It starts with a slight pull and a tight, uncomfortable feeling in the muscle that gradually gets stronger and really uncomfortable: A pulled muscle (ICD M62.6) is one of the most common sports injuries that every active person is likely to encounter sooner or later.
Find out more about the symptoms and treatment here and find selected doctors for the treatment of a pulled muscle
In a muscle strain(distension), the muscle fibers are stretched excessively and beyond the limits of their elasticity. This leads to irritation and inflammation in the muscle tissue, which slowly increases. In contrast to a torn muscle fiber, however, there is no tearing of the muscle fibers, only a severe overstretching.
As the tissue of the affected muscle remains intact, there is normally no bleeding. However, the inflammatory reaction typically leads to swelling of the muscle tissue, which can vary in severity depending on the extent of the injury.
The video shows how muscle fibers are structured:
The most common cause of a pulled muscle is incorrect strain, where the tense muscles are suddenly overstretched. This often happens during sport and especially when you accelerate abruptly - for example when sprinting off at speed or during a final sprint.
A rapid change between accelerating and decelerating, such as in tennis or soccer, is also a typical accident mechanism for muscle strain. Athletes who have not warmed up are particularly at risk, as their muscles are much more susceptible to injury. Muscles that have been pre-stretched during warm-up training are significantly less susceptible to overstretching and muscle strain.
Overexertion of the muscle through vigorous, frequently repeated movement during sport or at work can also trigger such an injury. Muscle strains are therefore not just an issue for athletes. Almost every physically hard-working person has to deal with an unpleasant pulled muscle from time to time.
A pulled muscle can affect any muscle. However, there are muscle groups that are particularly susceptible. These include the leg muscles in particular, especially the thigh and calf muscles. Groin strains(adductor strains) are also well-known and feared.
The muscles of the upper extremities, in particular the shoulder and arm, are less frequently affected. One of the reasons for this is that the muscles in the leg are generally much stronger and more developed than those in the arm. The chest and back muscles can also be pulled, but also much less frequently than the leg muscles.
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A pulled muscle causes pain, which often gets worse at first and reaches its maximum after 1-3 days. This is due to the increasing inflammation of the tissue and the resulting swelling. In addition, the muscles harden and those affected experience cramp-like, pulling pain with continued strain. Relaxation measures and shaking are also ineffective and do not lead to any improvement in symptoms. At rest, the symptoms usually subside again, which is why physical activity and sports training are usually voluntarily avoided.
A pulled muscle can usually be diagnosed solely on the basis of how the accident happened and the symptoms described. Patients typically report
A physical examination almost always reveals a painful pressure point in the area of the affected muscles. Relatively soon after the accident, a discoloration often develops due to an increasing amount of bruising. Swelling of the affected muscles and reddening of the overlying skin can also often be observed.
The injured muscles can also be easily and reliably visualized using an ultrasound examination. This usually reveals swelling and bruising in the affected muscles.
If injury to the bony attachment structures (tendons) is suspected or in the case of very protracted, severe courses of the disease, an MRI examination can also be arranged. Here, the tissue can be visualized even more reliably and better than with ultrasound diagnostics. If bone injuries are suspected, an X-ray examination is recommended.
Keeping calm is particularly important when treating a pulled muscle: stop doing sport or strenuous activity immediately! The painful part of the body now needs to rest.
Cooling as quickly as possible also helps in the phase immediately after the accident, for example with cool packs, compresses with cold water or by soaking the injured body region (bathing is also possible) in cool water. However, ice should never be applied directly to the skin, but wrapped in a protective cloth.
Heat is contraindicated in the acute phase (i.e. the phase immediately after the accident), which means that you should avoid heat at all costs. The application of heat further supports the inflammatory process and increases swelling and pain symptoms. Therefore, never apply heat in the acute phase!
After initial cooling, it is advisable to consistently protect the pulled muscle. This is best done by immobilizing it with a supportive and protective elastic bandage. Bandages have also proved very effective. Special shoes or hard-shell bandages (e.g. plaster casts) are not necessary.
However, additional elevation of the affected body region can be very helpful and quickly alleviate the pain symptoms. The reduced blood supply also often significantly reduces swelling and bruising hardly occurs or occurs much more slowly. Elevation also makes it easier for the body to remove the fluid that has leaked into the surrounding tissue. Swelling is an important cause of the pain symptoms of a pulled muscle, so that elevation is usually perceived as very pleasant.
Massages are also very helpful and support the healing process. This promotes recovery of the damaged muscles and reduces existing swelling. The massage treatment is also generally very pleasant for the patient.
After the acute symptoms have subsided, heat treatment can also be helpful, but in moderation and depending on whether and how the heat treatment is tolerated.
A healthy diet rich in magnesium and protein and sufficient fluid intake help the body to regenerate the damaged muscles and to remove the fluid that has leaked into the tissue as a result of the inflammatory process more easily.
The length of the rest period for a muscle strain depends on the type and severity of the strain. It is also important which muscles are affected. If a muscle strain does not improve significantly within a few days, medical help should be sought. What appears to be a pulled muscle can also be a torn muscle fiber or an injury to tendons or bones. A long course of illness and increasing pain should therefore be taken seriously and require a medical examination.
A visit to the family doctor is often sufficient, who will then decide whether an appointment with a specialist (specialist in trauma surgery, orthopaedics or sports medicine) is necessary. Further examinations can then be arranged and an assessment made as to how long the rest period should be. However, it is always necessary to weigh up the necessary recovery of the muscles against the disadvantages of a longer training break. For this reason, highly motivated professional athletes in particular will want to keep the rest period as short as possible. Nevertheless, resuming training too early can have long-term negative consequences, which can lead to a slump or the end of a professional athlete's sporting career. Experience has shown that a rest period of 5-7 days is sufficient to allow the muscle strain to heal.
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