Muscle injuries such as strains, pulled muscles and complete muscle tears are among the most common injuries in sport and usually result from overuse of the muscles. These injuries are usually treated by resting the affected muscle to allow it to regenerate. Surgical treatment is sometimes necessary when the muscle is torn.

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Muscle injuries at a glance

Muscle injuries (muscle lesions) occur most frequently in muscle groups that are heavily involved in sports activities, such as the thigh muscles, calf muscles and muscles in the back. A distinction can be made between mild muscle strains, partial muscle tears and complete muscle tears, all of which are caused to varying degrees by muscle overuse.

Mild muscle strain (pulled muscle)

A mild muscle strain occurs when the muscle fibres are overstretched, causing micro-tears. It is a mild form of muscle injury that is often caused by sudden or excessive strain on the muscle.

Partial muscle tear (muscle bundle tear)

A partial muscle tear refers to the partial or complete tearing of individual bundles of muscle within a muscle. A partial muscle tear typically occurs by suddenly overloading or overstretching the muscle.

Complete muscle tear (muscle rupture)

A full muscle tear is the most serious form of muscle injury in which the muscle is completely ruptured. It is a rare injury that often occurs as a result of extreme overuse or trauma.

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Causes

Muscle lesions often occur under intense strain, primarily during sports activities such as running, jumping and sprinting. In addition to intensive strain or severe overstretching, inadequate warm-ups prior to exercise, poor body mechanics, insufficient regeneration, muscle imbalance and trauma can also cause these kinds of injuries.

Symptoms

The symptoms depend on the extent of the injury:

  • Typical symptoms of a mild muscle strain are hardening of the muscle, tenderness on pressure, pain when stretching the muscle or cramp-like muscle pain that gets increasingly worse. Other symptoms of a mild muscle strain can include limited mobility of the injured muscle or muscle group as well as swelling or slight bruising of the affected area.

  • The symptoms of a partial muscle tear are typically acute and include a stabbing pain and bruising (haematoma), and dents in the affected muscle may appear. A partial muscle tear can also lead to restricted movement, local swelling or redness in the area of the severed muscle fibres.

  • A complete muscle tear is characterised by a popping or snapping sound when the injury occurs followed immediately by severe pain, often accompanied by a haematoma and a visible or palpable protrusion at the injury site. Other signs of a torn muscle are severely restricted movement and weakness in the injured muscle as well as localised redness and a hot sensation in the skin where the injury is located.

Diagnosis

If a mild muscle strain or partial tear is suspected owing to the presence of the characteristic symptoms, a specialist in orthopaedics or accident surgery will take your medical history, followed by a targeted clinical examination of the affected muscles and imaging techniques.

  • When taking your medical history, the doctor will also ask about the circumstances of the injury, the symptoms and possible previous injuries.

  • During the clinical examination, the doctor will check the affected area for swelling, hardening, tenderness on pressure and restricted movement. They will also check the strength and mobility of the affected muscle.

  • In some cases, an ultrasound is used to determine the severity of the muscle injury.

  • Magnetic resonance imaging (MRI) can be used to find out precise information about the extent and localisation of the muscle injury. An MRI is particularly useful for more serious injuries or when an accurate diagnosis is required.

Treatment

Mild muscle strains or partial muscle tears are usually treated conservatively, that is, non-surgically. Immediately after the injury, cooling bandages are applied and the affected limb is elevated. Painkillers and anti-inflammatory drugs can be used to relieve pain. In conservative treatment, the most important thing is to rest the affected muscle. You may need to rest the injured area anywhere from a few days to several months, depending on the type of injury.

Conservative treatment is also generally sought for complete muscle tears initially, similarly to strains or partial muscle tears. In some cases, however, surgery may be necessary, especially if the injury is severe or if the muscle is completely separated. The decision to operate depends on several factors, including the severity of the injury, the precise location of the tear, the symptoms present and the desired level of activity after recovery.

In rare cases, compartment syndrome may occur as a result of the injury: an increase in pressure inside the affected muscle, which must be relieved immediately through surgery.

The healing process of injured muscles can also be supported with physiotherapy, massages and electrical stimulation therapy.

Prevention

An appropriate warm-up before undertaking any physical activity is crucial in preventing muscle tears or strains. Dynamic stretching and activation exercises before exercising can help to prepare the muscles for the upcoming exertion.

It is also important to pay attention to correct technique when training or playing sport and to avoid overloading any part of the body. A balanced training programme that builds strength, flexibility and coordination can also help reduce the risk of injury. Taking regular breaks to recover between training sessions and sufficient rest periods are also vital when it comes to allowing for muscle regeneration and preventing injuries.

In addition, if you feel any pain, you should stop exercising immediately to avoid more serious injuries.

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