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Muscle Strains: Causes, Symptoms, Treatment and Exercises

massage therapy for muscle strainsA muscle strain or “pulled muscle” is a common injury that happens when muscle fibers rupture as a result of mechanical stress. Although often seen in hamstrings, quadriceps, calves, rotator cuff muscles and back, a strain can happen in any muscle of the body.

Depending on the severity of the tear, we can classify strains by 3 categories:

  • Grade 1 – Few fibers are torn. There is minimal pain with activity.
  • Grade 2 – Around 10-90% of the muscle fibers rupture. There is pain with activity, inflammation and some bruising of the area.
  • Grade 3 – There is a complete rupture of the muscle fibers and it often presents with complete loss of function, inflammation and significant bruising of the area. Surprisingly, pain may not be present. Surgery may be required depending on the muscle and your activity.

What Causes a Strained Muscle?

Muscle strains occur when the stress applied is greater than the capacity of the muscle in that moment in time. This overload can be the result of stretching a muscle beyond its ability to contract or engaging in a powerful contraction that the muscle was not ready for.

It is important to know that anyone can suffer a muscular strain. For example, if a person has muscular weakness from a previous injury or increased muscular tension, their movement patterns can be altered, making them prone to muscle strains when performing regular activities.

Athletes involved in sports that require rapid and explosive movements can often endure strains if they are not properly warmed up or conditioned for the activity.

Other contributing factors include extreme cold temperatures, poor biomechanics, underlying health conditions as it can decrease the health and extensibility of muscles tissue.

How Can Physiotherapy, Chiropractic and Massage Therapy Help a Muscle Strain?

A customized treatment plan is key to the recovery of a muscle strain. Physiotherapists, Chiropractors and Massage Therapists are trained professionals that can help you diagnose the injury and rehabilitate it. They do this by helping you to manage pain, decrease muscular tension, increase mobility and develop the strength necessary to return to your regular activities. In addition to this, they will provide you with strategies to prevent strains from happening again.

What Should be Avoided with a Muscle Strain?

If you suspect that you have a muscle strain, it is best to consult with your Physiotherapist, Chiropractor or Registered Massage Therapist. As a rule of thumb avoid the following:

  • Working through the discomfort and continuing to challenge the muscle
  • Stretching without proper guidance from a professional
  • Returning to sports too soon without clearance from a medical professional

How Long Does it Take to Recover from a Muscle Strain?

Recovery will vary depending on the area affected and the severity of the injury. Other factors including age, physical demands and access to care can impact the recovery time of an individual as well.

Generally speaking, a grade 1 strain can heal in 2-3 weeks, a grade 2 can take 4-8 weeks and a grade 3 can take 5-6 months or longer.

It is important to note that if not healed properly, muscle strains can re-occur or lead to more complex musculoskeletal injuries or dysfunctions as it will impact other areas of the body.

What are some Safe Exercises to do for Muscle Strains?

Every strain and every person is different, therefore the exercise protocol will be dependent of the affected muscle group and the severity of the injury. A physiotherapist, chiropractor or sports medicine doctor will be the best person to determine what is the most appropriate course of action in every case.

In the acute stages of healing performing active movement in a pain free range is a great way to maintain range of motion and decrease pain. As time progresses, introducing low – moderate intensity eccentric loading progressing to isotonic loading of the muscle will help increase strength. Once you have strengthened the muscle you will be ready for more complex movement patterns that are activity specific.

Remember, when dealing with any injury it is important to be patient to allow the body to heal properly. Your body is very smart and wants to get better. With proper treatment, the chances of recovery are very promising.

If you suspect that you have a muscle strain, at Rebalance Sports Medicine you will find a team of highly qualified Physiotherapists, Chiropractors, Physicians and Massage therapists that will be happy to guide you in your road to recovery. Contact us today and get on the road to recovery.


  1. Heiderscheit, Bryan C., et al. “Hamstring Strain Injuries: Recommendations for Diagnosis, Rehabilitation, and Injury Prevention.” Journal of Orthopaedic & Sports Physical Therapy, vol. 40, no. 2, 2010, pp. 67–81., doi:10.2519/jospt.2010.3047.
  2. Maffulli N, Oliva F, Frizziero A, Nanni G, Barazzuol M, Via AG, Ramponi C, Brancaccio P, Lisitano G, Rizzo D, Freschi M, Galletti S, Melegati G, Pasta G, Testa V, Valent A, Del Buono A. ISMuLT guidelines for muscle injuries. Muscles Ligaments Tendons J. 2014;3:241–249. doi: 10.32098/mltj.04.2013.02.
  3. “Muscle Strains.” Condition-Specific Massage Therapy, by Celia Bucci, Wolters Kluwer Health/Lippincott Williams & Wilkins, 2012, pp. 285–304.
  4. Physiopedia , contributors. Muscle Strain. Physiopedia , 20 Oct. 2019, www.physio-pedia.com/Muscle_Strain.

Desiree Caceres Ramirez, RMT

Desiree Caceres Ramirez is a registered massage therapist practicing at Rebalance Sports Medicine in downtown Toronto.

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Yonge & AdelaideRebalance Clinic Yonge Adelaide
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