In some respects, it’s a bit of a trick question to ask if your muscle is pulled or strained because a pulled muscle is a version of a strained muscle.
A pulled muscle is sometimes used as a colloquial term for a strain of moderate severity. A muscle becomes strained when it’s twisted, pulled, or torn in two.
Your muscles can become strained suddenly — an acute strain — or over time from a chronic or overuse injury
Pulling your muscle is something that usually happens in one — or a few — quick movements. This makes the injury an acute strain. Chronic strains, in contrast, are caused by repetitive or prolonged movements.
Strains can happen in all of your muscles, but your back muscles and hamstrings — the muscles at the back of your thighs — are two of the most commonly affected locations.
How is a pulled vs strained muscle diagnosed?
Your doctor will diagnose your injury as a pulled or strained muscle after a thorough physical examination. They’ll test your muscle for its range of motion and strength. They’ll probably also ask for a description of how the injury happened.
X-rays can’t detect soft tissues, so they aren’t useful for directly assessing damage to your muscles, but your doctor might order them to see if there’s any further damage in the area, like broken bones.
In some cases, your doctor may order an MRI (magnetic resonance imaging) or CT (computerized tomography) scan to further evaluate the extent of your injury and determine the proper treatment plan.
How are muscle strains classified?
The symptoms of your muscle strain can be mild, moderate, or severe. To help determine the best treatment, strains are classified by how much damage has been done to your tissue.
The classifications include:
- Grade 1 strains. These are mild and involve very little damage to your muscle tissue. Your muscle should still work normally but will be painful and tender.
- Grade 2 strains. These involve a lot of damage to your muscle fibers — the strands of your muscle tissue. Pain and tenderness will be much worse and could be accompanied by swelling, bruising, and a loss of strength. Pulled muscles can fall into this category of strain.
- Grade 3 strains. These are the most severe types of strain. In this case, your muscle is either torn in two or completely ripped away from a tendon — which connects it to your bones. You might hear or feel your muscle pop as the tear happens. You might be able to see or feel the dent caused by the separation of the two halves of your muscle. Pain and inflammation are the most severe in this case. Other symptoms include swelling, discoloration, and a complete loss of function in the muscle and corresponding body part.
What’s the difference between a strain and a sprain?
Even though a pulled muscle is just a version of a strained muscle, there’s a difference between a muscle strain and a sprain. Where a strain is an injury to a muscle or tendon, a sprain is an injury to one of your ligaments — the stretchy, connective tissues that link your bones together.
The symptoms and severity classifications of strains and sprains are very similar. They also have comparable treatments. A medical diagnosis is the best way to distinguish between these two types of injury.
How to treat muscle strains
The treatment for your pulled or strained muscle depends on how severe the injury is. Ibuprofen and acetaminophen can help manage your pain.
Mild and moderate injuries are treated with a series of steps known as RICE, which stands for:
- Rest. Move and engage your injured muscle as little as possible. You may need to rest it for several days to weeks. You’ll need to stop all strenuous activities — like heavy lifting — for up to eight weeks after the injury.
- Ice. Immediately apply ice to help manage your pain and swelling. Continue icing the area around three times a day for several days. You can ice the area less frequently as your swelling goes down.
- Compression. Applying pressure — for instance, with compression bandages — is a great way to bring down swelling. Just be sure you don’t cut off your blood flow to the area by wrapping your bandaging too tightly.
- Elevation. Keep the injury elevated — ideally, above your heart.
More severe injuries — like complete tears — can require surgery, followed by physical therapy, to heal. Your doctor will need to determine whether or not your injury requires this form of treatment.
One of the greatest treatments is prevention. Pulls and other strains are common in sports — particularly when you don’t warm up enough or allow your muscles to rest enough during training. A good warm-up routine increases blood flow to your muscles and makes it easier for them to perform physical activities without becoming injured.
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Muscle Strain Prognosis
Depending on their severity, strains can take weeks to heal but your symptoms should gradually improve over time.
Your muscles might repeatedly become pulled or strained in the same place. This is true in some areas of your body more than others — particularly your ankles. Repeated injury to the same area can lead to worse problems over time, such as arthritis.
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Harvard Health Publishing: “Muscle Strain.”
Nemours Teens Health: “Strains and Sprains.”
NHS: “Sprains and Strains.”
OrthoInfo: “Neck Sprain.”
University of Rochester Medical Center: “Sprains, Strains, Breaks: What’s the Difference?”
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