Muscle Strains

Apr 11, 2016

Strains are injuries involving muscles or tendons and are frequently referred to as muscle “pulls.” Strains and sprains are often confused both in terminology and evaluation. Remember that strains involve a stretch or tear of muscle and/or tendon tissue and sprains involve ligament and joints. Strains are caused when the muscle is stretched beyond its normal limits. They are often associated with abnormal muscle contractions caused by fatigue, mineral imbalance and/or strength and flexibility imbalance. This is a common injury in sports often affecting the muscles in the leg, groin and hip. Muscle strains are graded according to severity:

  • 1st degree – mild over-stretching of a muscle.
  • 2nd degree – moderate “over-stretching” of a muscle, some tearing of the fibres.
  • 3rd degree – severe tearing or rupture of the muscle or tendon.
Signs and Symptoms:
  • Muscle spasm
  • Swelling and possible discolouration
  • Tightness in movements and/or partial loss of function
  • Possible deformity (indentation, bump)
  • Point tenderness
  • A feeling of a direct blow with no history
Specific Areas of Concern:

Quadriceps. If the athlete can bend the knee to a 90 degree angle or beyond, the strain is mild. If not, the injury should be considered moderate to severe. The signs and symptoms are very similar to a “Charley Horse,” except without the history of trauma.

Hamstrings. Hamstring strains tend to reoccur. A severe strain may involve an “avulsion fracture,” which occurs when the muscle pulls away from the pelvic bone.

Calf. For less serious strains, placing a heel lift in both shoes will help to reduce the stress on the injured muscle.

Groin. Involve the muscles of the inner thigh (adductors). Several weeks away from full participation may be required, as groin strains tend to reoccur.

On-Site Management:

Control Inflammation. The practitioner should apply the P.R.I.C.E. (Protection, Rest, Ice, Compression, Elevation) principle. Ice massage before and after activity can be helpful. Therapists can apply various electrical modalities to assist in controlling inflammation.

Refer for a Correct Diagnosis. If the strain is severe, the athlete should be sent to a physician with the complete history, such as, how did it occur? Was the muscle sore or stiff at the beginning of activity? Physicians may prescribe anti-inflammatory medication.


Control Abuse. For minor strains, have the athlete gently stretch the muscle. Where pain and loss of function are severe, prevent the athlete from walking on the injured limb or stretching it. Do NOT massage, as it increases the blood flow to that area, counteracting the desired effect of the P.R.I.C.E. principle.

Return to Activity. For Grade II and III strains, the athlete should not return to activity until he or she has their physician’s approval. Strength and flexibility in the injured leg should be the same as the uninjured side. If the athlete’s sport involves quick acceleration movements, a very graduated return to activity must be followed.

  • Pre-season strength and flexibility training.
  • Warm-up prior to activity.
  • It is also important to be well hydrated at all times as muscle cramps and strains are often associated with abnormal muscle contractions as caused by fatigue and dehydration.


– SportMedBC

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