Strained muscle? What to do?

Posted on October 4, 2011

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Sarah asked a question in the comments of my recent post on icing an injury. I thought I’d make a post of my answer:

“So you’re saying ice is a personal choice, though not recommended for those with hypertension. Huh. Ok, so basically see how you feel after icing an injury. What are some things that CAN be done and ARE beneficial? Let’s use a strained hamstring muscle as an example. Compression? Ice as needed? Rest?”

When it comes to alleviating a strained muscle you need to first determine what the cause of the strain is. For example, in Just because it feels tight, doesn’t mean it is I used an example of the upper traps being chronically lengthened. This is relevant because in some muscle strains the strain is due to a sudden over stretching of the muscle. But in the case of the upper trap, in that post, the muscle is strained, but it is due to a chronic over stretching. In the case of a chronic overstretched muscle the solution is to help shorten the muscle (such as support the arms so the upper trap isn’t being as stretched) and to strengthen the muscle, also helping to tighten it up.

In other cases, often in hamstring strains, the strain is due to an underactive synergist. This means another muscle that performs similar actions to the strained muscle is not performing optimally. The hamstrings help to extend the hip and flex the knee, and often it is the glutes, also a hip extensor, that are not helping the hamstrings out as well as they could.

An easier way to think of this is if you have 10 workers doing construction on a house and suddenly 5 workers are out sick, the remaining 5 are going to get pretty pissed if they have to still perform the work that was expected by all 10. If they do this long enough they become tired, sick, burnt out…in other words, strained.

Get the glutes to fire better, get them stronger, that helps take off some of the pressure on the hamstrings.

In your case (Sarah is a client for other’s reading this), you walking with your knees constantly caved inward and internally rotated is a sign the glutes are not working well, as the glutes pull the knee outward and laterally rotate the knee. As I mentioned to you…try to stop walking with your knees hyperextended and caved inward so the hamstrings don’t have to constantly do so much work.

Unfortunately solutions for these types of things pretty much never consist of “do this exercise” but consist of “do these exercises AND STOP doing this or that in your daily life.” You can’t undo 16 hours of daily life with 1 hour of exercise.

As far as other modalities to help healing I’m really not aware of much that’s actually worth it. I mentioned in the icing post there was a study where compression and ice was put on an injury. That helped promote healing better than no modality at all. Since the research on ice seems to say there isn’t much efficacy for ice, one could possibly conclude the compression is what is helping. However, just like icing, it’s pretty damn hard to have a control group. That is, it’s very hard to measure the placebo effect. In the end, I’d be surprised if compression did much to promote healing.

In the end it seems to come down to finding out what is causing the strain, spending a few weeks correcting things based on the assessment, and letting the tissues heal on their own time.

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Posted in: Pain