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Strains are damage to muscles and/or tendons. Tendons connect muscle to bone. Most strains occur at the site where the muscle and tendon connect to each other (musculotendinous junction). There are three degrees (types) of strain.
A first degree strain is a minor trauma to the muscle or tendon and results in mild pain, possible swelling, and some disability. The muscle can still be used in a normal capacity but results in slight pain and discomfort.
A second degree strain is a moderate injury to the muscle or tendon and includes tearing of some muscle/tendon fibers resulting in moderate pain, swelling and disability. There is usually significant pain and weakness involved when the muscle is used.
A third degree strain is a severe injury and involves a complete tear or rupture of the muscle and/or tendon. Seek medical attention as soon as possible for this injury. Swelling and pain can vary with this injury. It may be mild or severe but there will be extreme weakness and possibly an inability to move the body part or contract the muscle.
Treatment
The best way to treat a strain is by remembering the mnemonic PRICES:
Keep the injured body part from sustaining further damage. Stop doing whatever it was that caused the injury. This is very important because you may prolong the healing process if you use the muscle too soon. The more severe the strain the longer you will need to protect the injury.
Rest
There are two types of rest for injuries, complete and relative. Complete rest is most important in the first 72 hours. After that you begin relative rest. Relative rest means that you slowly begin using the injured body part. This will be covered more in the rehabilitation section.
Ice
This is important to help control the amount of swelling. It also helps minimize the pain by numbing the area. If you are a first time “icer” it is important to note that there are four stages of sensation that you will go through as you ice. You will experience coldness, stinging, burning and finally numbness. These are all normal sensations and once it is numb, you have achieved your goal.
As a general rule, you should ice an injured body part for 15 to 20 minutes once per every waking hour. So, 20 minutes on and 40 minutes off. There is some danger associated with icing. If you leave it on too long you could get frost bite and/or nerve damage. Also, for added comfort and if you are using a blue gel ice pack you should place a wet wash cloth or towel between the ice and your skin. The gel ice packs can get colder than ice and can cause burning of the skin.
Compression
Wrapping the injured body part with an ace bandage or neoprene sleeve helps reduce swelling and also adds support to the injured structures.
Elevation
To aid in reducing swelling and to help rest the body part, it must be elevated. By elevation it means that the injured body part must be raised above the level of the heart. So sitting up with your foot propped up on a chair does not help unless the chair is higher than your heart.
Support
To do this you may need to splint the body part or use crutches while it is healing so that you don’t do more damage. If you are using crutches you can start to bear weight on the injured part as the pain subsides and gradually (day to day) increase the amount of pressure you put on it.