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Jai Ganesh

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Registered: 2005-06-28

Posts: 48,384

Muscle tear

Muscle tear

A mild muscle strain may cause some pain and weakness. Severe muscle strains involve much (or even complete) tearing. People often hear the muscle "pop" when the injury happens. This may result in extreme pain and not being able to use that muscle. A severe muscle strain injury is an emergency.

Summary

If you exercise regularly or if your job includes lots of physical activity, you may have had an ache or injury that could be a sprain, strain or tear.

Many of us have heard these words, but don’t exactly know what they mean or use them interchangeably when they aren’t really the same thing. If you’re not a doctor or medical professional, chances are you can’t diagnose yourself, so it’s best to schedule an appointment with a physician to understand whether your injury is a sprain, strain or tear and what the best treatment is to help you heal.

If you’re still wondering the differences between these three conditions, here’s a primer:

Sprains

What is a Sprain?

A sprain occurs when you overstretch or tear a ligament, which are the tissues that hold together your bones and provides support for them.

You experience a sprain when the joint bends unnaturally, and these injuries typically occur in the ankles, but also can happen in the fingers, calf muscle or shoulder.

What are the Symptoms?

Symptoms of a sprain include inflammation or swelling, mild or severe joint or muscle pain, tenderness, bruising and difficulty with movement at the injury site (for ex: not being able to move your shoulder or put pressure on your ankle).

What about Treatment?

A mild sprain can take around 10 days to heal, while a severe sprain can take several weeks to get better. Elevating the part of the body where you’ve suffered a sprain can help it heal (in the ankle, for example). Placing ice on the injury site, wearing compression garments to prevent swelling, taking over-the-counter medications and getting plenty of rest also will help with your recovery. However, in severe cases you may need to see a doctor and get a splint or cast to prevent further injury.

Strains

What is a Strain?

A strain occurs when you overstretch or tear the muscle or tendon, the latter of which connects muscles to the bones.

Repetitive movements or a single event can lead to a strain, such as a hamstring strain for a soccer player or an injury you experience at the gym from lifting too heavy a weight.

The back and hamstring are the most common locations for a strain, though this injury can affect any muscle in the body.

What are the Symptoms?

Bruising, cramping, difficult movement, muscle pain, spasms and weakness and swelling. Depending on whether the strain is mild, moderate or severe, it could take a few days or several weeks to heal.

What about Treatment?

Treatment for a strain is similar to treatment for a sprain: plenty of rest, ice and compression to reduce swelling. But if your injury is serious, if you have severe swelling and difficulty moving, it’s best to see a doctor as soon as possible for treatment.

Tears

What is a Tear?

A tear occurs when tissue rips in the muscles, ligaments or tendons. Typically, a tear occurs for the same reasons as overstretching, such as repeated movements that worsen the injury or one incident that causes the injury. However, a tear is more serious than a strain because it can put you out of commission for longer.

What are the Symptoms?

A tear usually comes with intense pain, severe inflammation, swelling and even bleeding at the injury site. The more severe the tear, the longer it’ll take to heal.

What about Treatment?

Rest, ice, compression and elevation can help your recovery, but some tears may require surgery to reconstruct and repair the ligament. One tear you may be familiar with is an anterior cruciate ligament (ACL) tear, which is common in athletes. Stars like soccer player Alex Morgan, New England Patriots quarterback Tom Brady and Orlando City Soccer’s Conor Donovan all have experienced ACL tears and successfully recovered.

Sprains, strains and tears can happen to anyone who is physically active. They also can happen at any time, like when you lift a heavy box, land on the wrong foot or during an accidental trip or fall. In most cases, rest, over-the-counter medication and icing the injury will help, as will compression to reduce swelling. But some injuries may require medical attention and even surgery. If you experience severe swelling that hinders your movement, don’t hesitate to see a doctor. Appropriate and timely medical care could keep it from getting worse.

Details

A strain is an acute or chronic soft tissue injury that occurs to a muscle, tendon, or both. The equivalent injury to a ligament is a sprain. Generally, the muscle or tendon overstretches and partially tears, under more physical stress than it can withstand, often from a sudden increase in duration, intensity, or frequency of an activity. Strains most commonly occur in the foot, leg, or back. Immediate treatment typically includes four steps abbreviated as R.I.C.E.: rest, ice, compression, elevation.

Signs and symptoms

Typical signs and symptoms of a strain include pain, functional loss of the involved structure, muscle weakness, contusion, and localized inflammation. A strain can range from mild overstretching to severe tears, depending on the extent of injury.

Cause

A strain can occur as a result of improper body mechanics with any activity (e.g., contact sports, lifting heavy objects) that can induce mechanical trauma or injury. Generally, the muscle or tendon overstretches and is placed under more physical stress than it can withstand. Strains commonly result in a partial or complete tear of a tendon or muscle, or they can be severe in the form of a complete tendon rupture. Strains most commonly occur in the foot, leg, or back. Acute strains are more closely associated with recent mechanical trauma or injury. Chronic strains typically result from repetitive movement of the muscles and tendons over a long period of time.

Degrees of Injury (as classified by the American College of Sports Medicine):

First degree (mildest) – little tissue tearing; mild tenderness; pain with full range of motion.
Second degree – torn muscle or tendon tissues; painful, limited motion; possibly some swelling or depression at the spot of the injury.
Third degree (most severe) – limited or no movement; severe acute pain, though sometimes painless straight after the initial injury

To establish a uniform definition amongst healthcare providers, in 2012 a Consensus Statement on suggested new terminology and classification of muscle injuries was published.

The classifications suggested were:

The major difference suggested was the use of "indirect" muscle injury verse "grade 1" to provide subclassifications when advanced images were negative.

Risk factors

Although strains are not restricted to athletes and can happen while doing everyday tasks, people who play sports are more at risk for developing a strain. It is common for an injury to develop when there is a sudden increase in duration, intensity, or frequency of an activity.

Treatment

The first-line treatment for a muscular strain in the acute phase include five steps commonly known as P.R.I.C.E.

Protection: Apply soft padding to minimize impact with objects.
Rest: Rest is necessary to accelerate healing and reduce the potential for re-injury.
Ice: Apply ice to induce vasoconstriction, which will reduce blood flow to the site of injury. Never ice for more than 20 minutes at a time.
Compression: Wrap the strained area with a soft-wrapped bandage to reduce further diapedesis and promote lymphatic drainage.
Elevation: Keep the strained area as close to the level of the heart as is possible in order to promote venous blood return to the systemic circulation.

Immediate treatment is usually an adjunctive therapy of NSAIDs and Cold compression therapy. Cold compression therapy acts to reduce swelling and pain by reducing leukocyte extravasation into the injured area. NSAIDs such as Ibuprofen/paracetamol work to reduce the immediate inflammation by inhibiting Cox-1 and Cox-2 enzymes, which are the enzymes responsible for converting arachidonic acid into prostaglandin. However, NSAIDs, including aspirin and ibuprofen, affect platelet function (this is why they are known as "blood thinners") and should not be taken during the period when tissue is bleeding because they will tend to increase blood flow, inhibit clotting, and thereby increase bleeding and swelling. After the bleeding has stopped, NSAIDs can be used with some effectiveness to reduce inflammation and pain.

A new treatment for acute strains is the use of platelet rich plasma (PRP) injections which have been shown to accelerate recovery from non-surgical muscular injuries.

It is recommended that the person injured should consult a medical provider if the injury is accompanied by severe pain, if the limb cannot be used, or if there is noticeable tenderness over an isolated spot. These can be signs of a broken or fractured bone, a sprain, or a complete muscle tear.

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