What is a Strain?


Have you, or someone you know, ever yelped “I think I’ve pulled something!” during a workout or while playing a game?



Depending on the warmup, or intensity level of the sport, a muscle can be overstretched during an activity leading to a Strain.
Here is a quick physiology review for those of you interested. Muscles are comprised of small fibers, think of spaghetti strands bundled together. This grouping is called a Fascicle, which is covered with tissue called Sarcolemma. Inside the muscle fiber grouping are even smaller groupings of Myofibrils, and inside those Myofilaments which contain Myosin and Actin. It is the interaction of the myosin and actin which cause the contractile motion of the muscle, helping to propel your joint into action.
Unlike a sprain, a strain is injury to a muscle or tendon. During a strain, one quick motion or high force, while those fibers are in their lengthened position can cause them to tear. This can happen in the muscle belly, or more commonly at the muscle/tendon junction.
Depending on the degree of overstretch, the velocity,  and angle of the force  depends on the degree of the tear. Like a sprain, and strain has 3 Grades of severity.
Grade I- Small tear to a portion  of the muscle fibers, about 5-10%. There is immediate pain, along with some redness, or small amount of bruising and swelling.
Grade II- A larger tear, with more significant bruising, swelling and pain. This takes longer to heal, and during this time the joint often feels very “stiff”. It is important however, to keep moving the joint.
Grade III- This is a complete rupture, and the muscle will not work at all. You might hear a “pop”, with surprisingly not a lot of pain, since the nerves are usually severed as well. You can typically feel a balled up muscle under your skin, and see a large amount of bruising from the torn blood vessels. Unfortunately, surgery is usually required in this case.
Rehab
Ice, rest and elevation. Depending on the severity you may need a evaluation from a health care provider for more specific rehabilitation interventions. Surgery maybe required to reattach the muscle, following a period of immobilization of at least 4-6 weeks to allow the muscle to heal. During this time you will not be able to activate the muscle.
If you go to physical therapy,  motion will first be restored to the joint. Then you will begin to activate the muscle throughout it’s full range. Just moving the joint through it’s full range of motion is the beginning of strengthening. If surgery was not required, strengthening progresses depending on what the muscle can tolerate.  However if there was a surgery, resistive strengthening will not be started until 10-12 weeks following the surgery.
Prevention
Slowly ease into a intense workout, or a game (AKA warm up, warm up, warm up). Muscles do not like going from 0-60 mph, in less then 3 seconds. In this case they have a harder time reacting to large stretches and forces. Muscles are also unable to react efficiently if they are fatigued. Stop when you are tired, and allow the muscles to fully recover.
Muscle strains can also occur if there are muscle imbalances in length (flexibility), and in strength. Make sure to include stretching and strengthening to your workout programs. If you have any questions feel free to send me an e-mail at berryhappybodies@gmail.com
References:
Levangie, P. Norkin, C. Joint Structure & Function A Comprehensive Analysis.Davis Company, Philadelphia. 2005.
Contributed by Dr. Alison Cupini

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