Definition

A strain is when a muscle is stretched too much and tears. It is also called a pulled muscle. A strain is a painful injury. It can be caused by an accident, overusing a muscle, or using a muscle in the wrong way.

Alternative Names

Pulled muscle

Causes

A strain may be caused by:

• Too much physical activity or effort
• Improperly warming up before a physical activity
• Poor flexibility

Symptoms

Symptoms of a strain can include:

• Pain and difficulty moving the injured muscle
• Discolored and bruised skin
• Swelling

First Aid

Take the following first aid steps to treat a strain:

• Apply ice right away to reduce swelling. Wrap the ice in cloth. Do not place ice directly on the skin. Apply ice for 10 to 15 minutes every 1 hour for the first day and every 3 to 4 hours after that.
• Use ice for the first 3 days. After 3 days, either heat or ice may be helpful if you still have pain.
• Rest the pulled muscle for at least a day. If possible, keep the pulled muscle raised above your heart.
• Try not to use a strained muscle while it is still painful. When the pain starts to go away, you can slowly increase activity by gently stretching the injured muscle.

When to Contact a Medical Professional

Call your local emergency number, such as 911, if:

• You are unable to move the muscle.
• The injury is bleeding.

Call your health care provider if the pain does not go away after several weeks.

Prevention

The following tips may help you reduce your risk of a strain:

• Warm-up properly before exercise and sports.
• Keep your muscles strong and flexible.

References

Biundo JJ. Bursitis, tendinitis, and other periarticular disorders and sports medicine. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 247.

Wang D, Eliasberg CD, Rodeo SA. Physiology and pathophysiology of musculoskeletal tissues. In: Miller MD, Thompson SR. eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 1.

Geiderman JM, Katz D. General principles of orthopedic injuries. In: Walls RM, Hockberger RS, Gausche-Hill M. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 42.