Muscle Strains

[Disclaimer: LUSA is providing the following information for reference only. If you or your child is injured, please contact or visit a doctor or physio-therapist prior to any treatment.]

Muscle Strains

Muscle injuries are a common injuries for all athletes but especially in sports where there is a high demands on the muscles of lower extremities such as soccer.

Muscle strains are classified as mild ( first degree), moderate (second degree, partial tears), or severe ( third degree, complete tears). They may be further be subdivided according to the site, as tears of the muscle belly usually heal more rapidly than do tears at the musculotendinous junction.

Classification of muscle injuries

1. Exercised induced muscle injury (delayed muscle soreness): the pain sensation  is related to the breakdown of muscle cells and associated inflammatory response
Onset at 24-48 hours after exercise

Related factors: 
increased activity
Unaccustomed activity
Excessive eccentric work
Viral infections

2. Strains

1st degree (mild): minimal structural damage; minimal bleeding in the muscle tissue; early resolution

Related factors:
Sudden overstretch
Sudden contraction
Deceleration limb
Insufficient warm-up
Lack of flexibility

2nd degree (moderate): partial tears; large spectrum of injury; significant early functional loss.

Related factors:
Increasing severity of strain associated with greater muscle fiber damage, more bledding within the muscle; and more eventual scarring

3rd degree (severe): complete tear; may require aspiration; may require surgery

Related factors:
Steroid use or abuse
Previous muscle injury
Collagen disease

3. Contusions

Mild, moderate or severe

Caused by direct blow to the muscle belly, associated with increasing muscle trauma and tearing of fiber proportionate to severity

The severity of these contusions have to be diagnosed early on in order to prevent more muscle damage with continued activity. 
Depending on the severity of the contusion we may see mild to severe functional loss. There will be bleeding inside the muscle due to the tearing of muscle fibers. This bleeding can calcify ( myositis ossificans) if there is continued stress by activity on the site. 

Healing of muscle trauma of moderate severity

1.Peritrauma period (0-6 hours)

Goal: minimize initial injury

2. Intense inflammation (6-24 hours)
Ice, Rest
Protect injured part

Goal: minimize inflammatory response

3. Phagocytises (24-36 hours)
Start physiotherapy protocol

Goal: prevent further injury

4. Early Healing (days 3-6)
Physiotherapy protocol

Goal: establish range of motion

5.Established healing (days 7-14):

Increase strengthening

6.Restoration of function (days 15-60):
Physiotherapy with focus on Range of motion, strength and establish normal movement patterns

Functional reintegration

Practice Point:     

Athletes should not train intensively if they have a significant bacterial or viral infection.