Muscle Strain

Medical Treatments and Alternative Therapies

By Robin Brain

A strain is an injury to muscles and perhaps tendons fibrous bands that connect muscles to bones. It should not be confused with a sprain, which involves stretching or tearing of ligaments the fibrous bands that connect bones and strengthen and stabilize joints. There are two general categories of muscle strain: acute injury from sudden and excessive pressure in which muscle fibers tear, resulting in bleeding, swelling, pain, and loss of strength and function; and overuse injury, in which muscles become stretched from chronic stress. In the latter, muscles are sore, but they are not ruptured and there is no loss of strength. Tears are likely to occur as muscles are subjected to sudden and extreme stress when cold, fatigued, or weak from disuse. The hamstrings (at the back of the thigh) are susceptible to such injury. For example, a torn hamstring might result when a normally sedentary per ­ son plays an intense game of tennis. In contrast, overuse injuries result from muscles being repeatedly stressed over a longer period, such as when gardening. Back and groin muscles are commonly affected, although the legs and shoulders are also vulnerable.

Diagnostic Studies And Procedures

A doctor usually can diagnose a muscle strain by examining the area, but may order an X- ray to rule out a fracture or other bone injury. In unusual cases, an MRI will be ordered to rule out a torn ligament. Another diagnostic tool is electromyography (EMG), in which needle electrodes are inserted into muscles to measure responses electrically. A chronic muscle problem may also be assessed by a specialist in sports medicine or a physiatrist, a doctor who specializes in physical rehabilitation.

Medical Treatments

Self-treatment is sufficient for most simple strains . However, a doctor should be seen if there is no improvement after three or four days, or as soon as possible if there is marked swelling and loss of muscle function. In such cases, a nonsteroidal anti inflammatory drug such as indomethacin may be prescribed to reduce inflammation and swelling and alleviate pain. Research suggests that these drugs should not be taken immediately after an injury; waiting at least one day allows the inflammation to help rid the injured area of damaged cells. A muscle relaxant may provide added if spasms are a contributing factor. injection of cortisone into the injured area can also reduce both the swelling and inflammation. Surgical repair might be necessary if a tendon has been ruptured or torn.

Alternative Therapies


This therapy may reduce soreness of a pulled muscle, but it is unlikely to be helpful for a ruptured muscle or tendon.

Alexander Technique

This approach is of greatest benefit as a preventive measure. A therapist will study the individual’s body movements and provide instruction in correcting any habits that could contribute to an injury.


These practitioners treat strained muscles in the neck, back, and shoulders by manipulating and realigning the spinal column. They may also use diathermy to relax tensed muscles.

Massage Therapy

Swedish massage and similar therapeutic techniques are favored by many athletes, professional dancers, and others whose muscles are often strained by overuse. The massage is sometimes combined with heat treatments or hydrotherapy in the form of hot and cold soaks, whirlpool baths, underwater massage, and needle showers.


This method of deep, often painful manipulation is intended to break down excessive connective tissue that interferes with the proper alignment of the body.

Yoga And Meditation

These and other relaxation techniques can help alleviate muscle soreness due to stress.

Self Treatment

RICE, an acronym for rest, ice, compression, and elevation, is the preferred self-treatment for a pulled muscle. The injury should be rested immediately, and ice packs applied for 10 minutes every half hour during the first day. (To create a soft ice pack, fill a plastic bag with crushed ice or frozen peas or corn.) Compression is accomplished by wrapping the injured part in an elastic bandage. Depending upon the site of the injury, it can be elevated by using a sling, pillow, or other support. After 24 to 36 hours, you may switch to a heating pad or hot packs. (These should not be used sooner, because heat increases blood flow to the area and may contribute to bleeding and swelling.) At this time, it is all right to take an anti inflammatory medication that contains aspirin or ibuprofen. Acetaminophen will reduce pain but not the inflammation. Ointments, liquids, and other rubbing agents such as Sloan’s Liniment or Ben Gay may ease pain by producing a sensation of warmth and numbness. However, these preparations are not as effective as anti inflammatory agents in healing a strained muscle.

Other Causes of Muscle Pain

Sprains, tendonitis, shin splints, dislocations, stress fractures, and other sports or work injuries also produce pain and swelling.

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May 04, 2008