By Steven Pisano from Brooklyn, NY, USA (Bishop Loughlin Games - Armory - Track & Field) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons
Strains are injuries to muscles or tendons. They occur when the force across the musculotendinous unit (the connected muscle and tendon) is great enough to cause tissue tear. It is classified as a contraction-induced injury where tear occurs due to excessive mechanical stress. Strains usually occur during the eccentric phase or when the muscle is overstretched. Improper use of the muscle, fatigue, and overuse are the common culprits.
A strain can be recognised by soreness, swelling, limited range of movement, bruising, discoloration, sudden pain, stiffness, weakness, and spasms.
Classification and causes
Strains are also classified in Grades from I to III, just like ligament sprains. They range from mild damage to individual muscle fibres to a complete rupture of muscle or tendon.
In Grade I (mild) strains, a limited number of muscle/ligament fibres are affected. They can be hard to notice until the day after because there is no reduction in pain-free range of motion. Athletes and bodybuilders following the motto ‘no pain, no gain’ frequently train to the point of a mild strain on consecutive workouts. This is not only counterproductive to progress but also leads to overtraining and increases the risk of injury.
A Grade II (moderate) strain means that up to 50% of the fibres are torn. Usually, there is a minor but noticeable decrease in muscle strength. Pain and swelling are very common as well. These types of strains are difficult to miss when they occur. Particularly tough trainees may choose to continue exercising through the pain and the functional loss. This is not very wise as it can lead to a severe strain within the same session and can significantly prolong healing time.
In Grade III (severe) strains the muscle/tendon is completely ruptured. Either the belly of the muscle is torn in two or the tendon is separated from the muscle. There is a complete loss of strength and function and significant pain and swelling. Surgical intervention may be required and healing can take months or more.
Strains can also be acute – caused by a sudden movement – hamstring during a deadlift, deltoid during an overhead press. Or chronic – developed over time through repetition – tennis elbow or golfer’s elbow or runner’s knee.
Acute strains are usually caused by one or a combination of the following: overexertion, fatigue, lack flexibility, poor form, lack of proper warm-up. Unfortunately, they are not limited to athletic or sporting activities. A slip while walking, a small jump, throwing something, or lifting a heavy object are common everyday situation where strains can occur.
Chronic strains can be seen as a repetitive stress injury. Repetitive movements of the arm in tennis, baseball and golf are common causes of problems for athletes. A sedentary lifestyle characterised by a lot of sitting with poor posture in particular can also lead to strains.
Healing and recovery must be approached with a similar mindframe to sprains.
A balanced and regular approach to physical exercise and maintaining a normal weight are the best forms of prevention. Regular resistance training may need to be combined with a form of stretching and stimulation for the cardio-vascular system for a balanced programme. Unless, of course, one practices a single activity designed to address all of these.
Avoiding long sitting and poor posture are also essential to prevent the development of chronic strains. Taking extra care during high-risk everyday situations like lifting heavy objects, climbing stairs, or hazardous terrain is also important.
Martin Stefanov Petkov
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