Muscle strain

synonym

Distension

definition

The term “muscle strain” (technical term: distension) is understood in medical terminology to mean the process of muscle stretching that exceeds the usual level. The muscle strain as such must be distinguished from a muscle fiber tear. The latter leads to the formation of tiny tears within the muscle fibers and an associated accumulation of fluid (Edema formation).

A muscle strain is one of the most common muscle injuries that can occur during sport, along with torn muscle fibers and tears. Muscle strain is the easiest of the three types.

introduction

The Muscle strain belongs to the most common injuries that occur in direct connection with sporting activities. Almost every athlete is affected by this disease at least once (more often) in the course of their athletic career. Clinically, the muscle strain together with the muscle and muscle fiber tears belong to the group of closed muscle injuries that do not affect the skin surface. Basically, there is an increased risk of developing muscle strains for all people who engage in frequent and pronounced sports. However, runners are particularly affected. In this group of patients, muscle strains occur in most cases in the area of ​​the Calves- and thigh muscles. In contrast to most sports injuries, the mechanism that causes a muscle strain is not based on external forces that act on the muscle tissue from outside (for example, blows or kicks). The muscle strain is caused by a excessive stretching of the affected muscle which leads to a rapid and strong contraction of the individual muscle fibers. As a result, there is one within the muscle tissue hardening. However, the muscle fibers themselves are not affected. Typically, the patients who suffer a muscle strain feel one sudden shooting, spasmodic, violent pain. Permanent damage that occurs in the course of a muscle strain can usually be ruled out. However, in order to ensure full recovery of the affected muscle, it must be remembered that after a muscle strain occurs, any physical activity should be stopped immediately. Otherwise, there is a risk that an initially harmless muscle strain will develop into a muscle fiber tear.

causes

Within a skeletal muscle, the so-called "Sarcomeres“The smallest units. Several of these sarcomeres together form a muscle fibril. These in turn accumulate to form individual myofibrils and muscle fibers, which in their entirety form a muscle fiber bundle. A muscle itself therefore consists of a large number of muscle fiber bundles. The main cause of a muscle strain lies in a stretching of the smallest structural units of the muscle (sarcomeres) that exceeds the usual extent. The actual function of the sarcomeres is disrupted in such a way that a contraction cannot initially proceed as usual. In contrast to muscle strain, a muscle fiber tear tears one or more muscle fibers. The muscle tear, in turn, is characterized by the tearing of the entire muscle fiber bundle. The cause of the muscle strain is therefore not damage to individual muscle fibers, as is the case with a torn muscle, but a disruption of the muscle tone. Furthermore, problems in the area of ​​the regulation of the muscle function can also be the cause of a muscle strain. In the case of people who are often involved in sports, the cause of the development of the muscle strain is in most cases a rapid change in load or direction during training. Muscles that were not or only insufficiently warmed up and stretched before the start of the sports unit cannot withstand these rapid changes in load or direction and are excessively stretched. The result is the development of a muscle strain. In addition, inflammatory processes within the body can significantly increase the risk of developing muscle strains.

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Risk factors

In addition to the actual stress (type and intensity), other factors can play a decisive role in the development of a muscle strain. The most relevant factors in this context include:

  • cool outside temperatures

  • No or too short warm-up training before exercise

  • Exercise despite tiredness or poor health

  • exhausted muscles due to insufficient regeneration time

  • Fluid and / or nutrient deficiency (electrolyte deficiency)

  • Misaligned feet

  • poorly fitted footwear

  • insufficient elasticity of the muscles

Symptoms

A typical symptom of a muscle strain is sudden, severe to sharp pain.

