Top Tips on how to treat Muscle Strains and Pulls.
Muscle injuries are one of the most common traumas occurring in sports, their frequency varying from 10-55% of all sustained injuries.
Clinically, ﬁrst aid for muscle injuries follows the RICE (Rest, Ice, Compression and Elevation) principle. The objective of RICE is to stop the injury-induced bleeding into the muscle tissue and thereby minimise the extent of the injury. Clinical examination should be carried out immediately after the injury and 5-7 days after the initial trauma, at which point the severity of the injury can be assessed more reliably.
Causes of Muscle Injuries
Muscle injuries can be caused by contusion, strain or laceration. Over 90% of all sports-related injuries are either contusions or strains, whereas muscle lacerations are uncommon injuries in sports. Muscle contusion occurs when a muscle is subjected to a sudden, heavy compressive force, such as a direct blow. In strains, the muscle is subjected to an excessive tensile force leading to the overstraining of the myoﬁbres and, consequently, to their rupture near the myotendinous junction. These are the types of injuries which occur during over use or quick sudden movements of joints, where there is lots of force put upon a joint.
Returning to Sport
The decision regarding the appropriate timing of the return to sports-speciﬁc training can be based on two simple and inexpensive measures: (1) The ability to stretch the injured muscle as much as the healthy contralateral muscle. (2) The pain-free use of the injured muscle in basic movements. It should always be emphasised that the ﬁnal phase of the rehabilitation, sport-speciﬁc training, should preferably begin under the supervision of a therapist, personal trainer or coach.
First few days after injury
During the ﬁrst few days after the injury, a short period of immobilisation accelerates the formation of granulation tissue at the site of the injury, but it should be noted that the duration of reduced activity (immobilisation) should be limited too, only until the scar has reached sufﬁcient strength to bear the muscle - contraction induced pulling forces without re-rupture. At this point, gradual mobilisation should be started followed by a progressively intensiﬁed exercise programme to optimise healing by restoring the strength of the injured muscle, preventing muscle atrophy and the loss of strength and extensibility, all of which can follow prolonged immobilisation.
10 Key Points about Muscle injuries
- Muscle injuries are one of the most common injuries in sports; diagnosis of a muscle injury is clinical
- Injured skeletal muscle should be placed to rest (immobilisation) after the injury for 3-7 days.
- Early, active re-mobilisation should be started within the pain limit.
- Immediate ﬁrst aid aims at reducing the bleeding to the injured area.
- Diagnosis can wait for the immediate treatment, icing should last for hours after the injury.
- Immediate treatment follows the 'RICE'-principle; Rest, Ice, Compression and Elevation.
- Mobilisation programs should not only include exercises for the injured muscle, but should be loaded with exercises improving agility and trunk stabilisation.
- Stretching is an important part of the mobilisation programme.
- Speciﬁcally tailored muscle strengthening protocols consisting of eccentric exercises are very effective in preventing muscle injuries. Varied training regimes which involve different types of muscle contraction make it ready for active sport
- Above all maintaining flexibility and warming up/cooling down after sport help to prepare the muscle and return the muscle to a fit state and so prevent injuries.
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