THE 101 on MUSCLE STRAINS
Emily R Pappas MS, Exercise Physiology
Pull your hammy?
Strain your quad?
Welp….looks like you are out of commission for a couple of weeks!
If the muscle strain is severe, it could be months. You’re probably thinking…
“What caused the strain in the first place?”
“Is there anything you can do to get you back into play faster?”
And…”How can I make sure this doesn’t ever happen again!!”
In this article, I’m going to…
- Break down how injuries happen
- Talk about recovery period (….and how to get back to your game sooner!)
- Give you the BEST tips of how to prevent a muscle strain from happening again
But first! What IS a Muscle Strain?
Your muscle is a pretty cool tissue.
It has the ability to PRODUCE FORCE and ABSORB FORCE by physically changing its length.
When you apply load to your muscle, your muscle has to absorb that load. As it absorbs, the muscle lengthens (eccentrically stretches).
If the load is TOO LARGE and/or TOO SUDDEN, the cells inside your muscle TEAR.
The more cells that tear, the greater the severity of your muscle strain. (1)
And…how does LOAD injure a muscle?
There are two ways load is forced on a muscle: ACTIVE and PASSIVE.
What is a passive load? Think about when you perform a stretch. As you PULL on the muscle you impose a force that is absorbed by the muscle as it elongates.
If the load is too big or too sudden, your muscles will be stretched BEYOND their recoverable limit (back to its resting state). (3)
The result….. “OH CRAP”
Load can also be applied to your muscles actively, either from an outside force or from its own contractions!
Think about when you run down the court on a break away in your basketball game. As you sprint FULL SPEED, you muscles must contract and produce HIGH forces, very RAPIDLY.
If you force the muscle to contract TOO STRONGLY or RAPIDLY, the resulting stretch of the muscle will be too great. (1)
The result….. “ OH CRAP”
The “oh crap” moment is when you stretched TOO FAR or suddenly SPRINTED down the court and felt that PULL. The “OH CRAP, WHAT WAS THAT” feeling.
How BAD is your muscle strain???
Like most injuries, some muscle strains are worse than others.
Muscle strains work like this:
Your muscle belly itself is composed of many smaller muscle cells. As the load applied to the muscle exceeds your muscle’s capacity to absorb that load, these smaller cells are stretched beyond their limits. The result? They TEAR.
The more cells that are torn, the greater the severity of the strain.
When the majority of cells in a muscle reach beyond their stretch limit, a COMPLETE muscle tear occurs.
Now not all cells in your muscle are created equal. Some muscles are more prone to strain than others.
Well, most muscle strains occur where your muscle cells transitions into their tendon (the tissue that connects muscle to bone). This transitional region is prone to strains as the tissue in this area is neither quite as strong as the muscle belly or the tendon. (4,5) It’s a literal “weak link”!
Because most tears occur in the weaker transitional areas of muscle, we see more strains in muscles that have two joints (or two tendon connections to bones).
Think areas like…
- hamstrings (near regions at your knee and hip)
- biceps (near regions at your elbow or shoulder)
These muscles are more susceptible to experience strains because are TWO regions where these transitional regions appear in the muscle. (1)
Get Back to Your Game: How YOU can Recover FASTER
Like we said, the muscle is a pretty cool tissue.
Like the majority of your body tissues, muscle has the capacity to HEAL itself.
But before you can get back to your game after a muscle strain, you need to understand HOW a muscle heals…and what that means for your recovery.
How MUSCLE Heals
Your muscles will heal after a tear, but not through growing new muscle. Instead, your body uses what we call “foreign” tissue (or SCAR tissue) to patch in the damage. (1)
This foreign tissue is WEAKER and LESS ELASTIC than the muscle tissue itself.
Unfortunately…this means that transitional area of your muscle just got a bit weaker. This is why muscles that were previously strained have a higher chance of re-injury!
What does this mean for your recovery?
If the strain is minor, your muscle will repair within three to six weeks. Fortunately with these injuries, if the muscles surrounding the scar tissue hypertrophies (or grows through strength training), your muscles will have no real loss of function/ strength. (6)
For more severe tears, the reparation process can take several months.
Even worse, the dense, inelastic scar tissue that results can impair future muscle function and contribute to future pain. OH CRAP!
So what does that mean for recovery?
