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Muscles make up over half of the weight of a human body and they are required to make even the smallest of movements such as nodding your head or tapping your toe. If too much stretch is put through one of your muscles you may end up with a painful muscle strain.
Muscles are composed of many fibers bundled together; more frequently used muscles have more fibers than the smaller, lesser-used ones.
Among the muscles are voluntary and involuntary muscles. Voluntary, or striated muscles, are those that we move by choice (for example, the muscles in your arms and legs).
Involuntary muscles, or smooth muscles, are the ones that move on their own (for example, the muscles that control your diaphragm and help you breathe). The muscles in your heart are called involuntary cardiac muscles.
What causes a muscle strain?
A muscle strain, or a muscle pull occurs when a muscle in your body is overstretched or overworked. A muscle strain can occur in any of your voluntary muscles (or tendons which attach to the muscle), but they are most common in the low back, the calves, the front and back of the thighs, the chest muscles, and the muscles of the neck and the shoulder.
A muscle strain can occur due to a one-time overstretching or overworking of a muscle (acute injury) or can occur from repetitive use of a muscle over time (overuse injury).
The immediate line of defense straight after a muscle strain should be the application of ice and compression, followed by rest and elevation for the affected muscle.
In cases where it is not an acute strain heat may be more useful in decreasing pain. Your Physical Therapist can advise you whether it is best to use ice or heat at your stage of healing. Your therapist may also use electrical modalities such as ultrasound or interferential current to help decrease the pain and control the amount of inflammation.
Once the initial pain and inflammation has calmed down, your Physical Therapist will focus on improving the flexibility and strength of the involved muscle. Static stretches to increase the flexibility of the muscle will be prescribed by your Physical Therapist early on in your treatment as these types of stretches encourage the healing tissues to withstand stretch and they ensure that you do not lose any range of motion overall. As your range of motion improves, more aggressive stretches will be added, however stretching should be limited such that it never causes pain. Feeling a gentle stretch at the end of the range of motion should be the limit otherwise further damage could occur to the muscle. As the muscle nears the end of its healing, dynamic stretching (rapid motions that stretch the tissues quickly) will also be taught and will be incorporated into your rehabilitation exercise routine in order to prepare your muscle to return to more taxing movements such as those involved in normal everyday activity or sport. Dynamic stretches are used to prepare the tissues for activity whereas static stretches focus more on gaining flexibility.
Rest is also an important part of your Physical Therapy treatment. ‘Relative rest’ is a term used to describe a scale of resting compared to the normal activity you would be doing. If you are experiencing pain while doing nothing at all it means the injury is more severe and your Physical Therapist may advise a period of complete rest where you do either no activity, or very little activity such as a few gentle stretches. As your pain improves then the rest to activity balance will swing the other way such that you will still require more rest for the muscle than usual but there will also be a gradual increase in activity including more aggressive stretches along with strengthening so long as there is no return in symptoms.
Along with stretching exercises, your Physical Therapist will also prescribe strengthening exercises in order to get your strained muscle back in top shape. Initially your therapist may suggest that you only do isometric contractions of your muscle, which means that you tighten the affected muscle without actually moving the associated joints. An example of this type of contraction occurs when people are asked to flex their biceps muscle, and they tighten the muscle fibers of the upper arm in place, without bending the elbow or moving the shoulder. This type of contraction is an effective way to begin strengthening an injured muscle. As the muscle continues to heal, more aggressive strengthening will be prescribed where you are moving your limb and using the weight of your body to provide resistance. When appropriate your therapist will prescribe strengthening exercises with free weights, elastic bands or tubing, weight machines, or cardiovascular machines such as stationary bicycles or a treadmill in order to continue to increase the strength and endurance in your injured muscle. As your strained muscle is more fully healed, your therapist will add eccentric type strengthening to your rehabilitation program. Eccentric exercises are ones that put load through your muscle as it is lengthening.
In addition to stretching and strengthening the muscle, taping or wrapping the affected muscle with an elastic bandage may be done by your Physical Therapist in order to assist initial swelling, and to provide support to the muscle as you rehabilitate it. They may even teach you how to tape or wrap your own muscle so you can do it on your own.
If you strained your muscles and would like to know more about our treatment, give us a call!