Muscle Strains – What is the Ideal Treatment? – Matthew Osborn AEP

In any sports or high intensity exercise, muscle injuries such as strains or tears are quite prevalent and can lead to loss of function and extreme pain. Muscle strains typically happen when a tensile force exerted on a muscle may lead to excessive stretching of the muscle fibres (from overuse, fatigue, or improper technique) and can cause a tear close to the muscle attachment to the tendon. This can happen with athletes, regular gym goers or even the older population.  There are different categories when it comes to muscle injuries, which can determine the time it takes to heal and return to normal activities.  These include;

Grade one – a mild strain and a bruise with symptoms such as bruising and swelling.

Grade two – Moderate strains which can cause greater damage and loss of function of the muscle can occur and typically resolves in two to three weeks.

Grade three – Typically a tear across the entire cross section of the muscle which results in intense pain and loss of function. Typically, this requires surgical management and takes four to six weeks for it to heal and three to four months of rehab work.

So how are these injuries treated?

Following the acute phase of injury, exercise is the optimal treatment for rehabilitation.   Light exercises can be completed roughly a week following an injury and depending on the stage of treatment, different types of exercises will be prescribed.

  • Isometric exercises– These exercises typically consist of contracting the muscle where the muscle length doesn’t change but tension increases (for example, a wall sit) and should be completed first. Once isometric exercises are progressed by adding weights and don’t increase pain isotonic exercises can be done.
  • Isotonic exercises– These are exercises where the muscle length changes during the exercises, with a constant load (e.g. A squat). This is done to promote blood flow and assist with the recovery, whilst starting to build up strength.
  • Following this, isokinetic exercises can be done once the above exercise can be done without pain.  Isokinetic exercises are typically those like cycling where the muscle contraction occurs frequently at a constant load.

Following initial acute rehabilitation with a physiotherapist, if there is continued pain and strength work needs to be completed, it is best to see an Accredited Exercise Physiologist to improve function and assist with return to normal activities.