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How to treat a muscle strain / tear

Updated: Jan 10

There is a basic treatment recipe that you can use to treat nearly any muscle strain or tear. Muscle tears can be graded from grade 0 to 5 but for this article I’m going to simplify things and talk about grade 1,2 and 3 muscle tears.



In this article:

  • Grading muscle tears

  • Recipe for treating muscle tears / strains

  • The golden rules when doing strength training for an injured muscle are:

Here's the video of the livestream I did about this in the Sports Injury Group:



Grading muscle tears


Grade 1: You likely have a grade 1 muscle tear if you have some pain in the muscle when you use it, but you can nearly do everything as normal. You usually don’t feel any pain when you rest it.


Grade 2: With a grade 2 tear you’ve torn a significant number of muscle fibres and there is usually quite a bit of swelling and bruising as well. You may have pain even when you’re lying down or sitting still and it is usually quite painful when you try and use the muscle.


Grade 3: A grade 3 tear is a more serious one where you’ve torn more than 85% of the muscle fibres. There is usually a lot of swelling and bruising (but not always). If the muscle is fully torn through, you may not have much pain but you’ll find that you can’t use the muscles – there’s just no power or strength in it. You may get an ache even while resting it.


Please make sure that you consult a physio or other healthcare professional if you have a significant tear in your muscle.


Recipe for treating muscle tears / strains


Day 1: Apply the RICE regime. Rest the injured body part and apply ice and gentle compression while elevating it. This will help stop the internal bleeding and limit the swelling.


Day 2 to 5: Continue using ice as needed, but you should now start to gently move your injured muscle. DON’T stretch it! The injured muscle has to grow back together and you’ll make your injury worse if you stretch it at this point. DO start to gently move it, but don’t push into pain. Gentle movements will help it recover more quickly. Check out the video above for a detailed explanation on how to do this.


After day 5: You now have to slowly start strengthening the muscle back up. What you do for strength training and how heavy you start can vary dramatically depending on how badly you’ve torn your muscle. For instance, for severe quad strains I may first get a patient to just tense their quadriceps muscle with their leg straight (isometric contraction) and hover the straight leg 5cm off the bed while if it was only a mild quad strain, I may get them doing squats.



The golden rules when doing strength training for an injured muscle are:


  1. Forget what you could do before your injury – you have to test what the muscle is capable of doing now and start there.

  2. Don’t push into pain. Especially during the first few weeks, you want the exercises to be totally pain free and also to not feel any increase in pain after doing your exercises.

  3. Do not go back to doing your sport if you’ve not done specific exercises to strengthen your injured muscle to the level that is needed for your sport. The strength training has to be a progressive programme that starts light but then increases in intensity so that it resembles what will be expected of your muscle when you play your normal sport. Grade 1 muscle tears take about 4 weeks to regain full strength while Grade 2 tears can take between 6 to 12 weeks.

Let me know if you have any questions. Need more help with your injury? You're welcome to consult me online via video call for an assessment of your injury and a bespoke treatment plan.

Best wishes

Maryke


About the Author

Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Masters Degree in Sports Injury Management. Follow her on LinkedIn, ResearchGate, Facebook, Twitter or Instagram.



References:

  1. Bisciotti, G. N., et al. (2018). "Italian consensus conference on guidelines for conservative treatment on lower limb muscle injuries in athlete." BMJ Open Sport & Exercise Medicine 4(1): e000323.

  2. Pollock, N., et al. (2014). "British athletics muscle injury classification: a new grading system." British Journal of Sports Medicine 48(18): 1347-1351.