What To Do When You Pull A Muscle
Have you ever pulled a muscle?
If you’re like 99.99% of the people on this planet, then chances are the answer is yes.
(I do know one guy who claims to have NEVER pulled a muscle in his life, but he’s either a) lying or b) a real-life version of Bruce Willis’ character in Unbreakable. I’m guessing A.)
Muscle pulls – also called muscle strains – are extremely common, affecting more than 3 million people per year. They can range from ultra-mild, like a minor neck strain you get from turning your head the wrong way, to very severe, such as a debilitating lower back injury that has you unable to walk for days.
When you regularly work out and / or play sports, you’re more at risk of developing a muscle strain.
That’s just how it goes when you’re repeatedly putting your body to the test and aiming to reach new levels of performance.
But that’s OK!
Because if you train smart and focus on proper form when lifting, you can greatly minimize these risks of injury.
Still, if you’re following a regular workout routine, then it’s just a matter of time until you suffer from a pulled muscle injury, and when that happens, I want you to know exactly what to do.
With swift and proper treatment, you can minimize the pain associated with a muscle pull and in most cases, quickly get back to your regular workout routine.
It’s important to note the difference here between sprains and strains. Sprains are injuries involving the ligaments, which is the tissue that connects bone to bone. Ankle sprains are the most common form of this type of injury.
Strains, on the other hands, are injuries involving the muscles and tendons. Muscle strains are the type of injury I will be discussing here.
In this article, I’m going to cover what exactly a muscle strain is, what to do when you pull a muscle, and perhaps most importantly, how to prevent muscle strains from happening in the first place.
What is a muscle strain?
A muscle strain is an injury to the muscle that occurs when the muscle fibers tear as a result of overstretching or overexertion. There’s also the potential for local bleeding and bruising if the damage from the tear is extensive enough to rupture the small blood vessels.
Muscle strains can be caused by all sorts of activities, from attempting a deadlifting personal record to normal, everyday activities like walking or carrying the groceries.
Here’s an embarrassing little story for you…
The week of my 30th birthday, I sneezed and pulled a muscle in my lower back. I was in so much pain and virtually unable to walk; I had to use my office rolling chair as a walker of sorts to get around the apartment.
That’s right – from sneezing. My friends were highly amused.
As embarrassing as it was, pulling out my back from sneezing actually made perfect sense. It forced a sudden, uncontrolled movement that my body just wasn’t prepared for.
It’s this kind of sudden, irregular movement that often results in muscle tears because the body is forced into an atypical movement pattern that it’s not warmed up for. Whiplash is a great example of this – it’s the sudden rapid back and forth movement of the neck that causes strain to the neck muscles.
Another common reason for muscle strains is overexertion. If you’re loading up too much weight on the bench press, for example, then you’re forcing your muscles to handle a load that they’re not able to. This can result in a muscle strain in the primary mover – your chest, in this case – and / or strains in the smaller muscles that assist in the movement (shoulders, back, triceps).
Symptom Of A Muscle Strain
When you strain a muscle, you will usually know it right away. Symptoms include:
- sudden onset of pain
- limited range of movement
- bruising or discoloration
- muscle spasms
What To Do When You Pull A Muscle
If the injury is severe, then you should immediately make an appointment with your doctor. Don’t mess around with severe injuries and try to treat them at home yourself.
The advice in this section is recommended for low-grade muscle tears with relatively minor symptoms. As always, use your best judgment and err on the side of caution – go see a doctor if you’re in any doubt whatsoever.
OK, so you’ve torn a muscle. Now what?
The First 24 Hours
I’m going to divide this section up into 3 parts so you know what to do at the various stages of the injury so you can get back to 100% as quickly as possible.
During the first 24 hours after your injury, I generally like to employ the tried and true RICE method. Note that this treatment protocol is only recommended during the first 24 hours maximum for reasons I will explain below.
The first thing you need to do is STOP doing whatever caused the pulled muscle in the first place. I can’t tell you how many times I’ve seen people injure their backs in the gym and then decide to go ahead and “push through it”. That ALWAYS makes your injury worse.
If you hurt yourself at the gym, stop your workout and go home so you can start treating the injury ASAP.
You want to stop putting stress on the muscle right away so you don’t do any more damage. Then continue to rest the muscle for the first 24 hours after the injury, using the muscle as little as possible so that healing can start to take place.
The sooner you apply ice, the better. My preferred treatment is to ice the injured area for 20 minutes on, 20 minutes off, and do this for 3 cycles (a total of 60 minutes with ice on).
Ice will provide immediate pain relief and help to minimize swelling. That’s the primary purpose of ice. It doesn’t actually do anything itself to promote healing. At this stage, it’s best to think of ice as a pain-reliever.
NOTE: Don’t apply ice directly to the skin.
After the initial 3 cycles of ice on, ice off, that’s it for the ice – no more ice is necessary. If the pain is bad and the ice is helping you feel better, you can continue to ice the injury for 20 minutes every hour or so, but after 24 hours, no more ice.
You can apply gentle compression to the injured area using a soft elastic bandage. This will help support the muscle and reduce swelling. Make sure not to wrap the area too tightly or your will restrict blood flow to the injury.
If possible, keep the injured muscle elevated, above the level of your heart. This will help to reduce swelling. Although in some cases this isn’t really feasible, so don’t worry about it too much.
