Strain

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What is a strain?

A strain is an injury to a muscle, tendon, or a connected group of muscles and tendons. Strains are sometimes confused with sprains because they have similar symptoms. However, sprains are a different type of injury. While strains affect muscles and tendons, sprains affect ligaments. Ligaments are the bands of tissue that connect bones at the joints.

To understand strains, it helps to understand your body’s muscles. There are three types of muscles in your body:

  • Involuntary cardiac muscle, or myocardium, is your heart muscle.

  • Involuntary smooth muscles are the muscles of organs, such as your stomach and intestines.

  • Voluntary skeletal muscles are muscles attached to bone.

Voluntary skeletal muscles are the type of muscle that can be strained. They help support your body’s skeletal structure and work together with tendons to enable movement. Tendons are strong cords of soft connective tissue that attach bones to muscles.

Muscles in the neck, back and legs are most susceptible to strain. However, other muscle areas can be strained, including those in the groin, feet, ankles, arms and hands. A strain can also be called a muscle strain or pulled muscle. Strains can range in severity from a mild stretch or pull to a complete tear and rupture of the muscle or tendon. Symptoms of a strain are muscle weakness, pain, spasms, swelling, cramping, or loss of muscle function.

Strains can be chronic (developing slowly over time) or acute (occurring suddenly). Chronic strains are the result of repetitive overuse of muscles. Acute strains are the result of immediate muscle overload. Typical activities that cause strains include sports and other exercise activities; accidents, such as falling or slipping; heavy lifting and other strenuous activities; and repetitive use of muscles, such as shoveling snow during the course of winter.

Rest, ice, compression, elevation, and nonsteroidal anti-inflammatory drugs (NSAIDs) help relieve the aches and pain associated with mild muscle strains. Often, this may be the only treatment needed for mild strains. Moderate to severe strains may require more extensive treatment, such as surgery, immobilization, and physical therapy.

In some cases, muscle strains can be serious. Seek immediate medical care (call 911) if you, or someone you are with, have serious symptoms of a severe muscle strain, rupture or tear. These symptoms may include hearing a popping sound when you are injured; severe, disabling pain or swelling; and inability to use the muscle, such as an inability to walk.

What are the symptoms of a strain?

The symptoms of a strain can range from mild to severe, depending on the type and extent of the strain. Chronic strains are the result of prolonged, repetitive overuse of muscles. The symptoms of a chronic strain are often overlooked because they develop over time. Acute strains are the result of immediate muscle overload from overstretching, excessive muscle contraction without adequate breaks, and trauma. Acute strains tend to have more severe and noticeable symptoms than chronic strains. However, both types of strain can cause these similar symptoms:

  • Bruising

  • Limited range of motion

  • Loss of muscle function

  • Muscle cramping or spasms

  • Muscle pain or weakness

  • Swelling

Symptoms that might indicate a serious condition

In some cases, muscle strains can be serious. Seek immediate medical care (call 911) if you, or someone you are with, have serious symptoms of a severe muscle strain, rupture or tear including:

  • Hearing a popping sound when you are injured

  • Inability to use the muscle, such as an inability to walk

  • Severe swelling

  • Severe, disabling pain

What causes a strain?

A strain occurs when a muscle or tendon is pulled, stretched, twisted or torn. There are two different types of strain, chronic and acute. Chronic and acute strains have different causes.

Causes of chronic strain

Chronic strains happen slowly over time from prolonged, repetitive overuse of muscles. Chronic strains develop from using the same muscle groups in the same pattern, causing even small stresses to build on one another. Causes of chronic strain include:

  • Improper body mechanics or using the wrong muscle groups for a task, such as repeatedly lifting heavy objects using your back instead of your legs

  • Improper sports mechanics or techniques, such as habitually gripping a tennis racket too tightly or an incorrect golf swing

  • Participation in the same exercises in the same way, day after day

  • Poor posture

  • Use of the wrong equipment, such as running shoes without the proper support for your foot type

Causes of acute strain

Acute strains occur suddenly due to immediate muscle overload. Causes of acute strain include:

  • Direct blow to the muscle, such as getting hit by a baseball or a lacrosse stick

  • Excessive muscle contraction, such as sprinting during a race or running bases

  • Overstretching, such as sudden movement of cold muscles without proper warm up or stretching

  • Trauma or injury, such as slipping and falling or a rear-end car accident, which can cause muscle strain in the neck

What are the risk factors for a strain?

A number of factors increase the risk of developing strains including:

  • History of previous strain injury

  • Muscle fatigue from overuse or underuse

  • Muscle imbalance in which one group of muscles overcompensates for another group

  • Muscle tightness from not warming up or stretching properly before and after sports or other strenuous activities

  • Participation in certain activities, especially sports, such as football, basketball, soccer, running, dancing, and skiing, and any activity that involves frequently moving or lifting heavy objects

  • Poor conditioning

Reducing your risk of a strain

You may be able to lower your risk of developing a strain by:

  • Achieving and maintaining appropriate physical conditioning, flexibility, and muscle strength

  • Avoiding sports or heavy lifting when your muscles are already fatigued or weakened

  • Cross-training with a variety of sports activities

  • Eating a balanced diet

  • Maintaining a healthy weight

  • Preventing slips and falls with appropriate safety measures

  • Stretching and warming up before any sports activity or other strenuous activity

  • Wearing a seat belt and adjusting the headrest properly when traveling in any vehicle

  • Wearing appropriate protective equipment when participating in sports or when lifting and moving heavy objects

  • Wearing footwear that fits properly and is not worn out

How is a strain treated?

Mild to moderate strains frequently heal on their own with proper home treatment including:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn). NSAIDs reduce swelling and relieve pain and soreness.

  • RICE, an acronym that stands for rest, ice, compression, and elevation of the strained area. Talk with your healthcare provider before using compression bandages to ensure safe use.

  • Therapeutic exercises to alleviate pain and restore range of motion

More serious strains, such as a muscle tear or rupture, may require surgical repair, immobilization, and regular physical therapy.

What are the potential complications of a strain?

Mild to moderate muscle strains usually respond to rest, ice, and over-the-counter anti-inflammatory medications. Serious strains or strains that are not properly treated can lead to serious complications including:

  • Chronic pain

  • Disability

  • Loss of mobility

  • Permanent damage to the muscle or tendon involved

  • Permanent limited range of motion

  • Poor quality of life

  • Weakness

It is important to contact your healthcare provider when you experience muscle pain, soreness or weakness for proper diagnosis. Following the treatment plan you and your healthcare provider develop specifically for you will minimize the risk of complications and help restore your mobility.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 9
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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