Can Osteopathic Manipulative Medicine (OMM) be performed on a patient with an acute muscle strain?

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From the Guidelines

Osteopathic manipulative medicine (OMM) should generally be avoided on an acute muscle strain, and instead, rest and limiting the use of the injured extremity, as well as cold application, are recommended as the mainstay of treatment. In the acute phase, the primary goal is to reduce pain and swelling, and according to the 2024 American Heart Association and American Red Cross guidelines for first aid 1, cold application can acutely decrease pain and swelling in joint sprains and muscle strains. The guidelines recommend limiting the duration of cold application to 20 to 30 minutes for 3 to 4 times daily, and using a bag filled with ice and water surrounded by a damp cloth to achieve the greatest tissue cooling. Some key points to consider when treating acute muscle strains include:

  • Rest and limiting the use of the injured extremity to avoid worsening the injury 1
  • Cold application to decrease pain and swelling, with the greatest tissue cooling achieved by using a bag filled with ice and water surrounded by a damp cloth 1
  • Avoiding direct manipulative techniques in the acute phase to prevent additional tissue damage or increasing inflammation Once the acute phase has passed, gentle indirect OMM techniques such as counterstrain, myofascial release, or balanced ligamentous tension may be appropriate to help reduce pain, improve circulation, and promote healing, as supported by the principles of osteopathic medicine and the guidelines for first aid 1.

From the Research

Omm on Acute Muscle Strain

  • There are no direct studies on the use of Omm (Osteopathic Manipulative Medicine) on acute muscle strain, however, the general treatment and management of acute muscle strain can be discussed.
  • The treatment of acute muscle strain typically involves rest, ice, compression, and elevation, as well as the use of nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation 2, 3, 4.
  • Some studies suggest that early rehabilitation and physical therapy can help to shorten the time to return to sport and improve outcomes after acute muscle strain 3, 4.
  • The use of NSAIDs has been shown to be effective in reducing strength loss, soreness, and blood creatine kinase level after an acute muscle injury, at least in the short term 5.
  • It is also important to note that muscle strain injuries can be caused by a variety of factors, including excessive strain on the muscle-tendon unit, forceful blows to the muscle, and poor warm-up and stretching techniques 2, 3, 6.
  • The diagnosis of acute muscle strain can be made based on history and physical examination, and imaging studies such as ultrasound and MRI can be used to confirm the diagnosis and assess the severity of the injury 2, 4, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Muscle strain injury: diagnosis and treatment.

The Journal of the American Academy of Orthopaedic Surgeons, 1999

Research

[Treatment of acute muscle injuries].

Ugeskrift for laeger, 2019

Research

Muscle Injury: Pathophysiology, Diagnosis, and Treatment.

Revista brasileira de ortopedia, 2022

Research

Muscle strain injuries.

The American journal of sports medicine, 1996

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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