Muscle Strain


A muscle strain is a minor injury to a muscle or an attached tendon usually due to overstretching, pulling, or tearing of the muscle. It is sometimes called a pulled muscle.


A muscle strain is often classified by physicians based on the severity of the damage:


More than nine million muscle strains occur in the United States each year, half of them requiring doctor visits. More than one-third of muscle strains occur in people ages 25 to 44. Men are 30% more likely to be injured than women. The most common muscle strain is to the ankle, followed by the wrist, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). The most common sports-related strain is to the thumb. Other common strains are to the back, neck, arms, groin, legs, abdomen, and shoulders. Muscle strains are more common in people over age 55 than in younger people, according to the American Association of Retired People (AARP). Nearly all fitness activities, even walking, carry some risk of muscle strain. However, they occur most commonly in sports, including football, basketball, baseball, softball, soccer, volleyball, and tennis. They occur less frequently in people doing general exercise programs at home or in fitness centers.

Causes and symptoms


Reasons for muscle strains include excessive physical activity, improper warm up before exercise, and poor flexibility. Muscle strains occur when a muscle is stretched too far and too quickly, causing a slight tear to the muscle and surrounding tissue. Wrist strains usually occur when a person falls and lands on one or both outstretched hands. Leg and ankle strains often come from walking, jogging, running, and roller blading. Shoulder strains frequently occur with weightlifters, and volleyball, tennis and golf players.

A form of ancient Chinese medicine that uses hand pressure on key energy sites on the body.
An ancient Chinese alternative medicine technique that treats conditions by inserting and manipulating thin needles under the skin.
Magnetic resonance imaging (MRI)—
A special radiological diagnostic test that uses magnetic waves to create pictures of an area, including bones, muscles, and tendons.
Orthopedic surgeon—
A physician and surgeon that specializes in disorders of the bones and associated muscles, tendons, and joints.
Pertaining to a particular area of the skin.

Signs of a muscle strain include pain, inflammation, swelling, bruising, redness, muscle weakness, or inability to use the muscle at all. Other symptoms include hearing a popping sound when the injury occurs, fever, an open wound caused by the injury, and a lack of pain relief after several days of using over-the-counter pain and anti-inflammation medicines.


Mild muscle strains are often self-diagnosed, while moderate and severe strains are generally diagnosed by a doctor, often a sports medicine or orthopedic specialist. A general examination of the sore or painful area by the doctor is often enough to diagnose mild or moderate muscle sprains. If the doctor suspects a severe strain or other damage, x-rays or magnetic resonance imaging (MRI) may be ordered. In Canada, all patients must be referred to an orthopedic surgeon or other specialist by a family physician.


Alternative medicine

Alternative medicine treatments for muscle strains include: applying a topical solution of ice cold tofu and rice vinegar; the Chinese herbs yu nan bai yao and shang shi zhi tong gao; using acupressure, acupuncture, and topical treatment with Himalayan crystal salt; and various topical oils including lemon grass, birch, marjoram, and lavender. These treatments are lacking in credible scientific evidence; however, many of them have been used for hundreds of years in Asia.


The duration of a muscle strain or other injury depends on its severity. Symptoms of a mild back strain, such as pain or soreness, usually improve in one to two weeks and should be gone altogether within six weeks. Muscle strains in the legs may take ten weeks or longer to heal. A severe strain may last until it is repaired by an orthopedic surgeon, followed by at least eight weeks of recovery and rehabilitation. A torn rotator cuff muscle can take months to heal, especially if surgery is required. Most muscle strains heal with rest or can be repaired.


Stretching plays a vital role in keeping muscles and joints strong and pliable so they are less susceptible to injury. It is an important part of warming up before physical activity and cooling down afterwards to prevent muscle strains. A stretching routine is beneficial even if no other exercise or physical activity is done. Preventative measures include:




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American Academy of Orthopaedic Surgeons, 9400 W Higgins Rd., Rosemont, IL, 60018, (847) 823-7186, (800) 626-6726, Fax: (847) 823-8125,, .

American Physical Therapy Association, 1111 N Fairfax St., Alexandria, VA, 22314, (703) 684-2782, (800) 999-2782, Fax: (703) 684-7343,, .

Canadian Orthopaedic Association, 4060 St. Catherine St. W, Ste. 620, Westmount, H3Z 2Z3, Canada, 1(514) 874-9003, Fax: 1 (514) 874-0464, .

National Athletic Trainers' Association, 1620 Valwood Pkwy., Ste. 115, Carrollton, TX, (214) 637-6282, # .

National Institute of Arthritis and Musculoskeletal and Skin Diseases, 1 AMS Circle, Bethesda, MD, 20892, (301) 495-4484, (877) 22-NIAMS (226-4267), Fax: (301) 718-6366,, .

Ken R. Wells

  This information is not a tool for self-diagnosis or a substitute for professional care.