Pulled muscles: Not nearly as much fun as Pulled Pork

Breaking the armHave you ever felt a muscle twinge as if you pulled a rubber band too far and it snapped?  Perhaps you were moving heavy boxes, carrying all your groceries in at once or playing an intense sports game. Whatever the case may be, most people have experienced muscle pain at least once in their life, but is it a strain or sprain?

Strain or sprain, who is the real culprit?

Sprains and strains are among the most common injuries in sports, resulting in a temporary cessation from physical activity. The two injuries differ by whether the injury affects the muscle tendon unit or the ligaments surrounding the joint. A strain is an injury where either the specific muscle itself tears, or the tendon, the fibrous cord of tissue connecting muscle to bone. Strains are widely known as “pulled muscles”. Strains most commonly happen in the lower back muscles or the hamstring muscle in the back of the leg, most commonly from lifting heavy objects and general overuse. Strains and sprains both are categorized as:

  • First degree
  • Second degree
  • Third degree

 Most strains happen at the onset of an incident, however chronic strains can occur because of prolonged overuse of the muscle. Sprains are the consequence of a stretching or tear to a ligament, the fibrous band of tissue connecting the bone to another bone or joint. Using the same scale as strains. The most common site for sprains is down in the ankle; the ligaments around the ankle turn inward or outward during a fall and twist, causing the ligaments supporting the ankle joint to tear.

Signs and Symptoms:

The joint or muscle where the injury occurs will be most notably:

  • Swollen
  • Irritated
  • Red
  • Unable to move in most cases

During a fall, joints can become twisted or out of position stretching the ligaments excessively and causing internal bleeding. This type of injury is very common in the ankle, accounting for 90% of all sprains.  Swelling may be absent in patients that have a history of multiple strains or sprains, but a feeling of weakness or instability will still accompany the injury. Whether or not swelling occurs, one needs to be cautious when navigating with that body part until a full recovery is complete.  Repetitive strain injury happens when the same muscle or muscle group is strained multiple times. The muscle will then experience throbbing pain, cramps or numbness. Rehabilitation strengthens the muscle after an injury helping to avoid reinjuring the muscle.


A player injuring himself or herself during a game or practice should immediately step off the field, ceasing play.  A good rule to follow after a strain or sprain is R.I.C.E.

  • Rest means to not use the injured area as much as possible. Laying down is the best form of rest because there is no pressure on the body.
  • Ice needs to be administered for 20 minutes several times a day.
  • Compression is important to reduce initial swelling. Wrap an ace bandage or
  • Elevation is keeping the injured area above the heart provides improved blood flow. Elevation helps to reduce swelling and pressure to the injured area.

Be cautious when putting ice directly on the skin because it can cause blisters. A light towel can cover the ice pack preventing any blisters from forming while still providing the benefits of icing. Compression is especially important directly following the injury. In ankle injuries, keeping one’s shoe on until medical attention can be administered helps to compress the area, reducing much of the initial swelling. Swelling is a major component in the length of the recovery; reducing the swelling will lead to a quicker rehabilitation. Mild to moderate strains and sprains can usually heal within a few days using this principle, but may need more time depending on the specific injury.  Monitoring the injury even after rehabilitation is important to ensure the same injury does not occur again. Strengthening the muscles involved in or surrounding the injury additionally helps to prevent a concurrent injury.


The American College of Foot and Ankle surgeons. (2009, December 08). Ankle sprain. Retrieved from http://www.foothealthfacts.org/footankleinfo/ankle-sprain.htm

Better Health Channel. (2012, July). Ankle sprains. Retrieved from http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Ankle_sprains

Hannafin, J. Health and human services, National Institute of Arthritis and Musculoskeletal and Skin Diseases (2012). Sprains and strains. Retrieved from NIAMS Information Clearinghouse website: http://www.niams.nih.gov/Health_Info/Sprains_Strains/default.asp

Hess, K. (2010, June 10). Injury recovery: The rice principle. Retrieved from http://www.dukehealth.org/orthopaedics/services/sports-medicine/care-guides/injury-recovery-the-rice-principles

Mayo Clinic Staff. (2012, AUGUST 12). Sprains and strains. Retrieved from http://www.mayoclinic.com/health/sprains-and-strains/DS00343

NHS choices. (2012, February 03). Repetitive strain injury symptoms. Retrieved from http://www.nhs.uk/Conditions/Repetitive-strain-injury/Pages/Symptoms.aspx