A strain to the muscle or muscle tendon is the equivalent of a sprain to ligaments. A muscle strain occurs when muscle fibers cannot cope with the demands placed on them by exercise overload and leads to tearing of the fibers. It is a contraction-induced injury in which muscle fibers tear due to extensive mechanical stress. This mostly occurs as a result of a powerful eccentric contraction or over-stretching of the muscle. Therefore, it is typical for non-contact sports with dynamic characteristics such as sprinting and jumping.[1]. Muscle Injury Classification[edit | edit source]Muscle lesions are classified as grade I, II, and III based on the number of fibers disrupted according to clinical and imaging investigations[2][3]: Grade I (mild) strains affect only a limited number of fibers in the muscle. There is no decrease in strength and there is a fully active and passive range of motion. Pain and tenderness are often delayed to the next day. The above classification is the traditional muscle injury injury grading by consensus in Munich.[4] Read the full article here: The table provides an overview of some of the newer muscle injury classification systems.
Predisposing Factors[edit | edit source]Three types of muscle are at possible risk of injury:[1]
The video below gives a good summary of the salient points [9] Signs and Symptoms[edit | edit source]Symptoms of muscle strain include:[10]
Risk Factors[edit | edit source]Strains are not restricted to athletes and can happen while doing everyday tasks, Athletes are more at risk for developing a strain. It is common for an injury to occur when there is a sudden increase in duration, intensity, or frequency of activity.[11] Treatment of Acute Strains[edit | edit source]Muscle strain treatment depends upon an accurate diagnosis from your health professional. The severity of your muscle strain, and what function or loads your injured muscle will need to cope with, will impact the length of your healing and rehabilitation process. The first-line treatment for a muscular strain in the acute phase includes five steps commonly known as P.R.I.C.E.[12]
[13] The first treatment is usually an adjunctive therapy of NSAIDs and Cold compression therapy. Cold compression therapy acts to reduce swelling and pain by reducing leukocyte extravasation into the injured area.[14] NSAIDs such as Ibuprofen/paracetamol work to reduce the immediate inflammation. New treatments are an expanding area. A growing number of health care professionals are using biological factors to favor the healing of muscle injuries. However despite relatively widespread use, the scientific evidence behind such products is scanty, and the results probably less dramatic than what reported in the lay literature.[15] The use of platelet-rich- plasma (PRP) injections which have been shown to accelerate recovery from non-surgical muscular injuries.[16] In the second phase, mobilization must begin as soon as possible but gradually and within the limits of pain, Mobilisation has shown to improve injured skeletal muscle regeneration. The cardiovascular conditioning program should be performed with a low impact. Since core stability programs have been shown to improve results in terms of lower re-injury rates and enhanced return to play, they must be introduced along with the specific rehabilitation program of the injured muscle. After 2 or 3 weeks of injury, tension should be applied in the line of normal stresses for proper remodeling anatomically and functionally. Proprioceptive and endurance training is used in the advanced stages of rehabilitation. After the athlete has regained full, pain-free active ROM and over 90% strength bilaterally, full participation is allowed. The maintenance programs should be continued to avoid any dysfunctional adaptation or compensation.[17]. References[edit | edit source]
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