide supports and decrease swelling. Do not wrap too tightly and do not use for prolonged periods, as this can hasten deconditioning.

E: Elevating the affected area, when possible, may also accelerate healing.

Anti-inflammatory medications (like Motrin or Aleve) can help with pain and swelling, though certain experts believe it is counterproductive to inhibit the body’s own response to injury. Tylenol does not have significant anti-inflammatory effects but may provide pain relief.

I recommend seeing a specialist for all but the most minor injuries. A doctor can help determine the extent of the damage and how to best treat it. A lack of severe pain does not necessarily mean the injury isn’t severe. Additionally, a minor injury can quickly become a major one if not handled properly.

To keep in shape, make sure your muscles are in shape, so treat them well.

Show 9 References

  1. Strains. ADAM Encyclopedia. Apr 2013.
  2. A muscle strain is actually a tear of the muscles (they are synonymous) – the severity just depends upon the degree of the tear.
  3. Safran M, Seaber A, Garrett W. Warm up and muscular injury prevention an update. Sports Med; Oct 1989; 8:4 239-49.
  4. Tears typically occur during eccentric contractions as opposed to concentric.
  5. Elliot M, Zarins B, Powell J, Kenyon C. Hamstring Muscle strains in professional football players. Am J Sports Med April 2011 vol. 39 no. 4 843-850
  6. LaBella C, Huxford M, Grissom J, Kwang-Youn K, Peng J, Christoffel K. Effect of neuromuscular warm up on injuries in female soccer and basketball athletes in urban public high schools.
  7. Gergley J. Acute effect of passive static stretching on lower-body strength in moderately trained men. J Strength Cond Res. 2013 Apr;27(4):973-7.
  8. Chen C, Nosaka K, Hsin-Lian C, Ming-Ju L, Kuo-Wei T, Chen T. Effects of flexibility training on eccentric exercise induced muscle damage. Am Jour Sports Med; 2011: 491-500.
  9. Muscle Strain. WebMD. 2013.

18Comments

  • Marc Perry, CSCS, CPT says:

    This is a very comprehensive guide, thanks for putting in the time to gather all this information and also make sure the claims were supported by research. Great article.

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  • Uzma says:

    Simple and quite informative.

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    • Kristin Rooke, CPT says:

      Glad you found the article informative!

      -Kristin, BuiltLean Coach & Managing Editor

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  • Your Name... says:

    I got a lumbar sprain. Who knew you could sprain a muscle in your back lol

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    • Kristin Rooke, CPT says:

      I'm sorry to hear you got a lumbar sprain! If the pain persists, I would recommend scheduling an appointment with your primary care doctor or physical therapist. Rest up, take it easy, and I hope you have a fast recovery!
      -Kristin, BuiltLean Coach & Managing Editor

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  • edy says:

    I currently have pain in my ankle as a result of a collision during soccer practice. I feel heaviness around my legs. What should I do?

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    • Kristin Rooke, CPT says:

      Hi Edy,

      Getting injured while playing sports is never fun. I would recommend scheduling an appointment with your primary care doctor or a physical therapist. A doctor will be able to assess and diagnose the injury, and provide you with information about next steps. If you see a physical therapist, they'll be able to help you develop a stretching and strengthening program to rehabilitate your ankle so you can return to playing soccer. Hope that helps!

      -Kristin, BuiltLean Coach & Managing Editor

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  • Gina says:

    I pulled a muscle in my groin a couple months ago... someone suggested icing it for 20 minutes daily to help speed recovery. I thought icing an injury was only helpful right after the injury occured? In your opinion, will it help speed recovery weeks or months later?

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  • Andrew says:

    Gina,

    Icing is even helpful for recovery without injury. Icing does two things as far as I know. 1- It reduces inflamation and swelling by limiting the physical response to injury. When the body is torn or broken, it bleeds causing swelling. More swelling, more inflammation etc...the cold causes arteries in this scenario to contract, limiting the bleeding and allowing for faster healing. I am sure it is much more complex than this explanation.
    2. When operating normally, the body will respond to cold by moving blood to the affected area. This brings blood and nutrients to wounds or broken down muscles and aids recovery.

    Leaving ice on for two long cycles the bodies response back to restricting blood flow, hence the 20 mins/hour recommendation.

    Professional athletes take ice baths or enter Cryo chambers to experience the benefits of icing after strenuous activity to speed recovery, even after practices, not just when injured.

    Technically, performing athletic movements at the bodies peak intensity will result in some form of wear and tear, one just doesn't want it to result in a strain or torn muscle. Yet PRICEing is almost always an afffective way to speed recovery of a muscle group.

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    • Kristin says:

      Thanks for sharing your insights and experiences, Andrew! You definitely share some great information about icing, and how it can speed recovery.
      -Kristin, BuiltLean Coach & Managing Editor

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  • Dave says:

    So...I have recurring lower back muscle "spasms" about every 18 months I do something seemingly simple ie put on my shorts. Right now I'm on a heating pad.
    Every time I gingerly get up while trying to protect those lower back muscles I enivitably trigger another spasm. I want to get up and get on with my recovery but are these recurring spasms causing more damage? Or should I just push through them?

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  • Chelsey says:

    I was holding too many bags and there was a really heavy one and my back aches and so does my arms (elbow up). I don't know what to do

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    • Marc Perry, CSCS, CPT says:

      Hi Chelsey, if you don't know what to do, set up an appointment with a doctor or physical therapist. I'm sorry to hear you hurt yourself

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  • Siobhan Mckinney says:

    I did a boot camp workout yesterday, silly I know because I'm 46 yrs an the most exercise I do is walk two dogs twice a week for 5k .. yesterday evening an this morning I can hardly move my legs from me knees to the top of my thighs , it's extremely sore to sit ,, is there anything I can do to ease the pain . Thank you

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    • Marc Perry, CSCS, CPT says:

      Hi Siobhan, unfortunately, the best thing may be to give it time. It doesn't sound like you have a pulled muscle, but muscle soreness. Check out my Muscle Soreness article. One effective way to reduce soreness is to actually increase blood flow by walking / doing light exercise. Sounds counter-intuitive, but it works. I am certainly not diagnosing your condition, be sure to see a doctor or physical therapist, just giving you some ideas! Hope you feel better soon.

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  • Jeffrey says:

    I was at work and I lifted some boxes over head and right after I felt throbbing in my right shoulder blade. It didn't hurt then so I decided to keep working.. it's been a week now and I still have nagging throbbing in shoulder with a little pain. Does that sound like a pulled muscle?

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    • Marc Perry, CSCS, CPT says:

      The shoulder is a complex joint because it's really 4 joints. There are so many possibilities, the best course of action is to see a doctor or physical therapist and get evaluated. Hope you feel better soon, Jeffrey.

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