A muscle strain or ‘pulled muscle’ occurs when the muscle belly or the tendon which attaches the muscle to bone, is overstretched or torn. Eccentric contractions (the muscle contracting while it is being stretched) can cause this overstretching or tearing.
A muscle strain is a common sports injury. Running, kicking and jumping are actions which frequently result in a muscle strain. An improper warm-up before activity; weak muscles; overuse and insufficient recovery time are reasons why a muscle can become strained. Lifting a heavy object using an improper lifting technique is also a common cause.
Strains are graded on a scale indicating the severity of the injury. A grade I muscle strain is mild, the muscle has been overstretched; it has not torn. The muscle may feel tender and slightly stiff, but a grade I strain should not affect function greatly.
A grade II strain is more severe as the muscle is partially torn. The muscle will feel stiff and painful and the area may be swollen and bruised. Trying to use the muscle will be painful and therefore a grade II strain will affect function.
A grade III strain is the most severe and means the muscle has been completely torn. You will have no muscle function. There may be a dent present over the muscle area and it will very painful and swollen.
Following an assessment, a physiotherapist will be able to diagnose the grade of muscle strain you have sustained.
After any muscle strain it is important to protect the area from further damage. You should rest the affected area for the first 2-3 days following injury, refraining from substantial activity. Applying ice to the muscle can reduce swelling and bruising if used during the first 2-3 days following injury. Ice should not be applied directly to the skin. Place a cloth between the icepack/ bag of frozen peas to prevent an ice burn. Apply the ice for approximately 20 minutes every few hours and, if appropriate, elevate the area. Also, swelling can be reduced by applying compression using an elasticated tubular bandage. Ensure this is not too tight and never wear overnight. Keeping the affected area elevated as much as possible will help reduce any swelling and therefore help reduce pain. It is beneficial to the healing process to begin gentle movements 3 days after your injury as long as they are relatively pain free.
What kind of physiotherapy you receive after a muscle strain will depend on the severity of the strain. A physiotherapist will provide appropriate treatment to regain range of movement, strength and flexibility at the affected area. Undergoing proper rehabilitation after a muscle strain is important in order to reduce the risk of reoccurrence of injury.
Ligaments connect bone to bone and help control the range of movement in a joint to keep it within a stable range. Ligaments also have numerous sensors called proprioceptors that feed back to the brain to let us know where we are in time and space.
If the force through a ligament is so great that it causes the joint to go beyond its normal range then the ligament will break down, resulting in a sprain. Sprains have three grades.
Grade I - A small number of collagen fibres in the ligament are damaged resulting in an inflammatory response with local tenderness over the ligament. Can often be treated with good advice and self management.
Grade II - A significant number of fibres within the ligament are damaged causing a larger inflammatory response, increased swelling and intense pain. Physiotherapy is required for these injuries.
Grade III - Complete rupture of the ligament. Large amount of swelling, instability of the joint and intense pain. May require surgery to restore the stability to the joint
The term "itis" means inflammation and we now tend to use the word tendonopathy for a problem with a tendon as it isn't always clear if the tendon is actually inflammed or not. Either way what ultimately happens is that the tendon gets over loaded through repitive activity or poor control of that activity. The tendon will get small microdamage or tears as a consequence. If the rate of these microtears is greater than the rate of recovery, this will lead to a prolonged inflammatory phase known as tendonitis. That will give way to the tendon scarring or degenerating and this then becomes a tendonopathy, as the tendon isn't necessarily inflammed anymore but there is pain, stiffness and limited ability to load the tendon to perform tasks.
The physiotherapists at spinal physio will be able to diagnose tendonopahties but more importantly identify the mechanisms as to why it developed and treat accordingly.