Definition

A strain is when a muscle is stretched too much and part of it tears. It is also called a pulled muscle. A strain is a painful injury. It can be caused by an accident, overusing a muscle, or using a muscle in the wrong way.

Alternative Names

Pulled muscle

Causes

A strain may be caused by:

• Too much physical activity or effort
• Improperly warming up before a physical activity
• Poor flexibility
• Falls

Symptoms

Symptoms of a strain can include:

• Pain and difficulty moving the injured muscle
• Discolored and bruised skin
• Swelling

First Aid

Take the following first aid steps to treat a strain:

• Apply ice right away to reduce swelling. Wrap the ice in cloth. Do not place ice directly on the skin. Apply ice for 10 to 15 minutes every hour for the first day and every 3 to 4 hours after that.
• Use ice for the first 3 days. After 3 days, either heat or ice may be helpful if you still have pain.
• Rest the strained muscle for at least a day. If possible, keep it raised above your heart.
• Try not to use a strained muscle while it is still painful. When the pain starts to go away, you can slowly increase activity by gently stretching the injured muscle.

When to Contact a Medical Professional

Call the local emergency number, such as 911, if:

• You are unable to move the muscle.
• The injury is bleeding.

Contact your health care provider if the pain does not go away after several weeks.

Prevention

The following tips may help you reduce your risk for a strain:

• Warm-up properly before exercise and sports.
• Keep your muscles strong and flexible.

References

Biundo JJ, Canoso JJ. Bursitis, tendinopathy other periarticular disorders, and sports medicine. In: Goldman L, Cooney KA, eds. Goldman Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 242.

Geiderman JM, Torbati S. General principles of orthopedic injuries. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 41.

Wang D, Eliasberg CD, Rodeo SA. Physiology and pathophysiology of musculoskeletal tissues. In: Miller MD, Thompson SR. eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 1.