Torn or badly sprained muscles can stop you in your tracks and sideline any further participation in sport. Read on for more on what to do when these common and potentially debilitating injuries occur.

Acute(sudden onset) muscle injury is characterized by muscle pain caused by micro-tears in the muscle.

How does a torn or injured muscle present?

• Commonly these injuries occur during sports such as running, soccer and football as a result of muscle weakness, fatigue or a sudden unexpected movement
• Sudden sharp pain occurs that often requires you stop your sport
• Immediately following the injury, the muscle becomes painful during contraction or stretching and the area can be bruised or swollen and is usually tender to pressure

What does current research support as the best treatment?

New guidelines for soft tissue injury suggest to apply the new acronym PEACE and LOVE.

For the first 72 hours, you should:

1. Protect the area by resting, avoiding any stretching and strengthening to prevent further damage to the muscle.
2. Elevate the injured site above heart level to help drain swelling out of the injured site.
3. Avoid anti-inflammatories. Inflammation happening in your muscle helps promote optimal recovery and the use of anti-inflammatories can affect the tissue healing. The use of ice is also questioned. If it helps you, continue to apply ice, but if you don’t feel the need to, it might be better to skip on it.
4. Compress the area with taping or tensile bandage to help limit internal tissue bleeding.
5. Educate clients on the benefits of an active approach to recovery.

Following any acute injury, characterized by a trauma, the human body has a phenomenal capacity to heal the torn muscle by itself. The injured muscle fibres should heal in 6-8 weeks. However, proper rehabilitation can be key during the healing to optimize muscles recovery and optimal return to sport.

When should you start physiotherapy?

Some studies suggest that early rehabilitation (starting 3 days after the injury) reduces the time between the injury and return to sports compared to delayed intervention (9 days) (Ref 3). Consulting a physiotherapist 2-3 days after the injury has been suggested to reduce recovery time compared to starting rehabilitation 9 days after the injury.

After 3 days or when pain decreased, you should:

1. Load the painful area, contracting the muscle for 5 seconds and the release and repeat. In the first days, pain should be avoided or minimized to a level of 3/10 during the contraction and should not get worse with repetitions (Ref 1).
2. Optimism. Stay optimistic towards your recovery –  this will have a positive influence on your healing process.
3. Vascularization (Blood flow). Ensure the area gets the blood flow it needs – Quickly engaging in a cardio-vascular activity that doesn’t exacerbate your symptoms is the best way to increase blood flow to the painful area and promote recovery.
4. Exercise. Specific exercise (not complete rest!) is the best way to rehabilitate an acute muscle injury to restore optimal strength and flexibility.

In order to ensure the best result from your rehabilitation, it is always wise to consult with a registered physiotherapist. We can individualize your assessment and tailor your rehabilitation plan to your specific injury needs and the demands of your sport in order to minimize the amount of time you are away from your sport and prevent recurrence of the injury down the road.

By Florence Charbonneau-Dufresne, M.Sc.(PT), FCAMPT
Registered Physiotherapist

References:
1. Bayer, Monika L; Magnusson, S. Peter; Kjaer, Michael (2017). Early versus Delayed Rehabilitation after Acute Muscle Injury. The New England Journal of Medicine, Volume 377, Issue 13.
2. Dubois, B., & Esculier, J. (2019). Soft-tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine, bjsport-101253. doi:10.1136/bjsports-2019-101253
3. Hickey, J. T., Timmins, R. G., Maniar, N., Rio, E., Hickey, P. F., Pitcher, C. A., Opar, D. A. (2019). Pain-free versus pain-threshold rehabilitation following acute hamstring strain injury: A randomized controlled trial. The Journal of Orthopaedic and Sports Physical Therapy, 1-35. doi:10.2519/jospt.2019.8895

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