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“PULLED MUSCLE”

 

     Let’s get started by saying that in order to “pull” a muscle, you have to do something to pull it.  In other words, if all you did was walk from the chair to the kitchen, the odds are that if a muscle hurts, you didn’t really pull it.  On the other hand, if you normally only walk from the chair to the kitchen and you just finished playing your 15-year-old in basketball, and your calf hurts, you probably do have a pulled muscle.  So there is cause and effect here. 

     You can pull a muscle anywhere, doing anything you are not used to doing.  This is especially true if you over do it, having done little for a long time.  This can occur lifting weights, running, even walking up a hill fast and far when your body is not accustomed to that sort of activity.

     If you are an athlete and you super-exerted, and perhaps ran extra hard, or lifted extra hard, you could pull a muscle.

     So what is a pulled muscle?  Really it is a micro or macro-tear within the muscle itself, or in the connective tissue attaching the muscle to the bones.  How bad it hurts and how long it will take to heal depends on how badly you tore it.  You can tear a muscle in half completely.  And we have seen that.  It is common in powerlifters and some bodybuilders to tear a triceps or bicep muscles.  If it is completely torn and not surgically repaired, it will remain torn for life.  A lesser and smaller tear will usually heal itself with appropriate rest and precautions.  Sometimes, when a muscle really hurts after a strenuous exertion, it is not the muscle at all, but rather the tendon attaching the muscle to the bone of the moving joint. Tendon tears are usually more concerning than muscle tears and might require an invasive procedure.

     If you have a severe tear, and you get a bruise that you can see, you will likely need to see an orthopedist or other doctor.  If your tear or pull is small, you might be able to handle it yourself.  We can’t tell you if it is big or small, but the appearance and pain should point you in the right direction.

     Let’s focus on smaller muscle tears and pulls, like you would get in a calf muscle if you ran too far and ran through the pain.  Likely, when you got home, it would hurt.  This is the time to ice it down to reduce the swelling.  It would also be a good idea, if not allergic, to take some ibuprofen or other non-steroidal-anti-inflammatory medication (NSAID).  Tylenol will reduce the pain, but NSAIDs will reduce the pain and the inflammation.

     Stay off that leg as much as possible.  Do nothing that makes it hurt more.  That is important and will speed up your recovery.  You can’t exercise your way through a truly pulled muscle.  You have to rest it.

     The following day, inspect it to look for a superficial bruise.  If not present, that is good.  If present, not so much.  The pull might be extensive and require medical help.  If it is still swollen, ice is still appropriate, along with more NSAIDs.  Be careful and take the NSAIDs with food to lower your risk of getting a stomach ulcer.  Do not try to stretch it or exercise it yet.  If you do, you will only delay your recovery.  Baby it, and keep your weight off of it.

     The next day, look again for bruising, as sometimes it takes a day or two to appear.  If you see a huge bruise, we suggest you go to a doctor.  If not, it still will likely hurt.  If it is still swollen, ice.  If not, nothing but NSAIDs and more rest. 

     The next day, if the tear or pull is small, and there is no swelling, still don’t exercise nor stress it.  Continue on the NSAIDs if your stomach is not hurting and continue to rest it.  If there is no swelling, you can start thinking about adding in some heat, but it might be a day early for that.

     The next day, the pain should be less.  You can put some weight on it, but if that makes it hurt at all, stop, and give it more time to heal.  No running or exercising that stresses it just yet.  Now would be a good time to add in some vitamin C.  Vitamin C is necessary to cross link collagen which is what your body makes to produce scars in damaged tissue.  It is part of the normal healing process.  So a little extra vitamin C can possibly make the scar stronger and heal faster.

     After a few days, you can start some more weight bearing and slight stretching, but only to the point where you feel the slightest twinge of pain, then stop.

     Once you can walk on it without pain, continue the stretching and add in some easy exercise.  This might take a week or longer, depending on how bad it is.  You can still use heat if there is no swelling.  If swelling occurs, then no heat.

     Only after you can walk normally on it with no pain can you even think of exercising on it again.

     When all the pain is gone, even when you stretch it, you must resume exercising it very carefully and gently.  You will have to take time to build the strength back after it heals.

     Most athletes make the mistake of reinjuring their pulled or partially torn muscles by trying to do too much too soon.  Don’t let that be you.  If you do, you will only delay the process. 

     Regardless of the muscle pull, the treatment is the same as above.  And remember, if it does not get better quickly, it might be a tendon and need a doctor’s attention.