How to Treat a Pulled Muscle—and Get Back to the Gym—In 7 Simple Steps
Every time you exercise, you put microscopic tears in your muscles. That's what's behind that next-day hurts-so-good soreness. And after your body repairs these tears, you become stronger, faster, and fitter. But if you stretch a muscle too far, lift too much, or are working out with a muscle imbalance, you might not just have microscopic tears to deal with. You could literally tear your muscle into pieces.
Pulls, sprains, and tears (all the same thing) range in severity. Grade 1 means the injury hurts but you can still move the muscle without too much trouble and it could heal in less than a week. Grade 3 means the muscle has ripped clean off of your tendon or bone and you'll probably need surgery to reattach it. Ouch.
"Think of your muscles like a piece of fabric that you're holding in front of you, between your two hands," says Jared Beckstrand, PT, DPT, physical therapist and founder of Tone and Tighten. "If I were to pull that fabric in opposite directions, it would stretch up to a certain point. If I continued to pull, some of those fibers would start to break. Then, given enough force, the entire thing would eventually rip right in half." Yeahhh, your muscles can do the same thing. Fun times.
Despite the gnarly description, exercisers rarely know how to treat a pulled muscle or do anything to treat their muscle sprains. They just try to tough it out, says Janet Hamilton, C.S.C.S., a clinical exercise physiologist with Running Strong in Atlanta. Bad idea. When not treated properly, even seemingly minor pulls can contribute to more severe ones later on. And those can send you to surgery and take you out of commission of several months.
Plus, if you do have a serious strain, you only have a window of a few weeks before your doctor really can't do anything for you, explains Hamilton. She recently had an MRI just in time to have a surgeon reattach her torn hamstring muscle.
So how do you know if your post-workout pain is a strain? Typically, the pain will be sharp, intense, and localized to one specific spot along your muscle, Beckstrand says. Massaging the area will likely hurt, and you may even feel a knot. While it generally hurts less when you're resting the muscle, it may still feel uncomfortable and spasm, Hamilton adds. Usually, the pain comes on all at once.
Sound all too familiar? Luckily, it doesn't have to be complicated to treat a pulled muscle.
How to Treat a Pulled Muscle
1. Elevate, compress, and ice it.
The sooner you can get the pulled muscle above your heart, apply compression, and ice it, the better, Hamilton says. All will help reduce inflammation and keep blood from pooling in your muscle—because, yes, torn muscles can bleed. Ice it for 15 minutes every hour or two for at least 24 hours following the pull, and continue elevating the area for an entire week whenever possible, she says. As far as compression goes, Beckstrand recommends wearing a neoprene sleeve, ACE wrap, or compression garment to squeeze excess blood out of the area, support the muscle, and speed recovery. Wait at least a week to wean yourself off of compression gear, advises Hamilton.
2. Avoid pain medications.
Your first instinct about how to treat a pulled muscle might be to grab some ibuprofen. But that's a big no-no, granted you can bear it. "Pain medications like over-the-counter anti-inflammatory drugs may not be your friend here," Hamilton says. "By interfering with the normal inflammatory process—an important part of healing—pain medications may interfere with the cascade of events needed to jump-start tissue regeneration and repair." If you do take pain meds, make sure to follow the bottle's directions. If they say to take two, don't go ahead and take three.
3. Watch for bruising.
If a bruise pops up around the pain site, your pulled muscle is likely serious. Bruising occurs when the muscle is torn so badly that it bleeds into your body, Hamilton says. That's a surefire sign you need to go to a doctor who knows how to treat a pulled muscle like this properly. But keep in mind, if the tear is deep in your muscle, it could take a few days for any blood to rise to your skin's surface and cause bruising, she says. (Here's why you bruise *so* easily.)
4. Don't stretch or roll it out.
At least don't do it immediately after pulling it. After all, stretching a sprained muscle will only pull the torn ends farther apart, potentially making things a whole lot worse, Hamilton says. The same goes for foam rolling. "Give it a chance to try to knit back together before you get too aggressive with the foam roller. There's a time and place for that but it's not in the acute phase," she says. If the strain is minor—and most are—you can try gently rolling the muscle a few days after pulling it. If foam rolling hurts, back off and try again in a couple days, she advises.
5. See a doctor.
"The biggest issue I see with muscle strains is people wait way too long before they come in to get help," Beckstrand says. After a few weeks, your body has already tried to heal itself, which often results in permanent scarring and tissue damage. "Rehab for a muscle strain becomes much more difficult with time," he says. "My recommendation is that if you're experiencing symptoms of a muscle strain injury, don't let symptoms go on for longer than two weeks without consulting your medical provider." The ideal expert is a physical therapist. Before scheduling an appointment, call your insurance company and find out if you have to see a primary care first to get a referral, recommends Hamilton. Some insurance companies insist on a referral, and you want to make sure all visits are covered.
6. Take it easy.
Depending on the severity of your strain, you may need to take anywhere from a few days to a few months off of exercise so that the muscle can heal itself. When you do head back to the gym, start with gentle bodyweight exercises (no plyometrics), Beckstrand says. Progressively add more sets, reps, and eventually weight. All the while, remember that the muscle should never hurt. If it does, stop the exercise and either try a different variation or back off entirely, he says.
7. Consider what went wrong.
Now that you know how to treat a pulled muscle, it's time to do a little analysis. As long as your pulled muscle isn't a case of "I tripped and fell," you need to address the cause of your muscle pull, Hamilton says. You may have a muscle imbalance that, if left untreated, will continue to contribute muscle strain. (For instance, runners often suffer hamstring tears because their glutes are too weak, she says.) Consider how you're training all of the muscles in your injured body part. And don't hesitate to talk to a physical therapist or exercise physiologist about how you can correct any muscle imbalances.