A pulled muscle — also known as a muscle strain — occurs when a muscle stretches too much, which causes the muscle fibers or tendons to tear.
Pulled muscles commonly occur in the lower back or hamstring. And while they can occur from overexertion during sports, even routine activities like a poorly placed step can cause a muscle strain.
Here's what you need to know to diagnose and treat your muscle strain.
Muscle strain symptoms
Muscle strains can be serious or mild in nature. "It totally depends on the severity of the trauma of tissue," says Clint Soppe, MD, orthopedic surgeon and sports medicine specialist at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles.
Doctors often assign strains a grade:
- Grade I is mild. While this level of sprain will hurt, you should still have somewhat normal strength.
- Grade II is moderate. For this level of sprain, you may notice swelling and bruising, as well as experiencing a loss of strength in the strained area or limb.
- Grade III is severe. The pain will be very harsh and you'll see visible signs of the injury, such as bruising or swelling.
How to treat a pulled muscle
You can use a variety of at-home treatments for your muscle strain. Soppe recommends the RICE treatment method:
Overall, RICE may be most effective at reducing symptoms, rather than healing on a cellular level — according to Soppe, that will only happen naturally, with time. "RICE helps decrease symptoms while the body is healing so we can carry on with our lives during the healing phase," he says.
Over-the-counter painkillers can also be effective at managing pain and reducing inflammation. "Tylenol and anti-inflammatories such as ibuprofen can be very helpful in terms of alleviating pain and allowing us to be more mobile while we're in the early stage of healing," Soppe says.
But don't overdo it: Non-steroidal anti-inflammatories (or NSAIDs) like Advil can cause gastrointestinal side effects if taken on an ongoing basis, while excessive Tylenol can lead to potential liver dysfunction.
RICE and over-the-counter pain medication "are by far and away the most valuable of initial treatments for these strains," says Soppe. If your muscle strain is more severe or these treatment methods don't work, you may also want to consider physical therapy, wearing braces or splints, or surgery.
When to see a doctor for your muscle strain
A pulled muscle — even a mild or moderate one — can take a while to heal. For some muscles it might take a couple of weeks, and for others, it can last months.
Muscle strains in the legs, such as the quadriceps, hamstring, or calves, may be particularly persistent. But typically, they should start to feel better over a few weeks, says Soppe.
"The majority of strains heal just by the body's own innate capabilities," he says. "The ones that linger tend to be more severe — like a tendon-type injury," Soppe says.
More severe (usually grade III) muscle strains may require surgical treatment. "If it involves the tendons or tendon attachments, it'll need surgery," Soppe says. The tendon is the tissue that connects muscle to bone — if it's torn, surgery can help with reattachment.
If you feel or hear a severe pop sensation when the strain occurs, that's a sign that you should see a doctor, says Soppe. Reach out to a doctor if you have significant pain or do not see progress in improvement after a few weeks, he says.