Muscle strain or tear
Muscles are strained or torn when some or all the fibres are unable to cope with the force. Muscle injuries commonly occur in sports affecting muscles such as the quadriceps, hamstrings, calves (gastrocnemius or soleus) or the rotator cuffs. Muscles are more prone to tears from training error, sudden acceleration or deceleration. Risk factors involve insufficient warm-up, inadequate rest periods, muscle or joint tightness, muscle weakness or previous injury.
Grades of muscle strain or tear
There are three grade of muscle strains or tears:
Grade I – small number of muscle fibres are strained, causing pain and minimal decrease in range of motion but usually no loss of strength. Recovery usually take 2-3 weeks.
Grade II – a large number of muscle fibres are torn but not completely ruptured, causing pain and swelling that are associated with loss of range of motion and strength. Partial tears may require 2-3 months before returning to sports.
Grade III – complete tear of muscle fibres or tendon causing severe pain, swelling, loss of strength and range of motion. Full rupture may require surgery to reattach the fibres. These injuries can take more than 3 months to heal.
Treatment of muscle strain/tear
Acute management of muscle strains or tears is similar to ligament strains. It involves RICE (rest, ice, compression and elevation) and nonsteroidal anti-inflammatory drugs such as ibuprofen. A short period of immobilisation may also be recommended depending on the severity of the injury. An ultrasound or MRI can be helpful in differentiating the grade of the muscle injury.
What is muscle contusion?
Muscle contusion is commonly caused by a direct blow or collision in sports, resulting in localised muscle injury and bleeding. Symptoms can involve pain, swelling, bruising or a lump over the skin called haematoma (pool of blood within injured tissue). In severe cases may be associated bone fractures and dislocations. Acute management also involves the RICE protocol for 48-72 hours followed by heat. See your doctor or physiotherapist to determine the severity of the injury. X-ray, ultrasound or MRI may be required in severe cases. Most of the time contusions heal quickly but return to sports require rehabilitation to restore pain-free range of motion, adequate strength and flexibility.