How to treat "pulled" muscles

Let's get the golfers back on the greens

This is not medical advice

Please everyone, let’s fix this. You golfers and pickle ball Nazis. You’re grumpy because you’re not able to go play. You’re driving the spouse/kids/grandkids/store clerks/doctors crazy, complaining about your woes, and how good of an athlete you are, and you just want to get back to it.

So you’ve “pulled” a muscle. That means you’ve strained a certain percentage of muscle fibers. Maybe you’ve torn a percentage of muscle fibers, but not torn the whole tendon. A sprain is an injury to a ligament, or bone to bone soft tissue.

You obviously have pain. This is a message from your body that something is wrong, and maybe you should rest and prevent it from getting worse.

Anti - inflammatories

One prevailing narrative is to take Ibuprofen or other anti inflammatories. We don’t like pain, but pain is a message that something is wrong, and we need to go easier for a short time to allow healing.

Inflammation is part of the healing process, so decreasing that may actually prolong the injury. Are we likely to hear that when the phamaceutical industry has a billion dollar lobby? Or are we more likely to hear that we constantly need to take these pills? Are they what’s best for our organs?

There are times when we might consider them for a short duration. If you are limping uncontrollably, and must get through the day, anti inflammatories might prevent the muscle pain or strain from getting worse.

When swelling is so outrageous, that someone thinks you’re wearing a watermelon on your knee, anti inflammatories might be reasonable. But that is more of a contusion than a strain.

Anti inflammatories should not be the long term answer or solution.

Ice or Heat?

Don’t we sound like completely arbitrary idiots when we say, “oh, well maybe ice or heat?” Well, which is it?

The ice follows the same thinking as the anti inflammatories. If there is significant swelling, it might be necessary. I like to think about human tissue as having a viscosity, in other words, when it is warm, it moves with less pain. I have read about putting heat on swelling, however that is a leap I’m not quite ready for. I have seen some infection swelling, where it might be dangerous to put heat on that.

Neck strains

I find that most neck muscle strains feel better with heat and massage.

Massage

Muscles have protective fibers that will contract the muscle when it senses too much pain or threat of injury. Massage helps to decrease that response. Massage also improves blood supply to the tissue, and blood is what helps heal tissue.

I think the industry will sometimes ignore massage because we just don’t feel like doing it. If I see someone that does get a massage, it’s only one part of the program, and usually only 10 minutes.

Foam rolling

Foam rolling is similar to massage. If you have an acute strain, some foam rolling postures can be too aggressive. This should be gentle in the early stages of a strain (first 2-4 weeks).

The most important part is next.

Constant Range of Motion

What will help a strained muscle the most is constant and easy joint repititions. If you have a leg muscle strain, then a stationary bike would be ideal. Provided that you can complete a full revolution without increasing pain. Small amounts of pain initially might be ok, so long as everything feels better later.

If it is a shoulder or arm strain, then you might use a stick overhead laying down, or pulleys. Again, hundreds of pain free repetitions, that lead to less pain later.

Stretching

I don’t find that stretching helps the strains as much as easy range of motion. If you are very tight due to the strain, or are lacking full joint range of motion, then that will gradually need to be restored to prevent “frozen” joints.

Go easy and gentle, and measure progress in some manner. Stretching should not make symptoms worse later.

Compression sleeves and braces

Some compression might decrease blood supply, which would delay healing. Sometimes people need a brace to decrease limping, however bracing should not be a long term solution.