Are Muscle Strains Preventable, and do they Require Medical Care?

At this time of year, sports seasons converge — the Miami Dolphins, Miami Heat, Florida Panthers — not to mention upcoming college football bowl games, college basketball and the Life Time Miami Marathon and Half.

With so many athletes out there doing their thing, muscle strains are, unfortunately, part of the game — with some injuries more high-profile than others. But muscle strains are also part of life for everyday people — whether they are passionate about pickleball, strain themselves chasing after a toddler, or even experience muscle overuse at work.

Elite athletes are far from the only ones to endure painful soft-tissue injuries. “It could be anybody,” says sports medicine primary care physician Michael Yurubi, D.O., of Baptist Health Orthopedic Care. It can even happen just stepping off a curb.

Michael Yurubi, D.O., sports medicine primary care physician with Baptist Health Orthopedic Care

What is a muscle strain?

A muscle strain is a twist, pull or tear of a muscle or tendon, the cord of tissue connecting muscle to bone. Most strains occur when the muscle fibers are stretched beyond their limits or the muscle is forced to contract too strongly. A direct blow to the muscle may also cause a similar injury.

Strains can range from a minor stretch to a partial or complete tear of a muscle or tendon. In some cases, such as accidents, they can’t be avoided. But there are steps that can reduce the risk of muscle strains from exercise, Dr. Yurubi says. These include strengthening, stretching, warming up and cooling down.

“The most important thing is to progressively load muscles slowly and then work up to your activity,” Dr. Yurubi say. “You shouldn’t go from a relatively sedentary lifestyle to bike riding a hundred miles. Your muscles likely aren't adapted to that kind of demand.”

Take the time to “ramp up” when starting a new activity or intensifying involvement, Dr. Yurubi advises. “I think resistance strengthening is underutilized,” he says. “It is important to use strength training to allow tendons and muscles to adapt to the extra load.”

Once a strain occurs, the muscle is vulnerable to reinjury, Dr. Yurubi notes, so it’s important to follow preventive guidelines.

When to seek medical help

Because muscle strains are fairly common, some people might hesitate to consult a doctor or urgent care for something they think is routine. But seeking expert care is the best way to know if something serious has occurred.

“If you can isolate a specific spot where you have pain, as opposed to having generalized pain, that is concerning,” Dr. Yuribi says. “Also, if there is weakness, that is a red flag.”

Medical treatment for muscle strains is designed to relieve pain and restore range of motion and strength. Muscles and tendons vary in their makeup, so having the injury evaluated is important. “Depending on where the pain is, I would adjust my treatment a little bit,” Dr. Yurubi explains.

Dr. Yurubi advises people to seek prompt care if they heard or felt a pop at the time of injury or if they have severe pain, swelling or discoloration. Consulting a doctor is also important if symptoms do not improve after 48 hours.

Most important, people should not hesitate to seek medical care out of fear that they might require surgery. The majority of strains can be treated nonsurgically, Dr. Yurubi says. “Muscles and tendons have a good blood supply, and wherever you get blood flow, you have a chance to heal.”

How serious is your strain?

To simplify diagnosis and treatment, physicians classify muscle strains based on the severity of muscle fiber damage:

• Grade I strain: This is a mild injury, in which only a few muscle fibers are stretched or torn. Although the affected area is tender or sore, there is no loss of strength or range of motion. Rest, ice, compression and elevation (RICE) is generally the recommendation, although prolonged immobilization can lead to stiffness and is not recommended. “Three or four days after, you want to start getting back to activities,” Dr. Yurubi says.

• Grade II strain: In this moderate strain, a greater number of muscle fibers are injured and there is more severe pain and tenderness. Grade II strains are associated with some loss of motor function and limited range of motion. There may also be mild swelling, a notable loss of strength and bruising. RICE therapy is again recommended, although healing may take weeks instead of days. While most strains heal on their own, a rehabilitation program may be advised.

• Grade III strain: In this more serious injury, the muscle is torn all the way through. People sometimes report experiencing a “pop” as the muscle rips or shears away from its tendon. Grade III strains cause complete loss of muscle function, as well as considerable pain, swelling, tenderness and discoloration. There may be an obvious “dent” or “gap” under the skin where the muscle has torn apart. In many cases, healing can occur without surgery, but physical therapy will be required. Full recovery may take months.

• Avulsion injuries: In the most severe injuries, the tendon tears completely away from the bone and may even pull a piece of bone away with it. These injuries may require surgery to reattach the tendon in order to return to normal function and movement. After surgery, most people regain normal muscle function with several months of rehabilitation.

A new era in orthopedic care and sports medicine launched in South Florida with the inauguration of Baptist Health’s state-of-the-art orthopedic complex on the grounds of the Miami Dolphins training facility. To make an appointment, please call 786-595-1300 or visit BaptistHealth.net/OrthoComplex for more information.