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2torial #0612:
Learn2 Treat a Pulled Muscle
Oh my aching latissimus dorsie...
Whether you're a weekend warrior or you exercise
every day, you've probably felt the effects of
overly intense physical exertion. Most pulled
muscles (also known as muscle strains) are the
result of overexertion: by a person without the
proper foundation of fitness, or a more seasoned
athlete that ignored some early warning signs of
incoming injury.
Strained muscles are commonly recognized by
restricted range of motion, stiffness and pain,
which intensifies during the first 24 hours and
then declines. For most folks, they occur in the
hamstrings (back of thigh) and calves (back of
lower leg), abdominal muscles, lumbar region (lower
back), and trapezius (neck and upper back).
Fortunately, with rest and simple home remedies,
you can nurse a strained muscle back to health.
What have I done, you ask, to develop a strained
muscle? Muscles are made of long fibers of tissue.
These fibers can be overstretched, with either a
sudden jerky movement or through extended overuse,
and you experience that overstretching as pain and
reduced movement. There are three progressively
severe grades of muscle strains, ranging from the
common strain that heals in a week or less, to a
complete tearing of the muscle fiber, sometimes
separating it from the muscle tendon. This 2torial
shows how to treat the first grade of strain and
how to avoid muscle strains in the future.
Note: After 24 hours, if the pain and stiffness
is such that you can't move easily, or if there are
any bulges or asymmetries visible in the muscle,
then make an appointment with your healthcare
professional.
- Learn the RICE guidelines. RICE is
short for rest, ice, compression, elevation.
These are the home remedies that are very
effective for Grade 1 sprains. If carefully
followed, this simple formula will speed up and
improve the healing process considerably. Note,
however, that RICE isn't in chronological order.
You should elevate the injured muscle as you ice
it; and you shouldn't compress it until you've
applied ice and elevated the injured muscle.
(More details to follow.) Rest, however, is
certainly the first step on the road to complete
recovery.
- Rest: If possible, immediately
discontinue use of the strained muscle, don't
finish out the game you're playing or the
workout you're doing. And limit the area's use
as much as possible in the next 24-48 hours. And
here's something to consider, if you find
yourself going back to your workout the day
after the strain. Some folks suffer a
psychological condition known as injury
depression, which results from a fear that their
injury will prevent them from returning to the
sport or activity that they love. In this case,
the ancient Chinese wisdom of "doing nothing to
accomplish something" is particularly relevant.
Lay off the activity that you were doing when
you strained the muscle, try to be patient, and
stay active with other, less intensive forms of
exercise. A forced or hastened recovery often
resurfaces a month later as a more serious and
debilitating injury. If you take time for the
healing process to complete itself, you'll enjoy
fewer injuries in the future.
- Ice: Ice application is crucial to
the healing process. The moist cold from the ice
penetrates deeply into muscle, slowing down the
flow of blood to the area. This reduces the
swelling which can lead to pain and restricted
movement. As a bonus, the nerve endings in the
area are numbed by the cold and will send fewer
pain signals to the brain, which means less pain
for you.
- Choose a pack, any pack: Here you
have some options, depending how well prepared
you are. If you train regularly (say, five days
a week), consider investing in a reusable,
combination cold and hot pack that you place in
the freezer and then apply it to the muscle.
Otherwise, you can improvise with whatever is at
hand: a tray of ice cubes wrapped in a towel, a
frozen bag of peas (reusable), or a paper cup
filled with water and frozen. Regardless of the
type of cold pack, be sure to cover it with a
towel or cotton cloth of some kind. Exposed ice
applied directly to your skin can produce a
burn--a superficial kind of frostbite. (The
exception is the paper cup filled with water and
frozen. That you can apply directly to the skin,
as long as you continuously circulate the chunk
of ice around the area of the strained muscle.
Tear off horizontal strips of the paper cup as
the ice melts down.)
- Frequency: Ice down the muscle in
increments of 20 minutes--20 minutes of ice on
the muscle, 20 minutes with no ice, and repeat.
Continue with this "Ice On, Ice Off " schedule
for up to two hours per session, with at least
two sessions per day. Follow this schedule for
the first 24-72 hours, depending on the severity
of the strain. More severe strains will require
additional days of ice treatment beyond 72
hours. If you're doing any alternative exercise,
be sure to ice down the muscle very soon after
finishing. For additional reduction of swelling,
elevate the injured area as you ice it (see
below).
How are you feeling? Here's the list of
sensations you'll feel when you apply ice to an
area: cold, stinging, burning, and the last stage,
numbness. Remove the ice pack once the area feels
numb, even if 20 minutes hasn't passed. If you're
alone for the ice application and you're lying
down, set a timer that will wake you up in case you
fall asleep. While most folks think that a big lump
of ice would prevent any snoozing, numbness does
set in. Recently, college athletes have fallen
asleep with an ice pack on them and have woken up
an hour and a half later with a frozen nerve: an
injury that requires six months of intensive
physical rehabilitation.
- Heat: Some physical therapists recommend heat as
well as ice, after 48 hours have passed. Evening is a good
time for heat application, having completed the ice applications
for the day. A moist heat is necessary: a hot compress purchased
for this purpose (heated in a pot of boiling water) works
best. Apply the heat for a single session of 20 minutes.
