Pain in the muscle, which occurs suddenly and without warning during specific movement probably knows everybody. These conditions often happen to athletes, during a hit, uncoordinated movement connected with muscle contraction during sudden unexpected resistance (for example by sprinters). But even during daily activities you can’t completely avoid it, you can get injured when you slip or when you are running to catch a bus.
PULLED MUSCLE VS. MUSCLE SPASM
It is important to say from the start, that the often used term “pulled muscles” as medical term doesn’t exist. It is always either muscle spasm or ruptured muscle. Muscle spasm causes very unpleasant even painful muscle tension, alternatively it can affect whole muscle groups. It can manifest transitionally or chronically, and usually it lasts only for few seconds, but also even few minutes. People who suffer from muscle spasms usually already know based on their feeling in the muscles whether it will lead to spasm or not. There can be several reasons why it happens. Usually it is caused by insufficient warm up before physical activity and overtraining, but it can be also lack of hydration of the organism, and absence of certain mineral substances (calcium, magnesium, iron, salt). The spasm itself is not dangerous. Relieving the muscle usually helps (stretching the muscle in different direction), and the pain fades away. Regular stretching should be prevention, just as drinking enough liquids and having enough minerals in your body.
Why injury occurs?
Every muscle in our body is composed of single muscle fibres, which are constantly in a certain tension. During a movement it can happen that the uttermost border of this tension is exceeded and the muscle gets injured. It happens usually when the organism is insufficiently activated for the activity (warm up) or tired, dehydrated or overloaded. This leads to ruptured muscle fibres, in less common cases it can result in complete rupture of the muscle. Pain, edema or blood clot cam occur in the area of the injury, the function of the muscle is disrupted.
Main cause of injury are usually insufficient warm ups before any physical activity, chronic overloading and avoiding pain which is a warning signal before any further tissue damage. Of course there are also factors which cannot be affect, such as ageing of the organism, congenital degenerative diseases, injuries and much more.
How to recognize muscle injury?
The injury is in most cases painful. If there is a rupture in only few muscle fibres without evident hematoma in the area of injury ir can be taken by most people as constant muscle contraction. In case bigger damage range, the muscle fascia may be injured (connective tissue), it is usually accompanied by sharp pain and the muscle cannot be further burdened. The area of injury, but also the attachments of the muscle are sensitive on touch. The muscle may get stiff, hematoma may occur, and you can feel pain in a peaceful regime. The magnitude of the injury should be determined by a doctor based on a clinical examination, ideally with ultrasound.
How to treat the injury?
If the injury occurs, or we have a suspicion that there is a muscle damage, it is important to immediately stop with the physical activity instead of continuing and risking even worse condition. Also do not try to activate or stretch the muscle, both options can lead to more severe consequences. In first 24 hour from injury you should put ice on the injured area in 15 minute intervals, with approximately one hour break during each application. Further you can apply antiedematous and anti-inflammatory creams. In the first few days it is also ideal to use compression bandages and keep the limb elevated above the level of your heart.
The time of recovery is depending on each individual, his/her predispositions and especially on the degree of the injury. Small cracks are treated approximately 1-2 weeks, the treatment of extensive ruptures can take few months. The muscle has to be treated with peaceful regime, and the rupture is healed with ligament scar (this tissue is not identical with its function with the muscle tissue - less flexibility, contraction). Which can be source of problems in the future. Frequent and untreated cracks are transforming into ligaments and over certain period of time it can lead to calcification of the ligament tissue.
HOW CAN PHYSIOTHERAPIST HELP
Based on extensive examination with the option of ultrasound imaging of the muscle are physiotherapists able to determine the cause of the problems and offer you optimal solution, which would lead to faster recovery.
Treatment can be supplemented with Focused Shock wave therapy for faster recovery, it increases the activity of cells and supports their multiplication during recovery of the tissues. The effect can be further supported by radial shock wave therapy, which lowers the surrounding tissues, that formed as a defending mechanism during injury. Long-term effect can be also supplemented by application of kinesio tape.
Author: FYZIOklinika physiotherapy Ltd., Prague, Czech Republic
Source: Clinical experience in private practice and physiotherapeutic field, FYZIOklinika