What Happens When You Pull A Muscle? SPrain vs STrain EXPLAINED (And what to do about it)

Rice Method

what happens when you pull a muscle

Have you ever pulled a muscle?

If you’ve ever moved your body, chances are you’ve pulled a muscle.

And when you do, don’t you know it!

When you have a pulled muscle the pain can range from mild, like a minor neck strain you get from turning your head the wrong way, to very severe, such as a lower back injury that leaves you unable to walk for days.

Just last week a gentleman walked into our physical therapy clinic in Arizona in agony.

He hobbled in, dragging his leg behind him barely able to walk, and asked us:

What Happens When You Pull A Muscle?

I was playing soccer with my nephew and as I kicked the ball, something went wrong in my hamstring and I couldn’t move – and I can still barely walk!…

What can I do to ease the pain quickly?!”

This man was struggling. Every step he took made him wince.

And I know what that’s like…

A few years ago, the week before my birthday, I sneezed and pulled a muscle in my lower back. I was in so much pain and completely unable to walk; I had to use my office chair with wheels to support me to get me around the house.

That’s right – I pulled a muscle from sneezing. My family was highly amused.

And as embarrassing as it was, putting my back ‘out’ from sneezing makes sense.

The sneeze forced a sudden, high-intense muscle contraction that my body simply wasn’t prepared for. And it’s this kind of sudden movement that often results in a pulled or strained muscle because the body is forced into an action it’s not warmed up for.

Common areas to pull muscles are:

  • Hamstring in the back of the thigh
  • Hip flexors and groin high up in your hip
  • Calves in the back of your leg
  • Neck and back muscles
  • Rotator cuff muscles in your shoulder.

Is a Pulled Muscle the Same as a Muscle Strain (Or Muscle Tear)?

Yes!  They have the same meaning.  Whether you pull, strain, or tear a muscle they are all words that describe the fact you have exceeded the muscle or tendon stretch limit causing the tissue to separate beyond it’s normal limit.  Strain injuries only happen to contractile tissue like muscles or tendons.  They do not happen to ligaments.  Injuries to ligaments are called sprains.  This is because ligaments do not stretch.  When you stretch something that is not supposed to stretch you sprain it.  When you OVER stretch something that is supposed to stretch (like muscles and tendons) you STRAIN them.

There are degrees of strain to help determine how severe the injury is.

They are described by grades I, II, III that correlate to mild, moderate, and severe.  Severe or grade III strains are complete tears of the muscle or tendon, often requiring surgery to fix.

Whiplash is a great example of this…

The sudden rapid back-and-forth movement of the neck causes strain to the neck muscles, leaving you feeling achy, and your neck too painful to turn properly.

And the same happened with this gentleman who walked into the clinic who had strained his leg badly from playing soccer – his muscles weren’t prepared and warmed up properly, so the sudden quick movement of kicking a ball came as a shock to his body, straining a muscle in his leg.

You don’t have to be a weightlifter, or be carrying anything heavy to pull a muscle…

Sneezing, turning your neck suddenly, sleeping in an awkward position, moving to pick something up, or even reaching for something that’s difficult to get to – are just a few examples of simple things you can do every day to pull a muscle.

And believe me when I say, when you pull a muscle, usually, you’ll know it right away.

You might experience a sudden onset of pain, soreness, bruising, stiffness, swelling, a limited range of movement, muscle spasms…

And that’s just a few of the symptoms!

What to do When You Pull a Muscle?…

Do you use ice or heat? Should you rest, or keep moving? Maybe you get a therapist to take a look?

If the muscle pull is severe – the kind that really does stop you from walking, or turning your neck at all. Then you should immediately see someone. Don’t mess around with severe injuries and try to treat them at home yourself, or it might last longer!

The advice I’m about to give you is for a mild muscle strain – the kind where you can still move, but you know you’ve done something. As always, use your best judgment – go and seek help if you’re in any doubt whatsoever.

Ok, so you’ve pulled a muscle – what should you do?

I’m going to break this down so you know what to do at all stages when you’ve pulled a muscle, so you can get back to 100% as quickly as possible.

As soon as you know you’ve pulled a muscle – I recommend you use the tried and tested ‘RICE’ method.

Note that this is a treatment protocol recommended to do in the first 24 hours…

So, “R” – stands for “Rest”.

The first thing you need to do is stop doing whatever you did that pulled your muscle in the first place. I can’t tell you how many times we’ve seen people injure themselves, especially when doing physical activity, and decide to go ahead and push through it – That is guaranteed to always make your injury worse.  However, it is important to note you should not just lay on the couch and do nothing.  Finding activities you can do to keep the muscle moving without increasing pain will help speed up recovery.

Next step – “Ice”.

A lot of people ask – “When do I use ice, and when do I use heat?”…

Well, the sooner you apply ice, the better! Ice the injured area for 20 minutes on, 20 minutes off, and do this up to 3 times. Then you can do 20 minutes every hour.

Ice provides pain relief and helps minimize swelling. Which is the primary purpose of ice – to reduce swelling.

It’s best to think of ice as a pain reliever.

But don’t apply it directly to the skin. Wrap it in a towel and then apply to the area.

Here is a great article that highlights the benefit of using ice.

Then you move on to “Compression”.

Apply a soft bandage to the area to help support the muscle and reduce the swelling. Make sure not to wrap the area too tightly or you will restrict blood flow to the area. For compression, I love using my normal tech compression boots

Next for the ‘E’ – “Elevation”.

If possible, try to keep the injured muscle elevated, above the level of your heart. This will help reduce swelling. Though I know this isn’t always possible in some cases, so don’t worry about this one too much.

As a general rule, after doing the above method for a day, I like to get moving as soon as possible. Even as soon as the next day.

I’m only talking about very gentle movements that don’t cause pain. If anything you’re doing causes pain – stop immediately.

So here’s my tip for you today: You don’t always need to rush off to a pharmacy and buy a “magic cure” to rub on muscles and joints or take painkillers.

There is NEARLY ALWAYS a natural solution out there waiting for you.

Second… if you are experiencing a pulled muscle, try this “RICE” method first. Although isn’t a guaranteed fix, it’s proven to help ease all of them and is a good place to start.

If you’ve got any muscle or sports injuries right now, here’s a free guide that shows you the BEST ways to get back to being active, and ease pain quickly.


Nick Hunter, PT, DPT

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