Pain, stiffness, and swelling: the tell-tale signs that something isn’t right the morning after a workout. A little next-day soreness is normal after a day session of strenuous activity, but when these sensations become debilitating, they can be signs of significant damage.
But where exactly do you draw the line? How do you know how to tell if you have pulled a muscle, or maybe if you just pushed yourself a little bit too hard?
The line is finer than you might think, but it’s an important distinction to learn; trying to power through a pulled muscle can have disastrous consequences. So in order to prevent more severe injury, you need to know what a pulled muscle is and how to identify one.
So What Does a “Pulled Muscle” Actually Mean?
When talking about muscle injuries, you’ll sometime hear about “pulls”, “sprains”, or “tears”. All of them basically mean the same thing: damage done to the muscle that outpaces the body’s ability to repair it.
You see, when you work out your muscles will form microscopic tears in their fibers. This is called “muscle hypertrophy“, and is completely normal. It’s what causes that “hurts so good” soreness the next morning and is a part of the process by which you strengthen your muscles.
Your body repairs these damaged muscle fibers by fusing them together, making them bigger and stronger than they were before. So far so good. Where you run into trouble is when you cause damage that your body can’t easily repair.
When this happens, you sustain a pulled muscle, or muscle sprain, or whatever your term of choice may be. Usually, these injuries are caused by stretching a muscle too far, trying to exert to much force, or working with a muscular imbalance.
In these situations, you risk exerting your muscles beyond just hypertrophy. In extreme cases, you can literally tear them apart!
How to Tell if You Have a Pulled Muscle
Muscular injuries are graded on a scale from 1-to-3. A grade 1 signifies mild damage to a small number of fibers, usually less than 5% of the total mass. A grade 3 is a complete rupture of the muscles, possibly including the muscle or associated tendons being pulled from the bone.
As that disparity suggests, the symptoms and prognosis can vary considerably depending on the severity of the damage. Mild cases can often be managed with home treatment and over the counter pain medications. Severe cases can necessitate surgery to reattach torn muscles to bones.
Usually, you will feel a muscle strain as it happens. Sudden, acute pain will be the first symptom that most people experience. Shortly thereafter, your body will initiate an inflammatory response as it starts to work on the damaged tissue. symptoms at this stage include soreness, reduced mobility, swelling, spasms, a “knotted up” sensation, and bruising.
If you experience any of these sensations either immediately or shortly after a period of intense exertion, then the odds are good that you’ve sustained a pulled muscle.
More severe symptoms will correlate with more severe damage. In instances of grade 3 strains, it is sometimes possible to feel a palpable defect in the muscle, or even a space between the muscle and the bone.
Treating a Pulled Muscle
Treatment for a pulled muscle will depend on the severity of the injury. Ideally, you can treat yourself with minimal need for medical intervention.
In modest cases, the injury can be self-manged with rest, ice, compression, and elevation (RICE).
A pulled muscle is like a sprained ankle or another comparable injury. Therefore, the first step to recovery is to rest the injured muscle as much as possible and let your body work on repairing the damage.
For the first few days, try to avoid using the muscle at all. Then, start gradually working up to a casual level of activity. This is to prevent the muscle from weakening form lack of use, which can prolong the healing process.
After pain, one of the first symptoms that you’ll likely notice is swelling. To reduce swelling, treat the injury with ice as soon as possible. Just be sure to avoid applying ice directly to the skin. Instead, use a towel or ice pack.
Do this for twenty minutes every hour on the first day of your injury. For the next several days afterward, apply ice once every four hours.
Once you have applied ice, you can reduce the swelling further by applying compression to the injury.
Wrap an elastic bandage snuggly around the affected area, being careful not to wrap too tightly and risk cutting off circulation. This will help keep the swelling down in between applications of ice.
Lastly, let gravity do some of the work for you.
Try to keep the injury elevated above heart-level whenever possible. This will help slow and reduce the swelling.
These steps will help to manage the immediate symptoms.
While healing, you can treat pain and discomfort with over-the-counter pain relievers like ibuprofen. After three days, you can also begin applying heat to the affected area to stimulate blood flow and promote faster healing.
Preventing Future Injuries
Preventing injuries can sometimes be easier said than done, as it’s not always obvious to us how we risk harm. Most people might not associate their neck pain with their morning run, for instance. However, there are some habits that you can practice to help mitigate your risks.
When exercising, the main thrust is to always prepare properly by stretching and warming up thoroughly. If you train with weights, always be certain that you are using proper form and avoid pushing yourself past your hard limits.
In everyday life, you can reduce the risk of muscle strain by practicing good posture, avoiding sitting in one position for too long, and being careful to avoid sudden falls and to lift heavy objects with care.
When to Seek Physical Therapy
Most muscle strains are minor, and knowing how to tell if you have pulled a muscle will help you to prevent further injury.
However, some injuries are too substantial to be self-managed and may require professional assistance. In these cases, a course of physical therapy will often be recommended. If you experience a pulled muscle and pain doesn’t subside within a week, then read up on the benefits of physical therapy and how they can help to speed your recovery.
Danh Ngo PT, DPT, OCS, SCS
Doctor of Physical Therapy
Board Certified Specialist in Orthopedic and Sports Medicine
Mind Body Health Results Coach