It is so important to keep in tune with how our bodies are feeling and be aware aware of any small niggles, and certainly seek to treat any that are becoming more troublesome to avoid them developing into an injury.
So, I thought it useful to share some information on what actually happens when you have a muscular injury, what to look out for and to understand if the muscle pain you feel is a strain or actually a tear, and also is there a difference?
Approximately 85% of muscle tissue is made up of muscle fibres and these fibres are organised in bundles, called fascicles, which are enclosed in fascia and together this is the endomysium. The fascicles are bundled together by their fascia and this is called the perimysium, which also carries the blood supply and nerves into the muscle fibres. The perimysium is enclosed by another rougher fascia, the epimysium. All 3 are joined together and wrapped in more fascia and all this creates a single muscle.
To explain let’s firstly look at what makes up a muscle?
Muscle fibres are mostly made up of collagen which provides the muscle with its elasticity and transmit the force of the muscle.
The protective covering of fascia also binds the tendons to the muscle and where these two merge is called the musculotendinous junction. There are tendons at either ends of muscles connecting the muscles to the bones.
So muscles are made up of groups of muscle fibres and fascicles and our bodies are organised this way so we can control our efforts. For simple easy tasks we only require a few muscle fibres to contract, whereas for harder, maximum efforts we obviously need every muscle fibres to be working to their best ability. This is muscle recruitment and is achieved by the nerves that supply the muscle, innervated by message from the brain and our reflexes.
A tear or strain (same meaning) can occur for a few reasons:
- also muscles contract in two ways – they either shorten and so contract concentrically or a decelerating contraction is where the muscle slowly lengthens generally to slow-down and counteract a contractile force/or gravity and the later is more frequently when a strain may occur.
This happens when muscle fibres are overloaded and fibres start to rupture under the force.
The percentage of muscle fibres involved and the severity of the tear determine the classification of the strain and to follow are the 3 grades used by Medical professionals to diagnose an injury:
Grade 1 – is a mild strain, only a small numbers of fibres (< 5%) are stretched or torn. While the injury may be painful, strength and mobility are unaffected and recovery is quicker. Grade I is “micro-tear” territory. The fibres have been pushed to the point of starting to tear but not completely. Full recovery is usually 2-3 weeks and athletes are able to resume activity when they are pain free.
Grade 2 - moderate strain, more fibres involved and torn, it is a much larger injury and the symptoms include pain, swelling and bruising/discolouration. Strength and mobility are significantly reduced and function is also impacted. Grade II’s are more severe and take longer, averaging 2-3 months to fully heal the damage.
Grade 3 - complete rupture, a muscle or its tendon are completely torn in two. This is a severe injury and includes considerable swelling, bruising, and pain, a complete loss of muscle function with significant losses in strength and mobility. You may also see defects in the muscle (gaps, dents, changes to the muscle shape itself) as the swelling subsides. A grade 3 will require medical intervention and often surgery.
The healing time for soft tissues varies depending on the type and severity of the injury, as well as individual factors such as age, overall health, and the presence of any underlying medical conditions. But most of all the type of tissue that is affected will be a huge factor:
Muscle strains - going back to “what makes up a muscle”, it’s structure, blood, nerve supply, elasticity and contractile properties influence how a muscle repairs. Muscle tissue heals quicker than tendons and ligaments and this due to muscles’ broader blood and nerve supply. Damaged muscle fibres cells divide and then fuse with existing muscle fibres, to regenerate and repair the damaged fibres.
Tendon strain - tendons connect muscle to bone, they are stronger than muscles, and their fibrous collagen tissues are viscoelastic (not contractile like muscle) which means they allow the tendon to withstand tension. Tendons are slightly elastic and viscous and recoil to it’s normal length after stretch.
Tendons’ blood and nerve supply is sparse compared to muscles ( and is particularly bad where tendons wrap underneath or around bone e.g. at the ankle, elbow). The mostly collagen tissues are not able to regenerate. This means the healing process takes longer, after approximately 10 weeks the maturation stage of healing is reached. A strained area will never regain its original strength and viscoelasticity.
Ligament strain - ligaments connect bone to bone and are formed of densely arranged collagen fibres bundled in fascicles like tendons. They are viscoelastic like tendons, so have some elasticity and recoil, but not much so they tear before they stretch and again their blood supply is sparse and worse than tendons. It is generally understood that ligaments take longer to heal than tendons. However, a ligament does not need to recoil so it’s healing process is simpler and often ligaments heal close to it’s original structure but its viscoelasticity will never be the same. The site of injury will always contain scar tissue. This is why injured areas are prone to re-injury.
