We’ve all done it – kicked a ball too vigorously, reached too far, or pushed ourselves too hard, only to feel sudden pain in a muscle. A muscle strain (or ‘pulled muscle’) can put us out of action for weeks at a time. So what are the best treatments for a quick recovery? We look at the facts.

Muscle strain

A muscle strain occurs when the muscle fibres are pushed beyond their normal limits. Some muscle fibres are torn, and this triggers inflammation and pain.

If only a small number of fibres tear – up to about 5% – this is a grade 1 strain.

Further along the continuum, a greater proportion of muscle fibres tearing constitutes a grade 2 strain.

A more serious injury can lead to significant or even total rupture of the muscle – a grade 3 strain. These are more commonly associated with trauma, such as a road traffic accident.

Why are some muscles prone to strain?

The hamstrings are a frequent site of muscle strain, along with the quads and the gastrocnemius (calf muscle). These muscles cross two joints (the hip and knee or knee and ankle) and deal with greater forces than other muscles.

However, the adductor muscles, which only cross the hip joint, are also frequently injured. Relatively weak, they can still be subject to sudden intense force during activities such as kicking. Injury here is known as a ‘groin strain’.

Muscle strains can, of course, occur in any muscle if it is subjected to sudden overstretch or repetitive overuse.

Symptoms of a muscle strain

A mild strain may feel no more significant than a slightly sore and tight muscle.

Beyond that, you may see some swelling and have a loss of function. The muscle will be weak, and it will hurt to use it.

The greater the injury, the more severe the symptoms.

What else could it be?

There are other injuries that may feel like a muscle strain. For example, a persistent ‘strain’ in the lower leg may in fact be a stress fracture or a deep vein thrombosis.

Alternatively, it’s important to discount conditions such as an inguinal hernia or a hip joint problem when diagnosing a groin strain.

The best course of action, then, is to seek advice from a health professional. This is especially true if you have significant pain, pain that isn’t related to muscle activity, pain that doesn’t start to ease after a week or so, or pain that you have no explanation for.

Muscle strain treatments

Just pulled a muscle? What should you do?

You may have heard of the PRICE treatment protocol. It stands for:

Protect – from further damage, perhaps using a bandage, splint or cane

Rest – to allow recovery, or ‘relative rest’, depending on the level of damage

Ice – to reduce pain and swelling

Compression – to minimise swelling and provide support

Elevation – above heart level, to stop fluid pooling at the injury site

You should initiate these steps within the first 24–48 hours after injury.

However, there’s a new protocol in town! Following the PEACE and LOVE acronym may give a better outcome, as it considers management in the longer term. Some elements repeat those given in the PRICE protocol, while others are new.



Avoid anti-inflammatories – these can inhibit healing if taken for too long


Education – understand your injury and learn the stages of healing


Load – gradually increase activity, based on your level of symptoms

Optimism – feel confident in your recovery and understand that you will heal with time

Vascularisation – encourage blood flow with pain-free cardiovascular exercise

Exercise – stay active as far as possible to maintain flexibility, strength and proprioception

Ice has become less popular as a treatment in recent years, in case it impedes healing. However, research suggests that it doesn’t interfere with tissue healing if it’s applied correctly. And since it’s a cheap and effective painkiller, it’s still worth considering – apply a cold pack for around ten minutes at a time, with 20 minutes in between.

The OCHK approach to muscle strain treatment

We look at an injury holistically, so that we can not only reduce symptoms but also prevent recurrence. We can integrate treatments to ensure you get the best outcome.

Here are some of the ways we can help:


The magic touch of a massage therapist can ease stiffness and encourage healing in an injured muscle.

Applied in the right way by an experienced hand, massage does more than just feel good. It also boosts repair of muscle fibres, improving recovery times and enhancing strength.

In fact, a study at Harvard University on the effects of mechanotherapy on mice suggests that applying a kneading pressure to muscle tissue clears away immune cells that interfere with the healing process. It therefore reduces tissue scarring and can double the rate of muscle regeneration.


Osteopathy can treat the acute stages of strain to help ease pain and swelling and maintain flexibility.

Strained muscle lays down scar tissue as part of the healing process. This tissue is less elastic than surrounding muscle, and it can cause adhesions across muscle layers. This makes the muscle more vulnerable to strain in the future.

Osteopathic treatment helps to align scar tissue fibres, reduce adhesion formation and aid the muscle to adapt and stay healthy. Sometimes, strain becomes a chronic pattern. Usually, a muscle is repetitively overused, causing minor tears and scarring that build up. As a result, the muscle loses strength and extensibility, allowing a vicious cycle of strain to develop.

Osteopathy can interrupt this cycle. By evaluating movement patterns and identifying areas that are weak or restricted, an osteopath can normalise loading across the body. We build a management plan around the way you function.

For example, many people have a sense of chronic tightness in their hamstring muscles. They often resort to repeated stretching to ease this. And while it feels good in the short term, stretching provides no long-term relief.

Often, this is because the hamstrings are really in a state of chronic strain. They are not able to adapt to the load repeatedly placed on them. In fact, the hamstrings, and sometimes surrounding muscles, need to be strengthened.

Our osteopaths can identify and treat these patterns of dysfunction, meaning less pain and better performance.

Corrective Exercise Therapy for muscle strain

Good rehabilitation is key to optimising recovery. This is where our Corrective Exercise Therapist, Jacqui, steps in.

She can undertake a comprehensive biomechanical assessment and formulate a tailored rehabilitation plan. Where appropriate, this can be done in conjunction with our osteopaths.

Resistance training is beneficial for improving pain levels, strength and function following a muscle strain injury. Jacqui will work with you to fine-tune your exercise, making sure you recover both fully and safely.

Jacqui understands the principles of progressive loading to make sure you’re fit and ready to get back to your sport or activity.

Are you struggling with muscle strains?

We know how to help. We have the expertise and experience to return you to health quickly and help you stay there.

Book with us today!

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