(Lacking a compress, soak the area in a tub of hot water
for ten minutes.) Heat will bring extra blood circulation
to the area and will decrease the possibility of muscle
spasm. Note: some trainers swear by heat, others strongly
recommend against it. Try it and see what effect it has
on the injured muscle.
- Compression: When possible, compressing the injured
area with an ace wrap (or other reusable elastic bandage)
helps into two ways: one, it reduces swelling through the
pressure of the bandage; and two, it supports the muscle
and limits its movement somewhat, thereby reducing the possibility
of additional strain. Compression is best applied after
a session of ice application and elevation and before you
do any activity--so don't strap on an ace wrap as you go
to sleep for the night.
- Wrapping the bandage is an art in itself--you want
a supportive compression, but you don't want to cut off
too much circulation, either. To avoid turning an ace wrap
into a tourniquet, start the wrap at the edge of the injured
area that's furthest from the body, and wrap towards the
body. If you've strained your calf muscle, then start the
wrap at the ankle and wrap towards the knee. If you've strained
your thigh, then start the wrap above the knee and wrap
towards the hip.
- Keep the wrap on for up to two hours;
if your schedule allows it, ice and elevate the
injured area immediately after unwrapping it.
Note: keep an eye on the wrapped limb; if its
color turns white or blue, then unwrap it
immediately, and wrap it less tightly next
time.
- Elevation: Elevation reduces pain and
swelling by helping to drain fluids from the
injured muscle, and is usually accompanied by an
ice application. Here's how to proceed: Get
comfortable. If the muscle is in your arm or
leg, use some pillows to prop up that limb
higher than the heart--that means you may want
to lie down so that you aren't propping your leg
up on five feet of pillows. If the muscle is in
your neck or back, just lie on your stomach or
in a position where you can be comfortable. Get
a book or magazine, put on an ice pack, and move
as little as possible.
Medications:
- Homeopathic remedies: Athletes are
turning more and more to homeopathic remedies to
speed up and improve the healing process. While
you should read up on homeopathic diagnoses or
visit a homeopath (a doctor practicing
homeopathy) before trying any oral remedies,
topical remedies like Arnica have proven to be
very effective on muscle and joint strains.
- Helpful western medications:
Ibuprofen and naproxen are effective
anti-inflammatory agents: they will reduce
swelling in the area (and pain as well). Aspirin
and acetaminophen also can be helpful for
reducing pain and swelling. All of these drugs
can upset your stomach, so give a trial to
discover which drug you tolerate best. In all
cases, consider looking for generic brands of
these drugs; if the potency is the same as a
name brand, you'll get the same effect for a lot
less money.
Avoid Strained
Muscles
Now that you're laid up with a strained muscle,
you have a little extra time on your hands--use it
to learn to train safely and reduce injuries.
- Stretch before you workout--and not
just the main muscle group you'll be working.
Runners, for example, will often only stretch
their hamstrings and calves, not realizing that
stiff abdominal and back muscles can overstress
other parts of the body. There are now many
books on stretching, and many yoga classes
offered in many areas. Just remember to proceed
gradually; overly enthusiastic stretching can
result in muscle strain that reduces your
flexibility and makes you more prone to injury.
In general, do ten minutes of stretching before
the activity and ten minutes afterwards. The key
to a good stretch is slow, deep, and regular
breathing--not by forcing the body into a
particular position. And never bounce on a
muscle as you stretch, in an effort to go
further. Instead, go deep into the stretch until
you can almost feel some discomfort; then
slightly back off the stretch until you feel
comfortable.. Hold the stretch for at least 20
seconds, preferably 30 seconds, breathing deeply
in and out.
- Train gradually, whatever the
activity. Some folks get overly enthusiastic
as they experience the higher levels of energy
and vitality that come with increasing levels of
fitness. If you drastically increase the amount
of training, you're probably on the road to
emotional and physical burnout. So start slow
and increase your workouts gradually; instead of
focusing on the amount you train on any given
day, focus on how many consecutive weeks you've
been training. That's a truer indication of a
commitment to physical fitness. And if you've
been sick for a week or unable to train for
whatever reason, consider reducing your workout
for a week as you come back to it.
- Cross-train: Whatever your main
training activity is, alternate it with other
activities: swimming (or water aerobics and
deep-water running in a pool), cycling, or
jogging. Changing the activity works a different
set of muscles, giving a rest to the ones you
use regularly. If you train every day, consider
taking two or three days per week to cross-train
with other activities. And if you do strain a
muscle, light cross-training activities allow
you to stay active and keep the circulation
moving through the injured area.
- Equipment: Runners should keep track
of their weekly mileage, and once they run more
than 300 miles on a pair of shoes, it's time to
retire them. And when you buy a new pair, be
certain that the width accommodates you
foot--remember that your feet will swell up as
you run.
- Get a trainer: Consider working with
a trainer for your main activity once a week for
a month or two. Poor form in any activity can
translate into inefficient movements that lead
to injury. Trainers may seem expensive or an
indulgence, but they're cheaper than doctors and
surgery. You'll also get greater enjoyment from
the training activity, since you're doing more
and spending less energy doing it.
- Rest: once every 20 to 30 days, if
you feel like it, take a scheduled exercise day
off; at the least, if you're feeling low in
energy, reduce the length and intensity of the
activity. The next day you can go out and have a
more thorough workout.
-end-
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