Muscle strains are one of the most common sporting injuries we see in clinic, especially in field sports such as soccer, rugby league and union, and AFL. Knowing how to recognise and treat them can help athletes get back to their sport quickly, safely, whilst also reducing the risk of further injury.
What is a muscle strain?
A muscle strain, also known as a muscle tear, is an injury that causes disruption to the muscle fibres. Muscle strains can be categorised by severity:
- Grade I: ~10% of muscle fibres are disrupted
- Grade II: 20-80% of muscle fibres are disrupted
- Grade III: Complete rupture
The severity of the muscle strain will influence recovery times; the more fibres that are torn, the longer recovery will be due to the increased need for healing. However, it’s also important to remember that the time it takes for a muscle to heal isn’t always the same as how long it takes to return to play, as you’ll see in the rest of this article.
How does a muscle strain happen?
A muscle strain occurs when there is excessive force going through the muscle at the point of injury. This usually happens when the muscle is under very high load (e.g., sprinting), or when the muscle is being stretched rapidly (e.g., kicking). When either or both of these things happen, the muscle may not be able to cope, and the tear happens.
What muscles can be affected?
Muscle strains can affect any muscle in any part of the body, but in most field sports, lower limb muscle strains are the most common. The hamstrings, groin, thigh and calf muscles are the most frequently reported strains.
The hamstrings are a group of muscles on the back of the thigh, and help with bending the knee and straightening the hip. The hamstrings are heavily involved in high speed running, and also undergo significant stretch during activities like slide tackling and kicking. Thus, the hamstrings are most commonly injured when performing any of the above.
The groin muscles are a group of muscles on the inside of the thigh, and work to draw the legs together. Some groin muscles also assist with bending or straightening the hip. In the athletic context, the groin muscles are heavily involved with change of direction activities, and are most commonly injured during cutting motions.
The quadriceps are a group of muscles on the front of the thigh, and help to straighten the knee and hip. These muscles are most commonly injured during kicking activities and sprinting.
No prizes for guessing where the calf muscles are located! The calf muscles are some of the strongest muscles in the body and are involved in pointing the foot. They are heavily involved with running, change of direction, jumping and hopping.
The following key features may help you recognise a lower limb muscle strain:
- Feeling or hearing a “pop” at the time of injury in the affected muscle
- Being unable to weight bear or walk
If you’ve experienced one or more of the above, it is likely you’ve sustained a muscle strain. So what should you do next?
What should I do?
The most important thing to do is to have a proper physical assessment with a skilled physiotherapist. Sometimes, there are other injuries that can mimic a muscle strain (e.g., an achilles tendon injury), or secondary injuries that happened alongside the muscle strain. It is important to recognise these, as this can affect your choice of treatment and recovery times.
As part of your assessment, your physiotherapist will ask you questions about what led to the injury, what you are currently experiencing, and what movements you find most difficult to do. They will then perform a physical evaluation to examine your range of motion, strength and other functional movements. Put together, your physiotherapist will have a good idea of the severity of your injury and will be able to provide you a recovery timeframe. All that’s left to do after that is to commence treatment!
What does treatment for a muscle strain involve?
The first part of successfully treating a muscle strain is planning: Understanding the sport and activities you want to get back to will help inform what kind of exercises and movements need to be included as part of your rehab.
Treatment for muscle strains should always involve progressive exercise. Whilst hands-on treatment like manual therapy can be used during rehab, rebuilding the functional capacity of the injured muscle is important in preventing reaggravation of the original injury as well as preventing new injuries.
Generally, some exercise can be safely started on day one to kick-start the recovery process; this is something that your physiotherapist will guide you through based on your assessment findings. Once the acute pain has settled down, your physiotherapist will continue to lead you through more challenging exercises involving heavier loads and higher speeds, and a gradual return to sport.
It’s important to note that feeling better (that is, having no pain) doesn’t always mean that you are actually getting better! The risk of re-injury is high, especially when a muscle strain has not fully healed or function is still compromised in some way.
If you’ve suffered a muscle strain from sport, check in with one of our expert physiotherapists for an assessment! We can help you get back on the field feeling stronger than ever.