Clinically reviewed by What is muscle strain
A muscle strain is a tear in muscle fibres. It happens when a muscle is stretched further or faster than it can take, usually while it is working hard at the same time. People call it a pulled muscle.
In Urdu it is pattha kheench jana, and a bigger tear is pattha phat jana. The hamstring, calf, groin, thigh and lower back are the usual sites.
A strain is not the same as a cramp or a spasm, where the muscle grips but nothing tears. It is also not a sprain, which is a ligament injury at a joint. Our muscle spasm page covers the gripping kind.
Symptoms you might have
- Sudden sharp pain during an effort, often with a tearing or popping feeling
- Pain when you stretch the muscle and pain when you contract it against resistance
- One tender spot you can put a finger on, rather than a general ache
- Swelling, then bruising over the next day or two
- Clear loss of strength, so the leg or arm will not do what it did yesterday
- A visible dent, gap or bunched lump in the muscle, which suggests a large or complete tear
Why it happens
- Sprinting, kicking, jumping or a sudden change of direction in cricket, football or kabaddi
- Lifting something heavy awkwardly, or lifting with a twist
- Coming back after a long break and working at the old level
- Fatigue at the end of a shift or a match, when muscles stop absorbing load well
- A previous strain in the same muscle, which is the single biggest risk factor
- A muscle that is weak or short for the work being asked of it
When you should see a physiotherapist
Come in within the first few days. The first week shapes how well a muscle heals and how likely it is to tear again.
See a doctor the same day if you cannot put weight on the leg at all, if there is a visible gap or a bunched lump in the muscle, or if the muscle feels loose and powerless, because that pattern suggests a complete tear or a tendon pulling off the bone. Those need imaging and a surgeon's opinion.
Go to a hospital the same day if the limb becomes very swollen, tight and numb after the injury, or if you pass dark brown urine after heavy exertion in heat. Also see a doctor if you have weakness that is getting worse rather than easing over the first week.
Al-Shama Physiotherapy Clinic
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How it is treated
In the first two days the job is to limit bleeding and swelling. After that the job is loading the muscle, in small steps, because scar tissue only becomes strong if it is asked to work.
- Early protection advice, relative rest, a snug bandage, ice and keeping the limb raised for the first 48 hours
- Exercise therapy, the main treatment, starting with pain-free holds and moving to strength work through the full length of the muscle
- Manual therapy and soft tissue work once the fresh bleeding stage is over, to stop the area stiffening
- Ultrasound and TENS for pain control in the first two weeks
- Dry needling for the protective tightness around the injury, never over a fresh tear or fresh bruising
- Return to activity testing, comparing the two sides before you go back to sport or heavy work
Most strains do not need surgery. Surgery is considered for a complete tear or a tendon pulled off the bone, and that is a surgeon's decision, not a physiotherapist's.
Exercises, and what to avoid
What helps
- Pain-free isometric holds in the first days, pushing gently against resistance without moving the joint
- Moving the joint through the range that does not hurt, several times a day, to keep it from stiffening
- Slow, controlled strength work as it settles, taking the muscle into its full length under load
- Speed, sprinting and heavy lifting added last, after strength is close to the other side
What to avoid
- Hard stretching in the first week. Pulling on a fresh tear widens it
- Deep massage, hijama or needling over fresh bruising
- Heat, hot oil massage and vigorous rubbing in the first 48 hours, all of which increase bleeding into the muscle
- Going back to full effort because the pain has stopped. Pain settles well before strength returns
What you can do at home
For the first 48 hours, ice for ten to fifteen minutes every two to three hours, with a cloth between the ice and the skin. Keep a snug bandage on and keep the limb raised when you are sitting.
No heat, no hot oil massage and no alcohol for those first two days. Heat early makes the bleeding and swelling worse, and this is the mistake we see most.
After 48 hours switch to heat before you exercise, and keep moving gently within comfort.
Keep the rest of your body working. There is no reason to stop walking because a shoulder is torn, or to stop upper body work because a calf is.
How long it takes
A mild strain, where only a few fibres have gone and strength is nearly normal, settles in one to three weeks.
A moderate strain, with clear loss of strength and visible bruising, takes four to eight weeks to be properly ready for sport or heavy work.
A complete tear takes three months or more and may need a surgeon's opinion first.
What slows recovery most is a return before strength is back. Healing muscle is weaker than normal muscle for several weeks after the pain has gone, so the re-tear usually happens in the first two or three weeks back. Going back on tested strength rather than on how it feels is what prevents it.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
پٹھا کھینچ جانے کا مطلب ہے کہ پٹھے کے ریشے پھٹ گئے ہیں۔ اچانک تیز درد ہوتا ہے، پھر سوجن اور نیل آ جاتا ہے، اور طاقت کم ہو جاتی ہے۔
پہلے 48 گھنٹے: برف دس سے پندرہ منٹ، پٹی، اور ٹانگ یا بازو اونچا رکھیں۔ ان دو دنوں میں گرم سیک، گرم تیل کی مالش اور زور کی مالش نہیں کرنی۔ اس سے خون زیادہ بہتا ہے۔
دو دن کے بعد گرم سیک اور ہلکی ورزش شروع ہوتی ہے۔ کھنچاؤ زور سے نہیں، ورنہ پھٹا ہوا حصہ بڑھ جاتا ہے۔
سب سے اہم بات: درد ختم ہونے کا مطلب پٹھا ٹھیک ہونا نہیں۔ طاقت بعد میں واپس آتی ہے۔ جلدی کام پر لوٹنے سے پٹھا دوبارہ پھٹ جاتا ہے۔
Roman Urdu
Pattha kheench jane ka matlab hai ke pathe ke reshe phat gaye hain. Achanak teez dard hota hai, phir sujan aur neel aa jata hai, aur taqat kam ho jati hai.
Pehle 48 ghante: barf dus se pandrah minute, pattee, aur taang ya bazu ooncha rakhen. In do dinon mein garam sek, garam tel ki maalish aur zor ki maalish nahi karni. Is se khoon zyada behta hai.
Do din ke baad garam sek aur halki warzish shuru hoti hai. Stretch zor se nahi, warna phata hua hissa barh jata hai.
Sab se ahem baat: dard khatam hone ka matlab pattha theek hona nahi. Taqat baad mein wapas aati hai. Jaldi kaam par lotne se pattha dobara phat jata hai.
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Questions people ask
How long does a pulled muscle take to heal?
Heat or ice for a pulled muscle?
Why did my hamstring tear again?
When can I go back to playing or heavy work?
Should I massage a fresh muscle tear?
Related conditions
- Muscle spasm and cramp treatment
- Leg cramps treatment
- Night cramps treatment
- Calf pain treatment
- Thigh pain treatment