Treating Muscle Strains

Treating Muscle Strains
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 overstressing 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 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.

Typically, people with a strain experience pain, muscle spasm, and muscle weakness.

They can also have localized swelling, cramping, or inflammation and, with a minor or moderate

strain, usually some loss of muscle function. Patients typically have pain in the injured

area nd general weakness of the muscle when they attempt to move it. Severe strains that

partially or completely tear the muscle or tendon are often very painful and

disabling.

Treatment for sprains and strains is similar and can be thought of
as having two stages. The goal during the first stage is to reduce
swelling and pain. At this stage, doctors usually advise patients to
follow a formula of rest, ice, compression, and elevation (RICE) for
the first 24 to 48 hours after the injury. The doctor may also
recommend an over-the-counter or prescription nonsteroidal
anti-inflammatory drug, such as aspirin or ibuprofen, to help decrease
pain and inflammation.

For people with a moderate or severe sprain, particularly of the ankle, a hard cast may

be applied. Severe sprains and strains may require surgery to repair the torn ligaments,

muscle, or tendons. Surgery is usually performed by an orthopaedic surgeon.

It is important that moderate and severe sprains and strains be evaluated by a doctor

to allow prompt, appropriate treatment to begin. The box above lists some signs that

should alert people to consult their doctor. However, a person who has any concerns about

the

seriousness of a sprain or strain should always contact a doctor for advice.

The second stage of treating a sprain or strain is rehabilitation, whose overall goal

is to

improve the condition of the injured part and restore its function. The health care

provider will prescribe an exercise program designed to prevent stiffness, improve range

of motion, and restore the joint's normal flexibility and strength. Some patients may need

physical therapy during this stage.

When the acute pain and swelling have diminished, the health care provider or physical

therapist will instruct the patient to do a series of exercises several times a day. These

are very important because they help reduce swelling, prevent stiffness, and restore

normal,

pain-free range of motion. The health care provider can recommend many different types of

exercises, depending on the injury. For example, people with an ankle sprain may be told

to

rest their heel on the floor and write the alphabet in the air with their big toe. A

patient with an injured knee or foot will work on weight-bearing and balancing exercises.

The duration of the program depends on the extent of the injury, but the regimen commonly

lasts for several weeks.

Another goal of rehabilitation is to increase strength and regain flexibility.

Depending on the patient's rate of recovery, this process begins about the second week

after the injury. The health care provider or physical therapist will instruct the patient

to do a series of exercises designed to meet these goals. During this phase of

rehabilitation, patients progress to more demanding exercises as pain decreases and

function improves.

The final goal is the return to full daily activities, including sports when

appropriate. Patients must work closely with their health care provider or physical

therapist to determine their readiness to return to full activity. Sometimes people are

tempted to resume full activity or play sports despite pain or muscle soreness. Returning

to full activity before regaining normal range of motion, flexibility, and strength

increases the chance of reinjury and may lead to a chronic problem.