What is the recommended treatment for muscle strain?

Treatment of Muscle Strain

The recommended treatment for muscle strain includes rest, avoiding activities that cause pain, applying cold therapy for 20-30 minutes several times daily, and gradually returning to normal activities as symptoms improve. 1

Immediate Management (First 24-72 hours)

• A person with a painful muscle strain should avoid activities that cause pain and seek medical attention if the injury limits use of the extremity 1
• Apply cold therapy (ice and water surrounded by a damp cloth) to the injured area for 20-30 minutes, 3-4 times daily to reduce pain and swelling 1
• Never place ice directly on the skin to prevent cold injury 1
• Compression may be applied to promote comfort, but should not compromise circulation 1
• Elevate the injured area when possible to reduce swelling 1
• Cyclobenzaprine may be prescribed as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions for up to 2-3 weeks 2

Rehabilitation Phase (After Acute Phase)

• Begin gentle movement and exercise as soon as pain allows to prevent muscle atrophy and promote healing 3
• A short period of relative rest (not complete immobilization) is needed initially to allow formation of scar tissue between damaged muscle fibers 3
• Early mobilization is essential to:
  • Promote proper orientation of regenerating muscle fibers 3
  • Minimize inactivity-induced atrophy 3
  • Restore flexibility and strength 4
  • Stimulate collagen production and guide normal alignment of newly formed collagen fibers 5

Exercise Progression

• Start with gentle range of motion exercises when pain allows 5
• Progress to strengthening exercises at a frequency of 2-3 non-consecutive days per week 5
• Begin with 1 set of 10-15 repetitions, gradually progressing to 3 sets as symptoms improve 5
• Mild discomfort during exercise is acceptable, but pain should not persist after exercise 5
• Eccentric strengthening exercises (where the muscle lengthens while contracting) may be particularly beneficial for tendon-related strains 5

Common Pitfalls and Considerations

• Avoid complete immobilization as it leads to muscle atrophy and deconditioning 5, 3
• Do not apply ice directly to the skin or for periods exceeding 20-30 minutes 1
• Avoid excessive heat in the acute phase as it may increase inflammation 1
• Do not return to full activity too quickly; gradual progression is essential to prevent reinjury 4
• Monitor for signs that require medical attention:
  • Severe pain or inability to bear weight 1
  • Significant swelling or deformity 1
  • No improvement after 7-10 days of appropriate self-care 4

Long-term Considerations

• Most muscle strains heal with excellent recovery when treated appropriately 3, 4
• Complete muscle ruptures with total loss of function may require surgical management 3
• Prevention strategies include:
  • Adequate warm-up before intense exercise 4
  • Avoiding excessive fatigue 4
  • Progressive strength training, especially for muscles that cross two joints 4
  • Maintaining flexibility through regular stretching 5