A muscle strain usually announces itself sudden cramp-like pain on. Based on this symptom alone, a muscle strain cannot be distinguished from a muscle fiber tear. Typically, the pain caused by muscle strain increases significantly with continued strain. This increase in pain only comes to an end when physical activity is interrupted. In addition, pure muscle tension, i.e. a lack of change in length of the affected muscle, is one of the typical signs of a muscle strain. If the affected muscle is passively stretched further, the symptoms felt by the patient usually decrease significantly. In addition, the State of tension (Muscle tone) iIn the area of ​​muscle strain mostly increased. In contrast to a muscle fiber tear, a simple muscle strain does not damage the individual muscle fibers. For this reason, both diseases can be distinguished from one another quite quickly. Just like with a muscle strain, the affected patients feel a suddenly shooting, cramp-like pain. While sporting activity could theoretically be continued with great pain in the presence of a muscle strain, it is practically impossible to continue straining the muscle in the event of a muscle fiber tear. The natural sequence of movements is completely disturbed when there is a torn muscle fiber. For this reason, affected patients usually take one Relieving posture one that relieves the muscle. Just like with a normal muscle strain, the state of tension (muscle tone) is significantly increased in a muscle fiber tear. In contrast to muscle strain, passive stretching causes a torn muscle fiber to increase pain. In addition, one usually forms in the area of ​​the affected muscle visible swelling and / or a bruise (Hematoma).

To the typical symptoms of muscle strain count immediate, violent to stabbing pain, swelling, bruise, Restriction of movement up to inability to move in the affected area. This pain usually increases, so that the sport activity canceled must become. At the beginning of a muscle strain, all movements can usually still be performed. However, over time, the affected muscle works only limited. The symptoms begin with pulling in the muscles, which then turn into pain. You can also Muscle spasms occur.

It is important to distinguish it from muscle hardening (= Myogelosis). Myogeloses are also painful and can also lead to the need to interrupt physical activity. Tense muscles develop through excessive and improper strain and are often easily palpable as real knots in the muscles. However, they are easy to treat as part of a physiotherapeutic treatment.

The most common muscle strain occurs

  • on the inside of the thigh,
  • in the calf muscles (calf strain)
  • or in the thigh muscles.

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diagnosis

The diagnosis of muscle strain is based on the symptoms that one is experiencing Talk to the attending physician turn out. As part of the conversation, the exact course of accident and explained the complaints. Then follows the physical examination.

The doctor checks the appearance and function of the affected muscle. Clear indications of a muscle strain are:

  • increasing pain,
  • limited muscle function,
  • additional Muscle spasms
  • and a hardening of the muscle.

If a muscle strain is suspected, the attending physician will open the affected muscle Tenderness and muscle hardness feel it. When a muscle strain is diagnosed, one is also done Functional analysisIt explains how the pain is more active and passive strain, as well as load behavior. In addition, it is determined how great the loss of strength is due to the muscle strain.

Diagnostic imaging tests such as a Ultrasound examination or one Magnetic resonance imaging can only diagnose a muscle strain Rare for use, they are only used when the strain is to be separated from a torn muscle fiber. Because with a strain, the muscle fibers not clearly structurally damaged and can therefore not be made visible by this method.

therapy

Part of the therapy is that too Preventing muscle strain:

Some factors favor the tendency of the muscle to tear:

  • Inadequate warming up and lack of stretching exercises
  • Insufficient training or Muscle fatigue through too few and too short recovery phases or through too many training units

Therefore, you should warm up appropriately before each training session and give your body enough time to recover after a session.

In the case of a strain, treatment is aimed at removing the eliminate muscular dysfunction and the relax the affected muscle againso that the symptoms are also eliminated. In any case: Immediate start of therapy. This means: You should stop any sporting activity immediately if you suspect a muscle strain.

If a muscle strain has now occurred, then it is "PECH rule" to apply:

  • P how Break: The sore body area should be immediately immobilized become.
  • E. how ice: Immediately apply ice, running cold water or a cold compress to the affected area cool. Cold reduces bleeding and swelling. Never put ice directly on them skin but cover the affected area with a cloth so that there is no risk of frostbite.
  • C. how Compression (Eng. compression): Applying a tight bandage with an elastic bandage should be done next. This avoids bruising, which could lead to further tears in the muscles.
  • H how Elevation: If the injured part is raised, the blood supply is reduced. This also reduces the pain and the feeling of tension.

