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How to treat a muscle strain

It is important to understand that a strain means a tear. Anytime you get a strain you have damaged the muscle. There are three grades of muscle strains:

Grade 1: Small trauma to the muscle. Strength of the muscle is within 80% of the bilateral muscle.

Grade 2: Partial tear to the muscle. Strength of the muscle is less than 80% of the bilateral muscle.

Grade 3: Full tear of the muscle. There is little to no strength to the muscle.

Depending on how severe the injury is will help you predict how long the muscle will take to heal. Here are the averages:

Grade 1: 1 week – 4 weeks

Grade 2: 2 weeks – 8 weeks

Grade 3: 6 weeks – 3 months

These are averages. If you are doing consistent active recovery with a professional you are more likely to heal faster. Every body is different and it is best to take each injury as a unique one and listen to your body as it is healing. This is why the following steps of rehabilitation is a general advisement not specific. It is not meant to be a treatment plan, just good information to get you onto the path of efficient healing.

Step 1 – Reduce Pain

Our first goal is to get rid of the pain and avoid anything that causes more pain. This means if using the muslce hurts you’ll need reduce activity. To help reduce pain you can use ice for the first three days. Ice can be applied directly to the skin for 30 minutes every 90 minutes. If you are using a gel pack it is usually colder than ice and you’ll need to reduce the time and make sure there is a cloth between the pack and your skin.

A few other ways to reduce pain is photobiomodulation, correct joint dysfunctions, muscle stimulation, and joint pumps.

Step 2 – Regain Motion

We need to get your muscle moving normal again. Now this does not necessarily mean stretching. It is recommended to NOT do stretching initially for a muscle strain. Most of the motion will be regained with consistent pain-free motion and light muscle releases. To optimize initial results follow the POLICE principle:

Protect – Avoid making the injury worse. Wear a brace, use crutches, or avoid activities that would make it worse.

Optimal Loading – Rest does not mean we completely stop, we want to figure out how much you can still do without making the injury worse. If you have a sprained ankle and you can still walk, then continue walking. Figure out a slow and steady way to adapt you injury back to normalcy.

Ice – Only useful within the first 2-3 days of the injury. You can use ice for 30 minutes every 90 minutes. You can put it directly on the skin if it is true ice at 32 degrees Fahrenheit. Gel packs tend to be colder so don’t put them directly on the skin.

Compression – Most useful at night. Use a compression sleep or ace wrap bandage to move swelling away from the injury. Only useful if there is swelling.

Elevation – If you are very swollen, getting your injury up above the heart can help get rid of swelling. Do this whenever you are stationary like at night.

Step 3 – Regain Strength

Usually you will want to start with isometric exercises. This allows you to strengthen the muscle at different angles without causing too much injury. If there is no pain you can do exercises with movement. From here doing concentric motions with light bands is a good initial way to retrain the muscle. Continue to add weight as long as there is no pain.

Step 4 – Proprioceptive Training

When you injure your muscle it will become deactivated. It does this because of muscle guarding, pain, weakness, and a disruption to your mind-body connection. Through proprioceptive training you can improve stability and balance and get you ready for full training. Much of this training is about balancing while doing certain tasks. 

Step 5 – Return to Function

From here you want figure out what you need to do to get back to normal. If you are a runner you’ll need to figure out what part of your gait hurts train that motion. During this period there is a lot of trial and error as you figure out what your muscle can handle. 

Like always let us know how we can help you!

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