Strain Injuries

A strain injury is a tear in the connective tissue, usually either muscle, fascia, ligament or combination thereof, as a result of overstretching the area. Muscles are more prone to strain injuries during an eccentric contraction (muscle is lengthening with resistance) versus a concentric contraction (muscle is shortening with resistance).  Tendons are less vascularized (less circulation) which makes them more prone to rupture/tearing at the area of least blood supply; usually the middle or at the musculotendinous junction (where the muscle attaches to the tendon).
 
Causes of Strain Injuries:

• Sudden Overstretching
• Extreme Contraction of the muscle against heavy resistance
• Warming up before an activity or sport decreases the likelihood of straining tissue. Other factors that can contribute include:
• Inflexibility
• Fatigue
• Poor form
• Repetitive overuse
• Muscle imbalance
• History of previous strain

 
Levels of Strain Severity
 
Grade 1, Mild or First Degree Strain: minor tear to the musculotendinous unit with minimal discomfort when contracting or stretching the area. Symptoms include:

• Mild Swelling, Heat, Bruising may be present
• Point Tenderness
• Minimal Loss of Strength or Range of Motion
• Able to Continue with Sport/Activity

Grade 2, Moderate or Second Degree Strain: the degree of tearing can be several fibres to the majority of the fibres. You would have difficulty continuing with your sport or activity due to weakness, reflex inhibition and pain.

• Snapping sound when injury occurred
• Moderate swelling, heat, hematoma and bruising
• Palpable gap in tissue
• Moderate point tenderness
• Moderate pain when stretching or contracting the affected muscle
• Moderate loss of strength and range of motion

Grade 3, Severe or Third Degree Strain: Complete rupture of the muscle/ligament or an avulsion fracture (the tendon and muscle fibres remain intact but break a piece of bone off the limb). Continuing with any sport or activity is not possible due to pain, muscle weakness and inhibition. This type of injury must be surgically repaired and followed with physiotherapy and massage to rehabilitate the tissue.

• Snapping sensation/sound when injury occurred
• Swelling, heat, hematoma and bruising
• Palpable and possibly visible gap in tissue. Muscle may bunch up due to spasmodic contractions
• Severe pain with immediate loss of strength and range of motion

 
A period of total inactivity after a strain injury is not recommended as the affected muscles will shorten, restricting range of motion, and atrophy which will weaken the area. If the injury is not treated with some sort of soft tissue mobilization it will develop adhesions. Chronic inflammation from micro-tearing during the healing phase can also occur.
If you continue to overuse a muscle that has been strained, without giving it adequate time to heal, the area will be prone to repeated strains. It is possible to strain any muscle but the most frequently strained areas are:

• Hamstrings (usually in the middle of the muscle belly or at the musculotendinous attachment on the ischial tuberosity/just below the bum)
• Quadriceps /Thighs
• Gastrocnemius / Calves (usually at the musculotendinous junction or the Achilles attachment on the heel.)
• Adductors /Inner Thigh/ Groin Muscle (usually in the middle of the muscle belly or at the musculotendinous attachment on the ischial tuberosity/just below the groin)
• Erector Spinae (Parallel to Spine)
• Iliopsoas (Deep Postural Muscle and Hip Flexor)
• Rotator Cuff
• Biceps (usually in the muscle belly or at the shoulder attachment)
• Whiplash: strain of several neck muscles that may include the scalenes, levator scapulae, posterior cervical muscles, infrahyoids, suprahyoids and longus colli)

Massage Therapy, Physiotherapy or Athletic Therapy can not only identify the level of injury, but can be very beneficial in:

• Speeding up healing time
• Preventing development of adhesions around the scar
• Regaining strength and mobility
• Regaining range of motion

Ultimately the goal is to return to your sport/activity as soon as possible. Identifying the factors that may have contributed to the injury in the first place is key in preventing it from reoccurring. We can recommend some sport specific and personalized exercises to help you stay injury free after your rehabilitation.