It’s happened to most of us: your workout is going really well, and then all of a sudden, you feel a sharp pain in your muscle, almost like a cramp, and realize you’ve pulled a muscle.
Or, perhaps everything seemed copacetic during your workout, but in the hours afterward, it begins to become evident that you have a muscle strain. Now what?
How do you heal a pulled muscle? Do you have to rest? Is the good old RICE (rest, ice, compression, and elevation) protocol the best way to heal a pulled muscle? Are there more effective ways to reduce pain from a pulled muscle and get back to your workouts faster?
In this article, we discuss how to heal a pulled muscle, tips for healing a pulled muscle faster, and ways to decrease pain from a muscle strain.
We will cover:
- What Is a Pulled Muscle?
- Symptoms and Grading of Muscle Strains
- How to Heal a Pulled Muscle
Let’s jump in!
What Is a Pulled Muscle?
A pulled muscle is the common term that refers to a muscle strain.
A muscle strain, or muscle pull, occurs when the muscle fibers are stretched beyond their limits, pulling apart the contractile units and proteins that normally have some degree of overlap in the healthy muscle tissue.
This leads to microscopic tears in the structural proteins and components in the muscle fibers; essentially, your muscle tissue is damaged and injured.
The pain associated with a pulled muscle or muscle strain is due to these microscopic tears and structural damage.
There can also be associated swelling and bruising from an influx of blood and lymph to help heal the muscle strain.
The pain and inflammation of the pulled muscle may also limit mobility, depending on the severity and location of the injury.
Muscle strains can theoretically occur in most of the major muscles of the body.
However, because it’s most common to pull a muscle during exercise, sports, or some type of daily life physical activity like lifting groceries, getting out of bed, or climbing stairs, the most common sites of muscle strains include the hamstrings, groin, calves, lower back muscles, abdominal muscles, quad muscles, and cervical (neck) muscles.
Symptoms and Grading of Muscle Strains
Symptoms of a pulled muscle generally include pain or discomfort, limited mobility or pain with stretching, spasms, swelling, and potentially even bruising, depending on the severity of the injury and the location.
According to the Hospital for Special Surgery, a muscle strain, or pulled muscle, is graded based on its severity:
- Grade I Muscle Strain: This is a mild muscle strain that will result in some discomfort but typically does not limit activity or cause a significant issue with functional movement.
- Grade II Muscle Strain: This is a moderate injury that can cause a fair amount of discomfort, and there might even be some noticeable bruising and swelling, depending on the location of the muscle strain. Additionally, you might have limitations in your mobility and range of motion, and performing high-intensity activities may be extremely uncomfortable (and not advisable).
- Grade III Muscle Strain: This is a severe muscle strain associated with significant pain, swelling, spasms, and bruising. You may be unable to effectively use the injured muscle.
How to Heal a Pulled Muscle
Unfortunately, there’s no magic bullet or secret recipe for how to heal a pulled muscle faster. In most cases, muscle strains heal on their own with time, but there are certain things you can do to help ease the symptoms and potentially support faster recovery.
The guiding principle for treating pulled muscles is to employ the RICE protocol: Rest, Ice, Compression, and Elevation. However, the extent to which you should rely on each of these constituent components, as well as additional healing modalities, will depend on your specific injury.
Rest
The first component of the RICE treatment is rest. Although no athlete wants to hear this dreaded four-letter word, rest is typically required for muscle strain injuries.
Rest is recommended in the acute or early recovery phase. The length of time you need to rest from a pulled muscle will depend on the severity of the injury, but typically something in the neighborhood of 1 to 5 days is recommended.
With Grade I strains, you might not need to take complete rest but rather just modify your exercise or workout routine.
For example, if you are a runner who has pulled your calf muscle, but the injury seems quite mild, you can try a short, very easy jog, or if possible, it would be best to try a low-impact cross-training activity such as indoor cycling for a day or two until you feel like the muscle fibers have healed up.
During the rest phase of a muscle strain injury, it is typically advisable to avoid immobilizing the injured site with a cast or brace. This can lead to excessive stiffness.
However, if you have a severe injury or cannot perform the functions of daily life without significant pain, speaking with the physical therapist about bracing or protecting the injured area, as well as receiving specific and targeted physical therapy modalities, is probably your best bet for a successful course of action.
Ice
Applying ice, also known as cryotherapy, can be useful in treating a pulled muscle, especially in the initial acute phase (first 24-48 hours), because it can reduce pain, swelling, and internal bleeding. Make sure that when you are using ice, you always use an interface between your skin and the ice pack to prevent frostbite.
You should apply ice for no more than 12 to 15 minutes at a time; however, you can ice a pulled muscle quite frequently throughout the day, even hourly, if you want to and find that it helps.
Compression
Immobilizing a cold muscle with a brace or cast is typically not recommended, but if you have significant swelling, you can periodically provide some targeted compression in short intervals to help encourage the removal of excess fluid from the area.
Compression doesn’t necessarily have to involve a traditional ACE wrap. Rather, it’s recommended instead to try some gentle massage. This can involve gently rubbing or squeezing the injured area or applying light pressure with a foam roller on the tissue.
In the very acute phases after the injury, you might want to avoid massaging or manually working the tissue with your hands or a foam roller, depending on how tender the area is.
However, once you feel like you can apply a little bit of careful pressure, you can begin working the area in very short intervals to help encourage circulation and prevent excessive stiffness in the muscle and overlying fascia.
If the area is not getting moved enough, the facia can tighten or seize up, further contributing to pain and potentially compressing the underlying muscle fibers into painful trigger points.
Elevation
Elevating the injured area will help reduce swelling if present. However, it’s also very important that a pulled muscle is receiving plenty of oxygenated blood, so you do not want to elevate your injury all that much, especially not for a prolonged time.
Short, 10-minute intervals might be helpful for those with muscle strains in lower leg muscles, such as the calves and shin muscles since these muscles are often in the “dependent“ position in that they are at a lower vertical height than your heart, so they are naturally prone to more swelling.
Anti-Inflammatory Medications
Depending on the severity of your injury and your overall health status, anti-inflammatory medications such as ibuprofen can help reduce swelling and temporarily alleviate pain.
However, these medicines should be avoided with pulled muscles unless otherwise specifically recommended by your doctor or physical therapist.
Not only can they cause gastrointestinal and renal symptoms, but the natural inflammatory process that occurs after sustaining a muscle injury is necessary for the recovery process.
Although treatment modalities such as ice do decrease swelling, the effect is more transient and typically not as significant as you would experience with an anti-inflammatory drug.
The other risk of these medications is that they can mask pain to the point that you feel like you are able to use the injured muscle more than it should be worked in the early stages of a muscle strain, potentially overworking the remaining healthy muscle fibers and exacerbating the strain on the injured structures.
Rehabilitation Exercises
Once the muscle is healed, gentle stretching can be initiated to help restore flexibility and range of motion in the tissue. However, stretching should typically be avoided in the acute phases and early healing phase because it can exacerbate the injury.
Strengthening the injured muscle and surrounding muscles is also an important component of rehabilitation and recovery.
Although there are a few different treatments that can be combined to help treat a pulled muscle, ultimately, patience is the key to healing a pulled muscle.
If you don’t have a pulled muscle per se but do have sore muscles after exercise or running, check out our article: How To Relieve Sore Muscles After Exercise Fast: Try These 21 Sure-Fire Techniques.