You are an active person. You train for many activities, both competitively and recreationally. Being physically active is part of your lifestyle more than it is a hobby. It is what you do. For our patient base, most who come in have had at some time a muscular injury that created a setback in progress.
In my experience, patients report that a muscular injury like a strain rarely happens at high intensity levels or max lifts, but during something that seems commonplace. Recently a patient reported that she had an injury from throwing a friend an eye dropper, a very simple task that required little muscular power. This injury while seemingly small put any exercising or rock climbing to a full stop. This “little” injury had become a nuisance that caused pain in several different positions during daily life and work.
Muscular injuries are not all created equal. There are different levels or grades of muscular strains. Let us discuss some of the obvious differences for each.
- Grade 1 -Mild. A grade 1 muscle strain findings include mild pain with activity of injured muscle, guarding, possible trigger points, with local mild compensatory joint motion restrictions. No bruising, but possible mild swelling, slight weakness with muscular contraction, pain with palpation of tissue. Generally considered as self-limiting, meaning heal with very little intervention.
- Grade 2- Moderate. Moderate to severe pain, guarding, loss of function, bruising and edema, moderate joint motion restriction. Possible antalgic movement or lack of use. Moderate pain with palpation of tissue. Significant loss of strength during muscle strength tests (⅗ or ⅘)Possible needs: diagnostic imaging; ie, diagnostic ultrasound or MRI. May require surgical intervention.
- Grade 3 – Severe. Severe pain at time of injury then less to no pain. Full thickness tear. Possible visual tear showing muscular ball under skin, can palpate the muscular defect. A Complete loss in strength and usually requires surgical intervention.
The Current Grading Scale of muscular tears
Each grade of muscular injury does provide their own difficulty in treating conservatively. If a grade 3 tear is suspected further testing is required to provide you with possible options.
For grade 1 strains the expected healing time can be anywhere from 2-7 days, but structural healing time can be 4-14 days. For grade 2 strains the expected healing time can be anywhere from 1-10 weeks for functional healing and 3-12+ weeks for structural healing. For grade 3 strains the expected structural healing time may be 12 months or more.
Most advice after an injury is to rest, ice, compress and elevate. While that has been the norm for decades, this has been debunked for several years. Our best approach to soft tissue injuries such as mentioned above is to first get assessed by a professional. Having your injury assessed will help the professional provide the correct treatment and advice.
Outside of discussing the myriad of manual therapy modalities that are available there are certain nutritional supports that are seen as helpful and important both at the time of an injury as well as concurrently for many athletes.
Here is what the research says on what is most beneficial when adding nutritional supplementation for muscular strains.
- Attention to increased Omega-3’s post injury up to 5g/day for the first two weeks post injury.
- Suggested dose of 2000-5000 IU’s of vitamin D daily (is dependent on sunlight exposure)
- 20 g/day of creatine for first 5 days post injury, then maintain 5g/day afterwards.
- 48mg/day of collagen is recommended to maintain normal collagen synthesis. Vitamin C must be taken at the same time for collagen synthesis.
One of our go-to’s in our office at ChiroMovement Muscle & Joint Clinic is the use of a Soft Tissue Support Pack from the company Orthomolecular Products. Here is the link to that product detail here. It includes a Complete Tumeric Matrix, proteolytic enzymes, flavonoids, GABA and Glycine amino acids. All of these nutrients are great injury healers.
Soft tissue injuries do heal at different rates. It is proposed that providing the tissue adequate and appropriate inputs with both manual therapies as well as nutritional supplementation can help to improve healing rates. We utilize both aspects when seeing someone for any muscular or soft tissue injury.
For continued help for muscular strains and manual therapies click that button at top right corner and let’s get started.
- Tipton KD. Nutritional Support for Exercise-Induced Injuries. Sports Med. 2015;45 Suppl 1:S93-S104. doi:10.1007/s40279-015-0398-4
- Vizniak, Nikita. Orthopedic Conditions Quick Reference Evidence Informed, www.prohealthsys.com Published in Canada pg 6-7
- Close GL, Sale C, Baar K, Bermon S. Nutrition for the Prevention and Treatment of Injuries in Track and Field Athletes. Int J Sport Nutr Exerc Metab. 2019 Mar 1;29(2):189-197. doi: 10.1123/ijsnem.2018-0290. Epub 2019 Mar 8. PMID: 30676133.