So I will finish where I started.....Sports Massage & Myofascial Release treatments are ideal to allow us to feel, importantly take the time to feel too, how our bodies are and be aware of any niggles, pain or restrictions in movement. This allows us to take control, understand how to help ourselves and the relevant self-care and rehab.
I hope you found this useful, any questions please let me know!
The protective covering of fascia also binds the tendons to the muscle and where these two merge is called the musculotendinous junction. There are tendons at either ends of muscles connecting the muscles to the bones.
So muscles are made up of groups of muscle fibres and fascicles and our bodies are organised this way so we can control our efforts. For simple easy tasks we only require a few muscle fibres to contract, whereas for harder, maximum efforts we obviously need every muscle fibres to be working to their best ability. This is muscle recruitment and is achieved by the nerves that supply the muscle, innervated by message from the brain and our reflexes.
If a muscle cannot respond adequately to meet the demands of a task i.e. a run, tennis stroke, digging in the garden, it can become overloaded and tear under strain.
- the muscle contraction required to perform the movement may be more than the muscle can generate.
- there was not enough time to fully recruit the muscle fibres e.g. turning quickly, or slipping
- restrictions in the muscle itself prevent the full contraction, this could be from lack of mobility of a joint, lack of strength, lack of recovery from previous activities
- also muscles contract in two ways – they either shorten and so contract concentrically or a decelerating contraction is where the muscle slowly lengthens generally to slow-down and counteract a contractile force/or gravity and the later is more frequently when a strain may occur.
Typically muscle injuries occur in one of three places:
- At the junction between the muscle and tendon (aka the musculotendinous junction). This is the most common area of the three.
- Within the muscle belly itself (think meaty section of the muscle)
- Where the tendon attaches to the bone
What does a muscle strain feel like?
This happens when muscle fibres are overloaded and fibres start to rupture under the force.
The percentage of muscle fibres involved and the severity of the tear determine the classification of the strain and to follow are the 3 grades used by Medical professionals to diagnose an injury:
Grade 1 – is a mild strain, only a small numbers of fibres (< 5%) are stretched or torn. While the injury may be painful, strength and mobility are unaffected and recovery is quicker. Grade I is “micro-tear” territory. The fibres have been pushed to the point of starting to tear but not completely. Full recovery is usually 2-3 weeks and athletes are able to resume activity when they are pain free.
Grade 2 - moderate strain, more fibres involved and torn, it is a much larger injury and the symptoms include pain, swelling and bruising/discolouration. Strength and mobility are significantly reduced and function is also impacted. Grade II’s are more severe and take longer, averaging 2-3 months to fully heal the damage.
Grade 3 - complete rupture, a muscle or its tendon are completely torn in two. This is a severe injury and includes considerable swelling, bruising, and pain, a complete loss of muscle function with significant losses in strength and mobility. You may also see defects in the muscle (gaps, dents, changes to the muscle shape itself) as the swelling subsides. A grade 3 will require medical intervention and often surgery.
Healing - this is always the big question?
Muscle strains - going back to “what makes up a muscle”, it’s structure, blood, nerve supply, elasticity and contractile properties influence how a muscle repairs. Muscle tissue heals quicker than tendons and ligaments and this due to muscles’ broader blood and nerve supply. Damaged muscle fibres cells divide and then fuse with existing muscle fibres, to regenerate and repair the damaged fibres.
Tendon strain - tendons connect muscle to bone, they are stronger than muscles, and their fibrous collagen tissues are viscoelastic (not contractile like muscle) which means they allow the tendon to withstand tension. Tendons are slightly elastic and viscous and recoil to it’s normal length after stretch.
Tendons’ blood and nerve supply is sparse compared to muscles ( and is particularly bad where tendons wrap underneath or around bone e.g. at the ankle, elbow). The mostly collagen tissues are not able to regenerate. This means the healing process takes longer, after approximately 10 weeks the maturation stage of healing is reached. A strained area will never regain its original strength and viscoelasticity.
Ligament strain - ligaments connect bone to bone and are formed of densely arranged collagen fibres bundled in fascicles like tendons. They are viscoelastic like tendons, so have some elasticity and recoil, but not much so they tear before they stretch and again their blood supply is sparse and worse than tendons. It is generally understood that ligaments take longer to heal than tendons. However, a ligament does not need to recoil so it’s healing process is simpler and often ligaments heal close to it’s original structure but its viscoelasticity will never be the same. The site of injury will always contain scar tissue. This is why injured areas are prone to re-injury.
So I will finish where I started.....Sports Massage & Myofascial Release treatments are ideal to allow us to feel, importantly take the time to feel too, how our bodies are and be aware of any niggles, pain or restrictions in movement. This allows us to take control, understand how to help ourselves and the relevant self-care and rehab.
I hope you found this useful, any questions please let me know!
Nicky Holbrook
Nicky'Sports Massage