Muscle Strains and Tears
In today’s blog post, we will be discussing muscle strains and tears! What are they? How do they happen? And what does the recovery processes look like?
Let’s start by taking a quick look at muscles and their function.
Our muscles are a type of soft tissue that is made up of blocks of proteins called myofibrils, which contain a specialised protein (myoglobin) and molecules to provide the oxygen and energy required for muscle contraction.
The muscles in the body can be categorized into 3 major groups:
When it comes to muscles tears, the particular group we will be looking at is the skeletal muscle.
Skeletal muscle is attached to bones and the combination of the muscle and bone create movement at a particular joint. Together, skeletal muscles and bones are referred to as the musculoskeletal system.
Generally speaking, skeletal muscle is grouped into opposing pairs, known as ‘agonists’ and ‘antagonists’. The agonist muscle is the muscle that provides the majority of the force to create a movement, while the antagonist muscle has the opposite role and functions to control the movement.
A prime example is the biceps and triceps combination of the upper arm.
When performing an arm curl, the biceps act as the agonist to create the curl while the triceps act to control the speed of the movement.
When the arm is extended again, the triceps act as the agonist (in combination with gravity) and the biceps act as the antagonist to control the movement.
Skeletal muscles are under our conscious control, which is why they are also known as voluntary muscles. This means that we can consciously activate them, whereas smooth and cardiac muscle contractions are beyond out conscious control.
Another term commonly used to describe skeletal muscle is striated muscles, since the tissue looks striped when viewed under a microscope.
A muscle strain or tear occurs when the amount of force being applied to the muscle exceeds its ability to withstand that force. This can occur:
When a muscle is stretched beyond its capacity to lengthen, e.g. overstretching your hamstring when kicking a ball.
When the muscle is not strong enough to withstand a force being applied to it, e.g. accelerating or decelerating suddenly
In the case of a muscle not being strong enough to withstand the force being applied to it, the tear occurs due to changes in muscle contractions. In skeletal muscle there are 3 types of contractions:
Isometric à there is tension in the muscle, but no movement occurs. E.g. flexing your biceps
Concentric à there is tension in the muscle as it shortens to create movement. E.g. bicep shortens to create an arm curl
Eccentric à there is tension in the muscle as it lengthens to control movement. E.g. lowering from an arm curl, the biceps lengthen to control the movement.
The best example of tearing under load, is a sprinter, when they damage their hamstring muscle.
During the practice of sprinting, the hamstrings must work eccentrically to control the forward movement of the leg during it’s swing phase.
Towards the end of the swing phase the hamstrings get close to the end of their flexible range and continue to work to slow the speed of the lower leg.
Once initial contact with the ground is made, they then need to rapidly change from an eccentric to a concentric contraction to propel the body forward over the stance leg. It is at this change of contraction point, when the muscle is near maximal stretch, that most muscle tears occur.
It’s important to note that the terms ‘strain’ and ‘tear’ are used interchangeably and both denote the same damage happening to the muscle. Lighter damage is commonly called a strain, while heavier damage often a tear. Clinically, muscle injuries are categorized in accordance to how severe the damage is and will be graded as follows:
Grade I - In this mild tear, only a few muscle fibres are stretched or torn. Although the injured muscle is tender and painful, it usually has normal strength.
Grade II - This is a moderate tear, with a greater number of injured fibres and more severe muscle pain and tenderness. There is also mild swelling, noticeable loss of strength and sometimes a bruise.
Grade III - This is a severe tear, that ruptures the muscle all the way through, sometimes causing a "pop" sensation as the muscle tears into two separate pieces or shears away from its tendon. Grade III tears are serious injuries that cause complete loss of muscle function, as well as considerable pain, swelling, tenderness and discoloration. Because Grade III strains usually cause a sharp break in the normal outline of the muscle, there may be an obvious "dent" or "gap" under the skin where the torn pieces of muscle have come apart. These tears may require surgery.
Symptoms of muscle tears include:
A pop or snap sound heard at the time of injury
A visually noticeable gap, dent or other defect in the normal outline of the muscle
Pain and tenderness in the muscle, especially after an activity that stretches or contracts the muscle
Increase in pain when the muscle is moved or activated, that is relieved by rest.
Muscle swelling, discoloration or both
Muscle cramp or spasm
Either a decrease in muscle strength or a complete loss of muscle function with pain on a contraction of the muscle
Pain when the muscle is stretched
The time it takes to recover from a muscle tear will ultimately come down to the grade of the tear and subsequent level of damage. Grade 1 tears usually take between 3-4 weeks, grade 2 tears 6-8 weeks and grade 3 tears 12-16 weeks. This can differ depending on where in the muscle the tear is located, and which particular muscle has been affected.
Treatment for muscle tears revolves around reducing pain and inflammation first, followed by restoring normal length to the muscle, then rebuilding strength before a return to activity can begin. A treatment plan will generally progress as follows:
1. Acute stage:
a. Rest from aggravating activities
b. Anti-inflammatory medication may be helpful
c. Compression and elevation to reduce swelling
d. Ice can be used for pain control.
e. Ultrasound therapy, dry needling and taping techniques to control pain and unload the muscle.
2. Chronic stage:
a. Continue soft tissue techniques and include joint mobilisations to surrounding joints
b. Progress to end range stretching
c. Begin light strengthening exercises – beginning with isometric à concentric exercises.
3. Return to Activity Stage:
a. Continue soft tissue techniques and joint mobilisations to surrounding joints
b. End Range stretching
c. High level strengthening progressing from concentric into eccentric exercises
d. Return to running program à return to sport specific exercises.
The prognosis for muscle tears is generally good, however there is a high chance of reoccurrence if a complete rehabilitation program is not adhered to.
As with all soft tissue injuries, they can be hard to predict and thus hard to prevent however there are a few things you can do to reduce the likelihood of incurring a muscle tear:
Ensure you participate in an active warm up and cool down before and after engaging in sports and physical activities.
Maintain good flexibility in the main muscle groups you use for your sport or activity
Maintain appropriate strength in the main muscle groups you use for your sport or activity
Increase the intensity of your training program gradually. Never push yourself too hard, too soon.
Use the correct technique when lifting heavy loads.
So that’s an overview of muscle tears and how they occur. If you have any questions or comments, please email us at firstname.lastname@example.org and we will be happy to answer them for you.
If you suffer from recurrent muscle tears or muscle pain, feel free to call us on (08) 9486 8653 and our therapists will be happy to chat with you.