Otherwise known as a muscle strain, muscle tears usually occur when the muscle has been stretched beyond its limits or has been forced to contract too strongly. This can occur secondary to a traumatic (acute) or overuse (chronic) injury.
Acute injuries are usually the result of a single traumatic event which causes macrotrauma to the muscle. These injuries normally occur in contact sports. Overuse injuries on the other hand, are usually of a subtle/insidious nature that occur over a long period of time which results from repetitive microtrauma to the muscle.
Muscle tears can vary in severity, but generally will be classed as 1 of 3 grades. These are:
• Grade 1 – A mild strain, where only a few muscle fibres are stretched or torn. Although the injured muscle is painful and tender, it has normal strength
• Grade 2 – A moderate strain, with a greater number of injured muscle fibres resulting in severe muscle pain or tenderness. This is often accompanied by mild swelling, loss of strength and a bruise.
• Grade 3 – A severe strain where the muscle rips into two separate pieces or shears away from its tendon. This can sometimes result in a “popping” sensation at the time of injury. A grade 3 muscle strain is often associated with near complete loss of strength, significant pain or tenderness, swelling and discolouration. There may also be a “dent” or “gap” under the skin attributed to a sharp break in the outline of the muscle.
Examples of common muscle tears:
Hamstring – The hamstring consists of three muscles: Biceps femoris, Semitendinosus and Semimembranosus. Hamstring strains are usually caused by a rapid contraction or a violent stretch. This is common in contact sports involving sprinting and jumping such as AFL and soccer. Hamstring strains usually result in sudden minimal to severe pain in the back of the thigh. A “popping” sensation can sometimes be heard. Swelling is also possible, however, this may only be present several days after the initial injury.
Groin – A groin/adductor strain often arise from an excessive stretch. The underlying injury is frequently a muscle/tendon strain at the point where the tendon of the adductor muscles attach to the bone. The adductor longus is frequently injured. The main sign of an adductor muscle injury is pain in the groin region and in the inner thigh.
Calf – The calf muscle consists of three muscles: Gastrocnemius, Soleus and Plantaris. Calf muscle strains often occur in sports involving high speed running or increased volumes of running load. This is a common muscle strain that results in a sudden sharp pain or tearing sensation at the back of the lower leg. Swelling and bruising often appear within hours to days. Calf stretches and resisted ankle plantarflexion (pointing your toes away from you) will often reproduce the pain. The calf muscle will also often be painful to touch.
As physiotherapists, we are experts in assessing and diagnosing muscle strains throughout the body, meaning we will be able to properly ascertain what structures have been injured and to what degree that injury is. With this, we can come up with a treatment plan that will allow full recovery from that injury. This plan could involve hands on treatment, therapeutic modalities and exercises to rehabilitate the muscle or potentially referral on to a surgeon if the injury is severe enough.
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