Physical Therapy for Muscle Tears

Rehabbing Your Torn Muscle.

Are you suffering from a torn muscle or think you may be? If you are experiencing muscle pain with a strong contraction, swelling or stiffness in the muscle, or weakness in that area, you might be right. A torn muscle, also called a “muscle strain”, occurs when muscle fibers are overstretched, overused, or contracted against a sudden load. At the moment of injury the stretch or stress on the muscle fibers is too great for the muscle to handle causing the fibers to tear and be injured. This article will help explain the anatomy and physiology of a muscle tear and how physical therapy can help it heal. 

LET’S TAKE A CLOSER LOOK AT YOUR MUSCLES

Muscles are the movers and stabilizers of the body. There are more than 600 muscles in the human body from the large muscles that straighten the knee to kick a soccer ball to the small muscles in your throat that help you produce sound when you talk. Muscles are made up of bundles of muscle fibers aligned in specific patterns. When these fibers contract they shorten the muscle and pull on the bones they attach to creating movement and strength.

At either end of these fibers is a strong band of tissue called the tendon which connects the muscle fibers to the bone. The tendon itself does not contract but is an essential component to muscle function as it creates stable attachment points on the bone to allow the muscles to do their work on the skeleton. 

If you’ve ever participated in sports or a regular workout routine, you know that one can increase the size and strength of muscles by regularly overloading them. This stress stimulus, when large enough, signals to the body that it needs to increase the size and efficiency of the muscles in order to meet the new demands you are placing on them.  For example, when you first start lifting weights you may find squatting with a 25lb kettlebell to be challenging.  After weeks to months of consistent training, however, you are now able to squat holding a 40lb kettlebell while the 25lb one feels “light”. 

HOW DO MUSCLE TEARS OCCUR?

The key to building strong and resilient muscles is through overload. This means asking the muscle to move a load or resist a force that feels difficult to you. When applied correctly, overload results in stronger muscles. Injury can occur, however, when muscles are asked to resist a stretch, force or load for which it is unprepared. This could happen when you select a weight that is too heavy while working out at the gym or when you pivot quickly and start to sprint off toward a ball during a soccer game causing your hamstring or calf muscle to suddenly contract very forcefully.

Muscle tears are categorized based on their severity:

Grade I strain (mild): very few muscle fibers are injured. Pain typically occurs the next day but no swelling or bruising is observed. Pain may be felt when the affected muscle is strongly contracted or stretched at its end range.

Grade II strain (moderate): many (but not all) fibers are injured resulting in stiffness, loss of flexibility and loss of strength. Pain is felt both during contraction of the muscle and during stretching. Swelling and bruising over the injured area is common. 

Grade III strain (severe): all fibers of the muscle are completely torn or the muscle belly has detached from its tendon. Severe pain is often felt upon injury and heavy swelling and bruising will develop. Range of motion may be either significantly reduced due to pain or excessive because the muscle is no longer limiting it. This muscle will generally be unable to produce any force due to the severe disruption in the fibers. 

SO YOU’VE TORN YOUR MUSCLE, WHAT NOW?

How you care for a torn muscle and how long it will take to heal depends on the severity and location of the muscle tear. In any case, a physical therapist can guide you on the initial steps for recovery and how to prepare the injured muscle for return to normal activity. When you first visit a physical therapist they will ask you a series of questions about your symptoms and examine the area of injury. The examination may involve palpating (gently pressing or feeling) the injured muscle for tenderness, swelling, or abnormalities, gently stretching the affected muscle to look for stiffness, pain, excessive or restricted range of motion, testing the muscle strength and observing your movement. 

Physical therapy treatment for a muscle tear depends in part on how long after the injury you seek care. If you visit your PT right after injury, and before seeing your doctor, and your physical therapist determines that your muscle tear is moderate or severe (grade II or III) they may refer you to a physician to further examine the injury and determine if any medications are necessary to facilitate healing and manage symptoms. Your doctor may recommend imaging such as an X-ray to examine the surrounding bones, or an MRI or ultrasound to examine the injured fibers. If the muscle tear is severe a surgical repair may be recommended.

During the acute phase of healing which typically refers to the 5-7 days immediately post-injury, the goal of physical therapy will be to protect the site of injury. In the acute phase of healing the body will begin to repair the injured tissue but at this point those repairs are very delicate. Any stretching or strong contraction of the injured muscle could re-tear the healing tissue causing the healing process to regress or begin again. 

If you tore a muscle in your leg and are limping, your PT may recommend crutches to allow the muscle time to heal until you can walk without limping. Splinting or bracing may be recommended to limit excessive movement or stretching of the muscle and help reduce pain. Application of ice, compression or taping techniques may also be prescribed to help reduce excessive inflammation and reduce pain. 

As the muscle tear begins to heal your PT may begin to apply very gentle stretching to help maintain tissue flexibility and later on more intensely to restore muscle length. You will begin to perform exercises to restore the motor control and coordination of the muscle initially and the strength and power of the muscle later on. Your physical therapist will help educate you on signs that your muscle is ready to progress to the next stage of rehab and signs that you have overstressed the tissues, such as increased swelling or prolonged pain, and advise you on how to care for it.  

If you had surgery to repair a severely torn muscle, your physical therapist will help to progress you through your post-surgical protocol with the same goals of managing pain, decreasing swelling, improving flexibility and restoring strength and coordination. Whether you are an athlete wanting to get back out onto the field or an injured worker trying to get back to your job, physical therapy is a great tool to heal your muscle tear. The physical therapists at Evolve are here to educate you on the process of healing, get you back to your favorite activities and teach you how to prevent re-injury in the future. 

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About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better! First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

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