MUSCLE STRAIN:
RECOGNIZING IT, UNDERSTANDING IT AND TREATING IT
The warm weather and running season is fast approaching and many of you will be getting ready to run outside. Unfortunately, most athletes end up with a muscle strain sooner or later.
I propose to explore the physiology behind this common early season injury, demystify the underlying inflammatory process and give you some tools to prevent and manage a muscle strain.
First, it's important to understand what a muscle strain is. "Muscle strain is a traumatic elongation (with tearing) of a muscle, resulting in the breakdown of one or more myocytes (muscle contractile unit), fascia and sometimes the tendon." The word muscle strain is therefore a nickname for a partial muscle tear that is the result of an extreme contraction. Micro-tears are ubiquitous when you strain your muscles even the slightest bit, but as long as they don't exceed your body's ability to heal, you'll only feel tolerable soreness.
It is when the tears exceed this threshold that we speak of a muscle strain, only then will you be bothered by them.
The muscles most often affected by strains are the large muscles of the lower limbs: the quadriceps, hamstrings and gastrocnemius.
There are four scenarios that can cause a muscle strain:
Spontaneously, following a muscle contraction stronger than the muscle can withstand.
Following a sub-maximal contraction, but from a muscle that is not sufficiently warmed up (the muscle's capacity to contract is diminished in this case).
Following a sub-maximal contraction, but from a previously fatigued muscle (the muscle's capacity to contract is also reduced in this case).
Following an important shock on a muscle in maximum contraction.
As you can see, the first three cases are related, because they are the result of the same phenomenon, but which occurs in a muscle depending on its state (tired, not warmed up), which influences its contraction capacity.
If you recognize yourself in one of these four cases, here is an exhaustive list of symptoms of a muscle strain that can help you recognize one (note that the intensity of these symptoms varies according to the severity of the tear):
A sudden, violent, flash of pain;
Sometimes a tearing sound is perceived;
Rapid formation of edema (inflammation);
Immediate functional impotence: muscle contraction is painful;
Pain on palpation;
Pain on walking;
Appearance of a hollow or a groove at the level of the injured muscle belly;
Appearance of one or more hematomas in the following hours;
Pain that lasts several weeks.
Now that you understand how a muscle strain occurs and how to recognize it, let's turn our attention to the healing mechanism: inflammation. The human body is made up of several fluids that travel in networks of circulation and that allow them to be mobilized to the necessary places. In these fluids (blood and lymph) are several immune agents, such as white blood cells, which have the function of destroying foreign particles, repairing damaged tissues and restoring balance in the body.
So when a muscle strain occurs, excess fluid is called to the site of the injury. It can then become swollen, red, hot and painful. The problem is that often the inflammation gets out of control and the agents that are supposed to remove metabolic waste or provide nutrients for repair get stuck in the engorgement. This is exactly like a traffic jam. So imagine a big accident on the highway: traffic condenses around it and ambulances, police and tow trucks have difficulty getting to the accident site or even out of it.
Traffic must therefore be restored to help the healing process. The problem is often that the muscle strain limits the movement of the muscle and, knowing that muscle pumping is an important factor in the circulation of fluid in the lower limbs, it is understandable that the inflammatory process takes all the more time to do its work. This is why it is often recommended to put ice on the muscle: cold has a vasoconstrictive action (reducing the diameter of the blood vessels) which helps to recirculate the accumulated fluids. Elevating the limb also helps, as gravity will help the fluids leave the area.