The secret to getting back in the game after a muscle strain is this: Keeping your injury site at rest…while still keeping your body active.
Calming some tissues down, while keeping the other ones alert
Like all injuries, allowing the angry tissues to calm down is key. This means staying away from activity that aggravates the area.
However, it does NOT mean STOP ALL activity.
Athletes who completely rest after experiencing injuries like muscle tears actually INCREASE their chances for re-injury (7)
If you rest completely, you body will DECONDITION. This decrease in fitness means :
- Slower recovery time
- Decreased strength and general capacity to handle loads in the future
BUT- athletes who train around their injury or “relatively rest” can improve recovery! How?
- Maintenance of her conditioning with different modalities that do not aggravate
- Crossover effect! Working the un-injured limb decreases the time it takes for the injured limb to essentially “catch up”
If you are suffering from a muscle strain, make sure you let your tissues heal while working your other ones to stay strong!
Putting in this work can mean a faster return to play and playing intensity.
What about STRETCHING?
Let’s put our thinking hats on:
If a muscle strain is just a bunch of small muscle fiber tears caused by too much load and too much stretch….
…then if we stretch after a strain, we will only add to the problem!!
In the acute phase of the tear, you need to let the tissues RELAX. This means, leave them alone!
Work around the injury to ensure you maintain good blood circulation so that your body can do its thing!
As the injury starts to heal and pain is reduced, we do want to regain ROM at the site of injury.
This is where a lot of old school methodologies like static stretching COULD play a part.
BUT as we discussed in our previous article The TRUTH behind static stretching, improving a joints ROM will not reduce your chance of injury without STRENGTH in that range of motion.
Static stretching WILL NOT make you stronger.
We repeat: without strengthening an improved range of motion, better positions alone will not be enough to reduce your chance of injury. (8)
Luckily, as the authors of Strength and Conditioning for the Female Athlete cite, “every strength session an athlete does is a flexibility-strength workout”. (9)
This means as the injury heals, the goal is to regain motion in the joint while also STRENGTHENING that improved movement.
In this way, when an emphasis is placed on movement quality in strength training, these workouts will not only “lead to increases in ROM over time, but more importantly concurrent increases in strength over that full range” (9)
This means through lifting, an athlete will not only return to her original baseline strength, but become even STRONGER than she was before!
So when can you stretch? Think of stretching as something that may help you reduce the sensation of pain. Feeling tight, go ahead and do some stretches or foam rolling after your workout. But know that this is a short term relief! (10)
How to REDUCE your risk of muscle strain
We know that previous strains increase your chance of re-injury.
But what else contributes to you tearing your muscles?
And what can you do to AVOID them?
Here’s how to combat the THREE things that influence your chances of getting a muscle strain.
Little to No Warm up
Remember when we said the muscle was a pretty cool tissue…..
WELL WE AREN’T LYING!
See muscle tissue is “viscous” meaning it has the ability to change its characteristics.
When it is contracting it can be as stiff as bone…
When it is passive it can be as compliant as your skin.
A good warm up is KEY to transitioning your muscles from one state to the other during intense movement.
By performing lower intensity movements / variations of those movements you are about to perform in game play, you get your muscles get ready.
By getting your muscles in this ready state, they will improve BOTH their force PRODUCTION and also their strain energy absorption (1)
So what’s the recipe for a good warm up?
- Lower intensity (aerobic) that aims to gradually elevate your heart rate
- Practice of movement patterns to progress into full play
- Think hamstring sweeps, inchworms, to high knees, to sprints!
- Think split squats, to body weight squats, to goblet squats, to back squats!
The goal of the warm up is to not only prepare the body physically for movement, but also mentally.
When you practice the movements you wish to perform later at higher intensities, you improve your motor control.
Your movement qualities matters!
Inefficient technique on the field or court will position your joints abnormally and place high loads on your tissues.
Poor mechanics = increased load on your tissues = increased chance of straining those tissues.
2. Inadequate Strength and Mobility
Strains occur when your muscle reaches its threshold for load.
By improving your body’s capacity to handle higher loads, the better chance you have at avoiding a hammy strain next season.
In our article “Why less is not more and more is not better“, we talked about improving your capacity for loading via strength training.