The Next 2-3 Weeks
After 24 hours have passed since you injured yourself, you want to stop applying ice. This is somewhat of a contrarian point of view, as many fitness professionals will tell you to continue applying ice, but from recent research it seems like ice has the potential to actually DELAY healing.
Ironically, the man who made RICE famous, Dr. Gabe Mirkin, is now speaking out against that same protocol:
“Coaches have used my ‘RICE’ guideline for decades, but now it appears that both Ice and complete Rest may delay healing, instead of helping. In a recent study, athletes were told to exercise so intensely that they developed severe muscle damage that caused extensive muscle soreness. Although cooling delayed swelling, it did not hasten recovery from this muscle damage.”
You can read the full article by Dr. Mirkin here:
Essentially, ice actually delays healing because it inhibits blood flow to the area of the injury, preventing cells which are responsible for healing from reaching the damaged tissue. And ice continues to inhibit blood flow for hours after it’s been applied, delaying the healing process even further.
And it’s not only ice that should be avoided at this point, either…
You may have noticed that in his quote, Dr. Mirkin mentions that complete rest may dealing healing as well. I’ve found the same through both personal experience with injury and the experiences of my clients.
The general rule I follow is that I try to start rehabilitating the injured muscle as soon as possible, possibly even the next day. Note that I’m only talking about very gentle movements that don’t cause any pain. If anything you’re doing causes more pain, stop doing it immediately.
This is basically your goal over the 2-3 weeks following your injury: slowly rehabilitate the muscle and gradually return to normal movement patterns as the pain subsides and you begin to heal.
And again, if it hurts, stop doing it. The pain is there for a reason.
Water and fish oil helps to keep the muscle fibers supple and elastic, and will immediately help to reduce pain and inflammation. These two “supplements” should be at the cornerstone of your supplementation regime anyway, but if you’re injured, then now is the time to ensure you’re getting enough of each.
In terms of getting back to your exercise routine, I only advise working out at this stage if the specific exercises you’re doing in your workout cause no pain. For example, if you suffered a strain in your shoulder, you may still be able to train legs without any problem at all.
On the other hand, if you’ve pulled your lower back and are having issues with overall stability, stay away from the gym for a little while.
After 2-3 Weeks
After 2-3 weeks have passed, the pain should be gone and you should be feeling back to normal. Again, we’re talking about minor muscle belly injuries here. If you’ve suffered a more serious injury, you should be following the advice of your doctor.
Whether you wait 2 or 3 weeks is largely up to you. You know your body better than anybody else, so if you’re feeling back to near 100% at 2 weeks, then you should be OK to go ahead with the advice in this section.
At this point, you can reintroduce resistance training for the injured muscle. Don’t push yourself, and start with a lighter weight than usual. The last thing you want to do is re-injure yourself. I like to start with a weight of about 50% of what I would normally use and see how that goes. If I feel great and there’s no pain, I’ll move to 70% of my usual weight, but then stop there. Never jump back into maximum effort the first week back in the gym.
You can also start doing some stretching of the muscle you had injured. Again, just as with your workouts, start light and don’t push it. Stretching will help you regain any mobility and flexibility you may have lost during the period of muscle rest and rehabilitation.
Finally, I often suggest doing some foam rolling and deep tissue massage (with a tennis ball or lacrosse ball) around the affected area. That’s because sometimes during an injury, other muscles are recruited to make up for the slack of the injured muscle, and as a result these muscles become overworked and “knotted up”.
These knots can cause residual pain in and around the affected area, so it’s good practice to look for potential trigger points and release them before they become a problem.
My favorite book on trigger point therapy is The Trigger Point Therapy Workbook. Trigger point massage requires a whole separate article for discussion and advice, but just know that it’s recommended at this stage post-healing.
A Note On Painkillers
You may have noticed that I don’t recommend the use of any painkillers in this whole article, and that was intentional. I’m honestly not a big fan of pain medication for minor muscle strains.
Like I said before, the pain is there for a reason. Pain is a protective mechanism that prevents you from exerting the muscle too much so you don’t cause any additional damage. Once you remove the pain, you have no way of knowing when you’re moving beyond your limits and hurting yourself further.
How To Prevent Muscle Strains
I mentioned at the beginning of the article that muscle strains are virtually unavoidable – I don’t know anybody (except for that one guy who’s lying) who had never pulled a muscle. So to some extent, muscle strains are inevitable.
However, just because you can’t prevent ALL muscle strains, doesn’t mean you can’t prevent MOST of them, especially muscle strains that occur as a result of exercise. A random cough or sneeze may take you by surprise, but you always have control over your exercise technique in the gym.
So that’s rule #1 – focus on lifting with proper form, always. As soon as form breaks down, the potential for injury increases tenfold. Don’t lift weight that you can’t handle, and don’t sacrifice form to impress your friends with a bigger bench.
Next, make sure you warm up before your workouts. This can be done by running on the treadmill for five minutes, doing some jumping jacks, or warming up for your strength training with a few high rep, ultra light warm-up sets. Warming up your body makes your muscles more elastic and less prone to injury.
And one last time – WATER and FISH OIL are two supplements that should not be forgotten and play a large role in helping to prevent muscle injury. Make sure they’re a regular part of your supplementation routine.
That was a long one, and I’m sure you have questions. So go ahead and leave them in the comments below and I’ll make sure to get back to you ASAP.
Stay safe out there and hopefully you won’t need to refer to this article anytime soon!