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Muscle Strain


What is a muscle strain?

A muscle strain is a twist, pull, or tear of a muscle or tendon. A tendon is a strong elastic tissue that connects a muscle to a bone.

What causes a muscle strain?

Stretching a muscle too much may cause a muscle strain. A strain may also happen when a muscle is used too much without rest. Leg muscle strains are more common in people who play sports, run, dance, and water-ski. Strains in the muscles of the abdomen may happen when you play volleyball, tennis, golf, or baseball and when you dive. Low back muscle strains may occur when you lift heavy objects or when you wrestle or do gymnastics.

What are the types of muscle strains?

  • A mild strain is also called a first-degree strain. It is a tear of a few muscle fibers with little swelling. You may have very little or no loss of muscle strength.
  • A moderate strain is also called a second-degree strain. There is more damage to your muscle or tendon, and it is weaker than it was before the injury.
  • A severe strain is also called a third-degree strain. This tear goes along the whole length of the muscle, and you are unable to use the muscle at all.

What increases my risk of a muscle strain?

  • Older age
  • Muscle fatigue (tiredness)
  • Not warming up before exercise
  • Past muscle injury, or going back to your usual activity before your injury has healed
  • Stiff, tight, and weak muscles
  • Training longer or farther than your usual time or distance
  • Problems with your feet, or your legs being different lengths

What are the signs and symptoms of a muscle strain?

The signs and symptoms of a muscle strain depend on how badly your muscle is injured. The signs and symptoms may or may not show up right away when the injury happens. You may have one or more of the following:

  • Bruised skin on the area of your injured muscle
  • Muscle soreness, cramps, or spasms
  • Little or stiff muscle movement, or loss of muscle strength
  • Swelling in the area of the injury
  • Muscle pain that gets worse with activity, or pain that moves or spreads to another body area
  • Crepitus (crackling sound or grating feeling) when you move your muscle

How is a muscle strain diagnosed?

Your healthcare provider will ask about diseases or injuries you have had in the past. He may touch and press parts of your muscle. He may bend, stretch, or move your joint certain ways. You may also have any of the following tests:

  • X-ray: This is a picture of the bones and tissues in your body. X-rays may be done to make sure that you did not break a bone when your muscle strain happened.
  • Magnetic resonance imaging: This test is also called MRI. During the MRI, pictures of your muscles are taken. An MRI may be used to check for tears or other muscle injuries. It may also be used to look at your joints, bones, or blood vessels. You may be given dye through your vein before the pictures are taken. This helps your body parts show up better. Tell your healthcare provider if you are allergic to shellfish (lobster, crab, or shrimp). People who are allergic to shellfish may also be allergic to some dyes.
  • Computed tomography scan: This is also called CT scan. A x-ray machine uses a computer to take pictures of your arms, legs, back, or abdomen. It is used to check for muscle injuries, broken bones, and damaged blood vessels.
  • Ultrasound: An ultrasound uses sound waves to show pictures of your muscles and tissues on a monitor.

What can I do to help a muscle strain heal?

  • 3 to 7 days after the injury: Use Rest, Ice, Compression, and Elevation (RICE) to help stop bruising and decrease pain and swelling.
    • Rest: Rest your muscle to allow your injury to heal. When the pain decreases, begin normal, slow movements. For mild and moderate muscle strains, you should rest your muscles for about 2 days. However, if you have a severe muscle strain, you should rest for 10 to 14 days. You may need to use crutches to walk if your muscle strain is in your legs or lower body.
    • Ice: Put an ice pack on the injured area. Put a towel between the ice pack and your skin. Do not put the ice pack directly on your skin. You can use a package of frozen peas instead of an ice pack.
    • Compression: You may need to wrap an elastic bandage around the area to decrease swelling. It should be tight enough for you to feel support. Do not wrap it too tightly.
    • Elevation: Keep the injured muscle raised above your heart if possible. For example, if you have a strain of your lower leg muscle, lie down and prop your leg up on pillows. This helps decrease pain and swelling.
  • 3 to 21 days after your injury: Start to slowly and regularly exercise your strained muscle. This will help it heal. If you feel pain, decrease how hard you are exercising.
  • 1 to 6 weeks after your injury: Stretch the injured muscle. Stretch the muscle for about 30 seconds. Do this 4 times a day. You may stretch the muscle until you feel a slight pull. Stop stretching if you feel pain.
  • 2 weeks to 6 months after your injury: The goal of this phase is to return to the activity you were doing before the injury without hurting the muscle again.
  • 3 weeks to 6 months after your injury: Keep stretching and strengthening your muscles to avoid injury. Slowly increase the time and distance that you exercise. You may still have signs and symptoms of muscle strain 6 months after the injury, even if you do things to help it heal. In this case, you may need surgery on the muscle.

How is a muscle strain treated?

  • Medicines:
    • NSAIDs: This medicine is used to decrease pain and inflammation. It can be bought without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems if they are not taken correctly. Always read the medicine label and follow the directions on it before you use this medicine. You should only use this medicine for 3 to 7 days after the injury happened.
    • Muscle relaxers help decrease pain and muscle spasms.
    • Steroid medicines: Your healthcare provider may recommend a steroid injection to decrease pain and inflammation.
    • Local anesthetic: This can be used to numb the are for a short time. This is often used if you have a muscle strain in your back.
  • Physical therapy: A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain.
  • Surgery: healthcare providers may recommend surgery if your muscle strain does not heal after 6 months of treatments. Surgery may be done to drain blood that has pooled in your muscle. If your tendon was torn off of the bone, it may be put back with surgery.

How can a muscle strain be prevented?

  • Always wear proper shoes when you play sports: Replace your old running shoes with new ones often if you are a runner. Use special shoe inserts or arch supports to correct leg or foot problems. Ask your healthcare provider for more information on shoe supports.
  • Do warm up and cool down exercises: Do stretching exercises before you work out or do sports activities. These exercises will help loosen and decrease stress on your muscles. Cool down and stretch after your workout. Do not stop and rest after a workout without cooling down first.
  • Keep your muscles strong with strength training exercises: Exercises such as weight lifting and stretching exercises help keep your muscles flexible and strong. A physical therapist or trainer may help you with these exercises.
  • Slowly start your exercise or sports training program: Follow your healthcare provider's advice on when to start exercising. Slowly increase time, distance, and how often you train. Sudden increases in how often you train may cause you to injure your muscle again.

When should I call my healthcare provider?

  • Your pain and swelling worsen or do not go away.
  • You have questions or concerns about your care or treatment.

When should I seek immediate care?

  • You suddenly cannot feel or move your injured muscle.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

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