Strain Injuries and Muscle Function

Now that I’ve talked about sprain injuries what about strain injuries. Strains are muscular in nature. They can happen from acute traumas, repetitive motion, over stretching, not warming up adequately before starting exercising and lifting beyond what the muscle can endure. These are the most common reasons for strain injuries I see in my office.

A little anatomy to enjoy first, I’m sure your tickled pink. First off tendons are the end points of muscle that attached to the bone. When we’re talking about bicep tendonitis we are talking about inflammation of the tendon of the bicep where it either originates or inserts into a bone.  It’s an injury to the bicep muscle just involving the tendon of the muscle. There are also three kinds of muscles in the body the first is cardiac muscle, the heart is a muscle. The second types of muscles we have in our body are called smooth muscles. Smooth muscle is involuntary in other words we can consciously tell smooth muscle to contract or relax. An example of smooth muscle is your intestines just imagine if you had to consciously tell your intestines to contract and relax during digestion. The third type of muscle which I’m going to spend the rest of the time talking about is called striated muscle or skeletal muscle these muscles have both voluntary and involuntary movement. Right now I’m typing this article, I’m thinking about what keys to press and the muscles in my arm, hand and fingers are tapping those keys. Too bad it’s the back space key to often than not. That’s a voluntary action just like running lifting your arm to catch a ball. Muscles can also contract in 3 different ways. The first type of contraction is Isometric contraction , This occurs when the muscle exerts force but there is no movement of the limb (for example; when carrying a bag of groceries, the arm muscles are contracting in order to hold the bag but the arm itself is not moving). The second type of muscle contractions is called Concentric contraction can be described as a shortening of the muscle in order to exert force and move a limb (for example; flexing the biceps muscle is a concentric contraction in order to do an arm curl). Eccentric contractions the third type are relied on the most. These are contractions that occur in the muscle while it is lengthening (for example; as a person lowers the curl bar in a biceps curl, the biceps are performing eccentric contractions in order to slow the descent of the bar. The muscle is getting longer but it is still exerting force). Within each muscle there are 2 kinds of muscle fibers Type I fibers have slower contraction rates and are used more for extended activities as they are more resistant to fatigue and Type II fibers have faster contraction time and are seen mostly in muscles that cross two joints performing eccentric contraction such as the hamstring muscle.
Injuries to muscle tissue can occur three different ways: contusion, strain or laceration. Ninety percent of occurrences are as contusion or strain. A contusion is described as a trauma occurring from a direct blow or a sudden heavy compressive force. In strains, an excessive tensile force upon the muscle fibers can lead to a rupture where the belly of the muscle becomes the tendon of the muscle. The more muscle fibers that are involved the more severe the injury is. The most common muscle types that strain are those that cross two joints known for eccentric contraction such as your calf muscle and hamstrings. There are three classifications of muscle injury: mild, moderate and severe. Mild (first degree) is described as a tear of only a few muscle fibers with minor swelling and pain. There is usually no or minor loss of strength or movement.
Moderate (second degree) is considered to have a greater damage of the muscle with a loss of ability to contract and is more painful. Severe (third degree) is defined as a tear extending across the entire muscle resulting in complete loss of muscle function. When a muscle contracts, it pulls on the tendon which in turn pulls the bone. A strain is an injury to that muscle or tendon. If the muscle is stretched too far or stretched while contracting, a strain can happen. The extent of the injury is a result of the stress on the muscle and is determined by the amount of tissue damage – defined earlier as mild, moderate or severe. Strain injuries will usually cause an increase in pain with active motion where sprain injuries will usually cause an increase in pain with passive motion.

Treatment of strain injuries requires time just like sprain injuries. If the is overpowered by use before it’s completely healed it can become reinjured. This will cause more scar tissue to form which makes the muscle weaker over time. Many people think once the symptom of pain goes away their 100% healed.  Healing takes time the absence of symptoms does not mean the muscle is healed it just means healing has started.

Treatment is always ice for the first 1-2 days after any acute injury to soft tissue. After that time I recommend to my patients a combination of ice and heat for another 2 days 3-4 times a day. Once the pain is 80% reduced which can be in a few days to a few weeks or more heat can be used before gentle stretching starts then followed by ice to prevent inflammation returning.  Goals are to reduce inflammation and allow the body to start the healing process. Depending on the severity of the injury immobilization and rest should also be considered. Therapies like ultrasound, electrical muscle stimulation massage can also help to promote healing. Personally, I do not recommend over the counter analgesics such as those creating heat or cold. They basically cover up symptoms. I do recommend to my patients arnica. In either pill form or cream form the herb arnica helps to heal muscle, reduce inflammation which will promote faster healing.

Can strain injuries cause subluxation to occur? Of course, if the muscle is damaged from a strain injury it can no longer give strength to that joint. If the joint is not allowed to heal increased stress is exerted to the ligaments which can cause further damage to the joint. The instability can lead to misalignment of the bones comprising the joint. Continuation of joint irritation will lead to further inflammation and a compromise joint function. If the injury is to the back for instance this inflammation can put undue pressure to the nerves exiting the spine causing dysfunction of that nerve. Continued muscle tightness occurs as your body’s way of self protection and guarding and all of a sudden from what seemed to be no big deal just a pulled muscle turns into not only chronic back issues but the potential of issues to those parts of the body that nerve innervates.

A few things to remember:

Always stretch, warming up muscles can prevent strains.

The first sign of muscle strain that pulled feeling stop and get some ice on it right away.

Start with gentle stretching as you get better increasing any physical activity slowly. Use a combination of  ice and heat to control inflammation and allow  new fluids to help the healing process.

.Arnica will help heal faster than over the counter analgesics.

Don’t be confused by the absence of pain, it’s just a symptom let the area fully heal before stressing it again.

If symptoms are not decreasing and other symptoms are starting to present themselves see your chiropractor. We are specialists in neuromuscular skeletal injuries.