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by Leach R
(Pulled Muscle; Strain, Muscle)


A muscle strain is damage the internal structure of the muscle. It can range from minor injury to severe with internal bleeding. If the damaged parts of the muscle pull away from each other, it is called a muscle rupture.

Muscles of the Back
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A muscle strain is caused by stress that the muscle cannot withstand. There are several ways that this can happen:

  • Muscle may not be ready for sudden stress
  • Tension may be too much for the muscle to bear, such as lifting a weight that is too heavy for you
  • Muscle is used too much on a certain day

Certain areas have muscles that are more likely to be strained than others, including:

Muscles that cross 2 joints are at the greatest risk.

Risk Factors

Factors that increase your chances of getting a muscle strain include:

  • Athletic activities, especially those with running, lifting, and jumping
  • Tight muscles
  • Fatigue
  • Overexertion
  • Cold weather


Symptoms depend on how you strained the muscle.

Strain while doing physical activity:

  • Immediate soreness or pain in the affected muscle
  • Increased pain if you try to use that muscle
  • Area becomes tender and swollen
  • May be a skin bruise because (more severe tearing)
  • Moving the nearby joints causes pain. Running and lifting are common activities that cause this type of muscle strain.

Strain from a build up of stress:

  • Very sore muscle the day after you do an unfamiliar activity (may not feel pain during the activity)
  • Use of muscle causes pain or discomfort


You will be asked about your symptoms and how injury happened. The injured area will be examined. A muscle strain can be diagnosed after an exam.

Tests are not often needed. The doctor may use them if there is severe pain or bleeding. Options include:


Treatment depends on the severity of the strain and the muscle involved.

Acute Care


The muscle will need time to heal. Avoid activity that stresses the area. In general, during recovery:

  • Avoid activities that cause pain.
  • Walk using a shorter stride.
  • Avoid playing sports.
Home Care
  • Ice may help decrease swelling and pain. It is most effective in the first few days after the injury.
  • An elastic bandage around the area can provide some compression. It may help to stop more swelling.
  • Elevate the area when at rest. This can also help reduce swelling.
Pain Relief Medicine

Pain medicine may be advised. These may include:

  • Over-the-counter medicine, such as aspirin, ibuprofen, or acetaminophen
  • Topical pain medicine—creams or patches that are applied to the skin
  • Prescription pain relievers

Returning to Activity

To prevent reinjury your doctor may recommend:

  • Rehabilitation with a physical therapist—for more severe injury
  • Heat to loosen muscle before activity
  • Regular stretching program to relieve some stress on the muscles


To reduce your chance of straining a muscle:

  • Keep your muscles strong. This will help to absorb the energy of sudden stressful activities.
  • After a short warm-up period, stretch out tight muscles.
  • Learn the proper technique for athletic activities to decrease muscle stress.
  • Stop when you are tired. Tired muscles do not function well. They do not react properly to sudden stress.


American Orthopaedic Society for Sports Medicine  http://www.sportsmed.org 

Ortho Info—American Academy of Orthopaedic Surgeons  http://orthoinfo.org 


Health Canada  http://www.hc-sc.gc.ca 

Public Health Agency of Canada  http://www.phac-aspc.gc.ca 


Counsel P, Breidahl W. Muscle injuries of the lower leg. Semin Musculoskelet Radiol. 2010 Jun;14(2):162-175.

Muscle strain. Johns Hopkins Medicine website. Available at: http://www.hopkinsortho.org/muscle%5Fstrain.html. Accessed December 31, 2018.

Orchard J, Best TM, et al. Return to play following muscle strains. Clinical Journal of Sport Medicine. 2005 Nov;15(6):436-41.

Sprains, strains, and other soft-tissue injuries. Ortho Info—American Academy of Orthopaedics website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00304. Updated July 2015. Accessed December 31, 2018.

1/4/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.

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