Muscle Tears

Muscle Strains and Tears

• Acute strains occur from undue pressure or overstretching of a muscle which results in a tear and damage to the muscle fibres and/or its attaching tendons

• Damage can occur to a small area causing a partial tear to the muscle fibres, or a large portion of the muscle causing a complete rupture of the muscle belly. They are graded accordingly from 1 to 3
• Muscle strains can occur in all muscles of the body during normal activities of daily life, work tasks etc, but most commonly present as a sporting injury
• Typical symptoms are pain, swelling, weakness and bruising or discolouration around the site of injury
• Chronic muscle strains can occur as small tears which happen over time with a continuously overloaded muscle
• The grading of acute muscle strains can determine the prognosis of the injury and helps to plan for return to sport
• A bad grade 2 tear may take 2-3 months to completely heal
• Depending on how many fibres are affected, grade 3 tears may require surgery

 
What you can expect/look out for
• Expect to see swelling and bruising/discolouration, this may continue to worsen in the days following the injury
• Pain, swelling and bruising usually subsides gradually over 1-3 weeks and the torn muscle begins to heal through scar tissue
• In most cases, with proper treatment most people completely recover from a muscle strain

Exercise

Muscle Tears – More information

• If surrounding muscles and/or joints are not working properly, one particular muscle may be being overloaded, leading to that muscle being injured with a smaller force.

 
Hints for self-management
• Initial management is as for most soft-tissue injuries
• Rest, may involve immobilising the area, a sling for the arm or crutches for the leg
• Ice the area with an ice-pack or ice-blocks wrapped in a tea-towel, for 20 minutes, every 2-3 hours over the next 72 hours
• Compress the area with a bandage
• Elevate the area above the heart i.e. a lower limb injury should be rested lying down with the foot up on a small stool/pillows

 
Management options
• After a period of relative rest it is necessary to exercise the injured and surrounding muscles to regain full function
• Exercises to stretch, strengthen and correct muscle imbalances are necessary
• Deep tissue massage may be appropriate after an initial period of rest to release the thickened scar tissue

Calf Muscle Tears

A torn calf muscle (gastrocnemius) is similar to an Achilles tendon tear or rupture, but occurs higher up in the back of the leg. A sign of a torn calf muscle is similar to that of an Achilles tendon rupture. You may think you’ve just been hit in the leg and potentially hear a “pop.” There is sudden pain at the back of the calf. Then you’ll experience pain, swelling or bruising in the calf muscle, and you’ll have difficulty walking properly or standing on your toes.

Calf muscle tears usually occur during acceleration or changes in direction (e.g. tennis, squash). However, we have known people to tear their calf muscle by simply walking across the road.

Illu_lower_extremity_muscles

Calf strain may be minor or very severe. Your physiotherapist will grade the injury accordingly:

Grade 1:

The muscle is stretched causing some small micro tears in the muscle fibres. Recovery takes approximately 2 to 4 weeks if you do all the right things.

Grade 2:

There is partial tearing of muscle fibres. Full recovery takes approximately 4 to 8 weeks with good rehabilitation.

Grade 3:

This is the most severe calf strain with a complete tearing or rupture of muscle fibres in the lower leg. Full recovery can take 3-4 months and, in some instances, surgery may be needed.

Prevention

  • Keeping calf muscles strong so they can absorb the energy of sudden physical stress.
  • Stretching out calf muscles before physical activity, i.e. calf raises. Gradually including weights or additional resistance over time.
  • Learning the proper technique for exercise and sporting activities. This will decrease stress on all muscles, including calf muscles.
  • Undertaking training prior to competition to ensure readiness to play.
  • Undertaking fitness programs to develop strength, balance, coordination and flexibility.
  • Gradually increasing the intensity and duration of training.
  • Allowing adequate recovery time between workouts or training sessions.
  • Drinking water before, during and after play.

Signs and symptoms

  • A sudden pain at the back of the leg, particularly at the muscular tendinous junction.
  • Difficulty in contracting the muscle or standing on tiptoe.
  • Pain and swelling or bruising in the calf muscle.
  • Pain on resisted plantar flexion or contracting the muscles against resistance.
  • If the Soleus muscle is damaged pain might be incurred lower in the leg and when contracting the muscle against resistance with the knee bent.

Immediate Management

The immediate treatment of any soft tissue injury consists of the RICER protocol – rest, ice, compression, elevation and referral to a sports medicine professional. RICE protocol should be followed for 48–72 hours. The aim is to reduce the bleeding and damage in the muscle. The leg should be rested in an elevated position with an ice pack applied for 20 minutes every two hours (never apply ice directly to the skin). A correctly sized compression bandage should be applied to limit bleeding and swelling in the injured area.

The No HARM protocol should also be applied – no heat, no alcohol, no running or activity, and no massage. This will ensure decreased bleeding and swelling in the injured area.