Research has consistently demonstrated the positive relationship between athletes engaged in a properly executed strength training program and reduced injury risks. (10)
At the end of the day, we know injuries occur when the stress applied is too high.
If we want our bodies to be able to handle these high stresses, we must prepare them better.
Strength training acts as a tool to reduce your injury risk simply because it improves your tissues ability to handle high loads. (11)
Even more, when performed with an attention to movement quality, the athlete improves her motor control leading to both improved performance and decreased injury risk. (2)
So what we are saying here is the athlete with a higher work capacity can
- handle higher loads
- do MORE work
- recover BETTER from that work
- IMPROVE at a faster rate
- AND can reduce her chance of being sidelined.
3. Excessive Fatigue
So I think we understand by now that strains occur when loads are too fast or too big.
But what does fatigue have to do with it?
Well you see, when muscles are continually loaded (like in a 3 hour volleyball practice or all day tournament with insufficient recovery), they fatigue
When your muscles are fatigued, their elastic qualities as well as those of your tendons DECREASE. (1)
This means there is less wiggle room for your muscles to stretch
Less wiggle room = more likely they will tear.
When your central nervous system is fatigued (think that drained feeling), there is greater likelihood your movement patterns deteriorate.
Poor mechanics = more likely the muscles will be loaded high leading to a strain.
How can you avoid fatigue?
Your body fatigues as a result of it being broken down.
Your body cannot build back up for the better without first being broken down.
AKA your muscles will always fatigue with increased volume of play: training, practice, games, etc
We can reduce this type of fatigue through recovery methods like ice baths, foam rolling, (7) but our body will naturally recover (and ADAPT!) from this type of fatigue with sufficient sleep and nutrition.
Nervous system fatigue is another necessary player in the improvement game. If you want to learn a new skill, you have to stress the system.
Unfortunately, this type of stress is also felt through other aspects of our life: think school/ work, social, and other emotional factors that influence how you feel. We can reduce this type of stress through methods in addition to sleep and nutrition such as relaxation, massage, meditation, and even laughter!! (13)
LET’S BE HONEST: All injuries that keep you sidelined are HEARTBREAKING
Muscle strains suck!
If you load your muscles by stretching too hard or fast or by performing sudden intense movements, they can tear.
The severity of this tear depends on the amount of load applied and the time your muscle experiences the load.
BUT, with enough rest for tissue recovery, PLUS strength training for improved work capacity and strength…you could be back in action in just a couple of weeks.
BEWARE….completely resting or jumping back in the game too soon? You could be out for the season!
Want to avoid a muscle strain?
Strength training is KEY. You can improve your muscles ability to handle these high loads by hitting the weight room.
Remember, a stronger female athlete is more resilient to any force that comes her way.
(2) Heiderscheit, B. C., Sherry, M. A., Silder, A., Chumanov, E. S., & Thelen, D. G. (2010). Hamstring strain injuries: recommendations for diagnosis, rehabilitation, and injury prevention. The Journal of Orthopaedic and Sports Physical Therapy, 40(2), 67–81.
(4) Whiting W, Zernicke R. Biomechanics of Musculoskeletal Injury. 2nd ed. Champaign, IL: Human Kinetics; 2008.
(5) Tidball J, Salem G, Zernicke R. Site and Mechanical Conditions for Failure of Skeletal Muscle in Experimental Strain Injuries. J Appl Physiol 1993;74:1280–6.
(8) Andersen, J. C. “Stretching Before and After Exercise: Effect on Muscle Soreness and Injury Risk.” Journal of Athletic Training 40.3 (2005): 218–220. Print.
(9) Sargent, D., Clarke, R. (2018). Strength and Conditioning for Female Athletes. Mobility for Performance in Female Athletes. Marlborough: Crowood. pp 111-139.
(10) Gabbett TJ. Debunking the myths about training load, injury, and performance: empirical evidence, hot topics and recommendations for practitioners. J Sports Med Published Online First: 26 October 2018. Doi: 10.1136/bjsports-2018-099784.
(11) Malone Shane, Hughes Brian, Doran Dominic A, Collins
Kieran, Gabbett TimJ.Can the workload–injury relationship be moderated by improved strength, speed and repeated-sprint qualities?.Journal of Science and Medicine in Sport https://doi.org/10.1016/j.jsams.2018.01.010