A strain is when a muscle is stretched too much and tears. It is also called a pulled muscle. A strain is a painful injury. It can be caused by an accident, overusing a muscle, or using a muscle in the wrong way.

Pulled muscle

A strain may be caused by:

• Too much physical activity or effort
• Improperly warming up before a physical activity
• Poor flexibility

Symptoms of a strain can include:

• Pain and difficulty moving the injured muscle
• Discolored and bruised skin
• Swelling

• Apply ice right away to reduce swelling. Wrap the ice in cloth. Do not place ice directly on the skin. Apply ice for 10 to 15 minutes every 1 hour for the first day and every 3 to 4 hours after that.
• Use ice for the first 3 days. Either heat or ice may be helpful after that if you still have pain.
• Rest the pulled muscle for at least a day. If possible, keep the pulled muscle raised about your heart.
• Try not to use a strained muscle while it is still painful. When the pain starts to go away, you can slowly increase activity.

Call your local emergency number, such as 911, if:

• You are unable to move the muscle.
• The injury is bleeding.

Call your health care provider if the pain does not go away after several weeks.

The following tips may help you reduce your risk of a strain:

• Warm-up properly before exercise and sports.
• Keep your muscles strong and flexible.

Biundo JJ. Bursitis, tendinitis, and other periarticular disorders and sports medicine. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 271.

Brinker MR, O’Connor DP, Almekinders LC, et al. Physiology of Injury to Musculoskeletal Structures: 1. Muscle and Tendon Injury. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 1, section A.