Muscle strains run the gamut from a mild annoyance that goes away after a few days to a serious injury that requires surgery and knocks you off your game for months. Either way, it’s best to avoid them and you can dramatically increase your chances of doing so by taking a few simple steps.
However, if you’ve suddenly increased your level of exercise during the COVID-19 lockdown, you might not be aware of those steps, and you might have suffered a pulled muscle as a result. A study from Bupa UK has found that 14% of UK adults have injured themselves during lockdown and of these injuries pulled muscles are the most common, making up 36%.
For expert advice on how to spot, treat and ideally prevent pulled muscles, we spoke to Damian McClelland, clinical director for musculoskeletal services at Bupa UK Insurance.
Why do pulled muscles happen?
Your muscles are made up of bands of fibres, which relax and tighten to make you move. You may strain a muscle if you stretch it beyond its normal comfortable range, or make it work too hard or too fast, such as during exercise or sports.
The most common muscle strains tend to be in the legs, such as calf, hamstring or quadriceps strains, but other common strains occur in the back, neck and arms.
What are the symptoms?
Muscle strain symptoms vary depending on how bad the injury is, but normally include pain, tenderness when you touch the muscle, swelling or bruising, and weakness or loss of movement.
The symptoms normally ease in a few days, depending on the grade of muscle strain. The longer your symptoms last, the worse your injury is likely to be. A grade one muscle strain is where the fibres are slightly damaged – there may be some pain but the strength of the muscle shouldn’t be affected, and it should settle in a few days.
A grade two strain is a partial tear of the muscle, and you might have some bruising or swelling as well. If you have a grade three strain, you may have felt a popping sensation when you hurt your muscle, and you may have a lump at either end of your muscle and have lost all the strength in your muscle so you can’t use it. If you think you might have a grade three strain it’s important to go to A&E immediately.
How can you prevent them?
There are lots of steps you can take to help prevent muscle strains when exercising. Make sure you warm up thoroughly first with some gentle exercise. Ideally, you should do a dynamic warm-up, which takes your muscles through the range of motion for the activity that you’re about to do. Do this for around five to ten minutes. Warm down afterwards by gradually decreasing your activity levels until your breathing and heart rate return to normal.
It’s also important to use the correct equipment, and always wear the right shoes for your activity: for example, wearing running trainers when you go jogging, and replacing them when they wear out and no longer provide any support.
Make sure you take the time to perfect your technique when you try something new – especially when using weights. Although you might not be able to speak to your gym instructor face to face at the moment, many are offering online appointments to make sure your technique is safe.
And most importantly, seek help if you think you may have hurt yourself. There’s no need to grin and bear it if you’re in pain. If you need to speak to a physiotherapist or a consultant, phone or video appointments allow quick access to advice and treatment. Bupa’s Direct Access MSK service allows customers to bypass the GP and be referred directly to a specialist.
Are there more serious conditions that have similar symptoms, and if so how can you tell the difference?
If you heard a crack, or the injured body part has gone numb, discoloured or cold to the touch or has changed shape, you may have a broken bone so it’s important to go to A&E immediately.
You should also go to hospital if you felt a popping or tearing sensation when you pulled your muscle, are in a lot of pain, have a lot of swelling or find it difficult to move the muscle – for example you may not be able to walk on it. These symptoms can indicate a more serious condition such as grade three muscle strain, where the tendon has separated from the muscle or the muscle has torn apart.
How do you treat pulled muscles?
You can usually treat mild muscle strains at home. Sometimes you may need to see a physiotherapist or have an operation to repair your damaged muscle depending upon how severe the strain is.
If your muscle strain isn’t a bad one, there are several things you can do at home to ease your symptoms and speed up your recovery. You should follow the POLICE procedure as soon as possible after you’ve injured yourself, which will give your muscle a chance to heal and protect it from any more damage:
- Protect your injury from further harm, for example by using a support.
- Optimal Loading. It’s important to start moving the muscle again sooner rather than later, but only do what feels comfortable and speak to a physiotherapist if you’d like further advice.
- Ice. Apply ice or frozen peas wrapped in a towel. Use for around 20 minutes roughly every two hours. Avoid putting ice directly on the skin.
- Compression. Bandage your injury, but not too tightly and remove before going to sleep.
- Elevation. Try to keep your injured muscle raised above the level of your heart to help reduce swelling.
You can also use over-the-counter painkillers if you need pain relief. It’s important to rest your muscle immediately after an injury. After this, you can start to move around gently and slowly, as long as this doesn’t cause any pain. Gradually build up your activity until your muscle feels like it’s getting back to normal. You might also want to do some exercises to strengthen the muscle. A physiotherapist can advise you on what’s best.
If your muscle doesn't start to get better and you can’t put weight on it after about a week, contact a physiotherapist or your GP.
How long do they take to heal?
Recovery from a muscle strain will depend on how bad the injury is and which muscle is involved. It may take you a few weeks to be able to walk as normal and it may take even longer for you to get back to your normal exercise or sports. With a very bad strain, it may take months for you to recover completely.
It’s important to keep your muscle moving after an injury, but you may need to make some changes to the way you do things. You may be more prone to hurting that muscle again in the first four to six weeks, so you’ll need to take extra care not to re-injure it.