In addition, the liquid that comes from the Blood vessels leaked into the surrounding tissue is more easily transported away.

The affected area should be carefully cooled immediately after the onset of pain typical of a muscle strain. The Cool using a cooling pad or cold compresses should be done over a period of about 15 to 20 minutes. However, during cooling it is especially important that the Never put coolant directly on the skin surface may be placed. In order to avoid cold damage, it is therefore advisable to wrap the coolant in a thin towel and only then apply it to the affected area. In addition, the Elevation the part of the body affected by a muscle strain to alleviate the symptoms and avoid consequential damage. By creating a elastic bandage (Compression bandage), the accumulation of fluid in the area of ​​the pulled muscle can be avoided and the healing time can be significantly shortened. Even by using these simple first aid measures, the symptoms caused by the muscle strain can be alleviated promptly. Nevertheless, even if the pain disappears quickly, it should be ensured that the affected muscle must be spared for the time being. On exercising everyone sporting activity should therefore for a period of at least one to two weeks can be waived. They also need during the healing phase passive movements are also urgently avoided. In addition, it is important to note that if a muscle strain is present, local warming measures and massages can disrupt the body's own repair mechanism and thus delay the healing process.

When do I need to see a doctor?

If a muscle strain is present, a doctor must always be consulted if the resulting pain does not subside significantly within a short period of time. In addition, the restriction of mobility and the lack of muscle strength are an indication of the presence of a more serious injury.

Prevention (prevention)

Light warm-up training is important to prevent muscle strain.

In many cases, the development of a muscle strain can be effectively prevented with simple measures. For this reason, athletes should note that every exercise session must include a light warm-up training must be started. In this way the muscles are warmed up and prepared for the later stress. Since cold weather conditions in particular significantly increase the risk of muscle strains occurring, great importance should be attached to an extensive warm-up before the actual training. This warm-up training should last at least 15 to 20 minutes, especially on cold days. Although it can be assumed that the risk of developing muscle strains is much higher in cold weather, it cannot be concluded that extensive warm-up training can be dispensed with in warm weather conditions. A higher ambient temperature lowers that cold-related risk the occurrence of a muscle strain, but the organism loses a lot of fluids and electrolytes, especially in warm weather. Both the dehydration, as well as the Deficiency of certain ions (especially calcium and magnesium) can influence muscle function in such a way that muscle strains develop much faster. That is why it is urgently necessary before any sporting activity Consume adequate amounts of fluids and electrolytes. In addition, the right equipment can help effectively prevent muscle strain. Especially suitable footwear plays a decisive role in this context.

In summary, it can be said that some factors promote the tendency of the muscle to tear:

  • Inadequate warming up and lack of stretching exercises
  • Insufficient training or Muscle fatigue through too few and too short recovery phases or through too many training units

Therefore, you should warm up appropriately before each training session and give your body enough time to recover after a session.

course

The course of a muscle strain depends on how severe the previous injury was, that is, how strong the muscle was overstretched. Depending on the extent and scope, a muscle strain is needed two to three weeksuntil it heals.

forecast

In most cases a muscle strain will heal within a period of one to two weeks completely off. However, if a suitable treatment (PECH scheme) is initiated quickly, the affected patients will feel a short time after the causative event significant decrease in complaints. Nevertheless, the muscle affected by a muscle strain should not be subjected to excessive strain even after the pain has subsided. In general: Light activities are allowed during this period. However, strong muscle loads should be avoided at all costs. Above all, after a muscle strain, there is no athletic exercise until full recovery

Exercise. Otherwise, even an uncomplicated muscle strain can quickly develop into a muscle or muscle fiber tear. This in turn can lead to the development of scar tissue within the affected muscle and permanently limit performance.