Strain What is it?
A strain to the muscle or muscle tendon is the equivalent of a sprain to ligaments. A muscle strain occurs when muscle fibers cannot cope with the demands placed upon them by exercise overload leading to tearing of the fibers. It is a contraction-induced injury in which muscle fibers tear due to extensive mechanical stress. This mostly occurs as result of a powerful eccentric contraction or overstretching of the muscle. Therefore, it is typical for non-contact sports with dynamic characteristics such as sprinting, jumping.
Strains are categorized into 3 grades of severity
- Grade I (mild) strains affect only a limited number of fibers in the muscle. There is no decrease in strength and there is fully active and passive range of motion. Pain and tenderness are often delayed to the next day.
- Grade II (moderate) strains have nearly half of muscle fibers torn. Acute and significant pain is accompanied by swelling and a minor decrease in muscle strength
- Grade III (severe) strains represent complete rupture of the muscle. This means either the tendon is separated from the muscle belly or the muscle belly is actually torn in 2 parts. Severe swelling and pain and a complete loss of function are characteristic for this type of strain.
What are the causes?
A strain is caused by twisting or pulling a muscle or tendon. Strains can be acute or chronic. An acute strain is caused by trauma or an injury such as a blow to the body; it can also be caused by improperly lifting heavy objects or over-stressing the muscles. Chronic strains are usually the result of overuse–prolonged, repetitive movement of the muscles and tendons. Two common sites for a strain are the lower back and the hamstring muscle (located in the back of the thigh). Contact sports such as soccer, football, hockey, boxing, and wrestling put people at risk for strains. Gymnastics, tennis, rowing, golf, and other sports that require extensive gripping can increase the risk of hand and forearm strains. Elbow strains sometimes occur in people who participate in racquet sports, throwing, and contact sports.
How can physiotherapy help?
Physiotherapy is one of the first lines in the management of the strain. The application of ice with the aim to reduce the inflammation is the goal as a first step in the management of the strain. Compression with a bandage is another technique which can assist in both providing support and reducing inflammation in the initial stages.
Physiotherapy management includes first aid to minimize bleeding and swelling (RICE), electrotherapy modalities (e.g. Ultrasound) to promote efficient scar formation, Massage, stretching and strengthening (in the end stages of healing).
Consideration of exercise programme
The exercises are contraindicated in the first stage. As part of the physiotherapist management, the massage can be applied to patients affected by strain. Sometimes is going to be necessary a surgical management. The exercises after the acute phase are going to be indicated a relation with the localization, the specific diagnosis, and the cause.
For example, in the case of neck strain, some exercises are
- Neck rotation
- Neck stretches
- forward neck flexion
- Lateral (side) bend strengthening
- Forward bend strengthening
- Neutral position strengthening
- Chin Tuck