Recover from a Strained or Pulled Muscle

Muscle strains, also called pulls, occur when the small fibers within a muscle are stretched beyond their limits, which results in a partial or complete tear (rupture). All muscle pulls are categorized as either Grade I (tearing of a few fibers), Grade II (more extensive fiber damage) or Grade III (complete rupture).[1] Most mild-to-moderate muscle strains heal within a few weeks, although your recovery may be quicker and more complete if you follow some tried-and-true home remedies or seek professional treatment.

Steps

Recovering From a Muscle Strain at Home

  1. Take it easy and rest your strained muscle. Most muscle pulls occur from either lifting too much weight, doing something too often (repetition), moving awkwardly or experiencing trauma (car accident, sports injury).[2] The first step with any muscle strain (and most musculoskeletal injuries in general) is to rest it. This may require taking a few days off work or away from the team, but muscles recover quicker if they are given the appropriate time to rest. If your muscle pull takes longer than a few weeks to recover, then either a significant proportion of the muscle fibers are torn or there's involvement of a related joint and ligaments.
    • Dull, achy pain is usually indicative of a muscle strain, whereas sharp and/or shooting pain with movement is often caused by joint / ligament sprains.
    • A moderate-to severe muscle strain will usually cause a bruise to form pretty quickly, which indicates some blood vessels that feed the muscle are damaged and leaking.
  2. Apply something cold if the muscle injury is acute. If your muscle strain is acute (within a few days old), then inflammation is likely an issue and should be addressed.[3] When the muscle fibers tear, the immune system sends lots of fluid containing white blood cells. White blood cells clean up the debris from the damaged cells and connective tissue and lay the framework for a healing response; however, too much inflammation creates pressure, which causes more pain. As such, using cold therapy (ice or a frozen gel pack wrapped in a thin towel) should be applied to muscle strains as soon as possible because it constricts local blood vessels and reduces the inflammation response.[4]
    • Cold therapy should be applied for 10-20 minutes every hour (the larger or deeper the affected muscle, the longer the time), then reduce the frequency as the pain and swelling subside.
    • Compressing the ice against the muscle pull with the help of an elasticized bandage will help to further impede the swelling, as will elevating the affected area.
  3. Apply moist heat if the injury is chronic. If your muscle strain has lingered on and become chronic (longer than a month old), then inflammation control is not such a pressing issue. Instead, the muscle is likely weakened, too tight and lacking in normal blood flow, which translates into inadequate nutrients (oxygen, glucose, minerals). The application of moist heat can decrease muscle tension and spasm, increase blood flow and promote healing in chronically strained muscle tissue.[5]
    • Use a microwavable heat pack and apply it to your sore muscle(s) for 15 – 20 minutes at a time, three to five times per day, until the tension and stiffness fade away. Herbal bags usually contain bulgur wheat or rice, as well as soothing herbs and/or essential oils such as lavender.
    • Alternatively, soak your chronically strained muscle in a warm Epsom salt bath for 20 – 30 minutes because it can significantly reduce pain and swelling in muscles.[6] The magnesium in the salt is thought to help the muscle fibers relax and the warm water promotes circulation.
    • Don't use dry heat, such as heating pads, on your chronically strained muscles because you risk dehydrating the tissue and making the issue worse.
  4. Take anti-inflammatory medicine. As mentioned, inflammation is a major contributor to the symptoms associated with acute musculoskeletal injuries such as strains, so taking over-the-counter anti-inflammatory pills during the initial stages of the injury is also a good strategy.[7] Common anti-inflammatories include ibuprofen (Advil, Motrin), naproxen (Aleve) and aspirin, but they tend to be hard on the stomach, so limit your use to less than two weeks. Anti-inflammatories are for symptomatic relief only and don't stimulate healing, but they can certainly allow you to resume work or other activities (when it's appropriate) in more comfort.
    • Ibuprofen is not appropriate for young children, so always consult your doctor before taking any medications or giving them to your kids.
    • For more chronic muscle issues, consider taking a muscle relaxant (such as cyclobenzaprine) to reduce muscle tightness and/or spasms.
  5. Try some light stretching. Muscle stretching is mainly thought of as an injury prevention strategy, but it can be used during injuries also (albeit with caution and common sense).[8] Once the initial pain of the acute injury settles down after a few days, consider doing some light stretching just to keep the muscle pliable and prevent spasm. Start with two to three times daily and hold the stretches for 15 – 20 seconds while taking deep breaths. Chronic muscle strains are likely even more in need of stretching, so increase to three to five times daily and hold for about 30 seconds until the discomfort fades away.
    • If you stretch properly, you should not have more muscle soreness the following day. If you do, then it may be an indication you've overstretched and need to go easier by reducing the intensity of the stretches.
    • A common cause of "overstretching" is doing stretches while the muscles are cold. As such, make sure to get your blood flowing or apply moist heat to any muscle before you attempt to stretch it.

Seeking Help with Recovery

  1. Go for a deep massage. If your home remedies don't seem to be impacting your recovery as well as you hoped, or if you just want to augment what you're doing, then consider seeing a professional massage therapist for a deep tissue rub down. A deep massage is helpful for mild-to-moderate strains because it reduces muscle spasm, combats inflammation and promotes relaxation.[9] Start with a 30 minute session and allow the masseuse to go as deep as you can tolerate it without wincing. Your therapist may also do trigger point therapy that focuses in on the injured muscle fibers.
    • Always keep well hydrated after a massage in order to flush inflammatory by-products and lactic acid from your body. If you don't, you may experience a mild headache or nausea.
    • If your budget doesn't allow for professional massage therapy, then consider using a tennis ball or foam roller as a substitute. Depending on where the strain is, use your body weight to roll over the tennis ball or foam roller until you feel the tension and pain start to dissipate.
  2. Get therapeutic ultrasound treatments. Therapeutic ultrasound machines produce high frequency sounds waves (not audible to people) by vibrating crystal material, which then has a therapeutic impact on soft tissue and bone. Although it's been used for over 50 years by physicians, physiotherapists and chiropractors for a variety of musculoskeletal injuries, the exact ways it impacts tissue is still not entirely understood. It produces a thermal effect (heat) on certain settings, which is of benefit to chronic muscle strains, but it also seems to reduce inflammation and promote healing on entirely different (pulsed) settings, which can help with acute injury.[10] Ultrasound frequency can be altered so that it penetrates the body either superficially (on the surface) or much deeper, which is great for shoulder and low back strains.
    • Ultrasound treatment is painless and lasts from three to 10 minutes depending on the location and if the injury is acute or chronic. Treatments may be repeated one to two times daily for acute injuries, or less frequently in chronic cases.
    • Although a single ultrasound treatment can sometimes provide substantial relief to a strained muscle, more than likely it will take three to five treatments to notice significant results.
  3. Consider muscle stimulation treatments. Another type of treatment that can be effective for both acute and chronic muscle strains is electronic muscle stimulation.[11] Electronic muscle stimulation involves the placement of electrodes over injured muscle tissue in order to transmit electrical currents and cause contraction. For acute strains, muscle stimulation devices (depending on the settings) can help pump out inflammation, reduce pain and desensitize nerve fibers. For chronic strains, electronic muscle stimulation also has the ability to strengthen muscle and "re-educate" the fibers (allow them to more efficiently contract in unison).
    • Health professionals most likely to use electronic muscle stimulation include physiotherapists, chiropractors and sports physicians.
    • Electronic muscle stimulation devices can be readily purchased from medical supply and rehabilitation stores, as well as online. They are much more affordable than ultrasound devices, but they should only be used under the supervision or advice of a healthcare professional.
  4. Consider infrared therapy. Also in the realm of frequency therapy is infrared radiation. The use of low-energy light waves (infrared) is able to speed up wound healing, reduce pain and decrease inflammation, particularity in chronic injuries.[12] Use of infrared therapy (via a hand-held device or within an infrared-emitting sauna) is thought to penetrate deep into the body and improve circulation because it creates heat and dilates blood vessels. Treatment times vary from 10 – 45 minutes depending on the injury and whether it's acute or chronic.
    • In some cases, significant pain reduction occurs within hours after the first infrared treatment, but your results may vary.
    • Pain reduction is typically long lasting — weeks or sometimes even months.
    • Healthcare professionals most likely to use infrared therapy include chiropractors, osteopaths, physical therapists and massage therapists.

Tips

  • To help prevent muscle strains, establish a warm-up routine prior to engaging in any strenuous physical exercise.
  • Poor conditioning can leave your muscles weak and more prone to strain.
  • Fatigued muscles from intense exercise are also more likely to succumb to injury.

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Sources and Citations