MUSCLE OR TENDON STRAIN

Muscles and their tendon attachments combine to form what are known as musculo-tendinous units. These musculo-tendinous units provide the force which is necessary for movement.
 

• GRADE 1 STRAIN: There is damage to individual muscle fibers (less than 5% of fibers). This is a mild strain which requires 2 to 3 weeks rest.

• GRADE 2 STRAIN: There is more extensive damage, with more muscle fibers involved, but the muscle is not completely ruptured. The rest period required is usually between 3 and 6 weeks.

• GRADE 3 STRAIN: This is a complete rupture of a muscle. In a sports person this will usually require surgery to repair the muscle. The rehabilitation time is around 3 months.

All muscle strains should be rested and allowed to heal. If the patient continues to play, the condition will worsen. If ignored, a grade one strain has the potential to become a grade two strain or even a complete rupture.
 

• STAGE 1 - REGENERATION OF MUSCLE FIBERS: New muscle fibers grow from special cells within the muscle.

• STAGE 2 - FORMATION OF SCAR TISSUE: There is bleeding in the gap between the torn muscle ends, and from this blood a matrix, or scaffold, is formed to anchor the two ends together. This matrix eventually forms a scar within the muscle that makes the muscle more resistant to further stretch damage.

• STAGE 3 - MATURATION OF THE SCAR TISSUE: The collagen fibers which make up the scar tissue become aligned along lines of external stress and are able to withstand more force.

• The immediate treatment consists of the 'PRICE' protocol: Protection of the injured part from further damage, Rest, Ice, Compression and Elevation. The aim of this protocol is to reduce bleeding within the muscle tissue. Ice therapy in the form of ice pack applications should be continued for the first three days after the injury (never apply ice directly to the skin).

• The rehabilitation after this period involves gradually stretching the muscle to elongate the scar tissue and progressively increasing the muscle strength.

• Once this has been achieved, the player can begin sport-specific exercises, such as running, jumping and kicking. 

• Warm up prior to games and training is thought to decrease muscle stretch injuries because the muscle is more extensible when the tissue temperature has been increased by one or two degrees. A good warm up should last about twenty minutes - starting gently and finishing at full pace activity. Practicing game activities helps tune co-ordination and mentally prepare.

• Recovery after training sessions and games can be enhanced by performing a cool down, which is thought to help muscles get rid of waste products. This is also the ideal time to do stretching exercises. Repeat stretching routine approx. 2-3 hours following activity.

• Maintaining good muscle strength and flexibility may help prevent muscle strains. Muscle strength allows a player to carry out activities in a controlled manner and decreases the uncoordinated movements which can lead to injury. Tight muscles are associated with strains and stretching is therefore practiced to maintain muscle strength and prevent injury.

• Diet can have an affect on muscle injuries. If the muscles become short of fuel, fatigue can set in during training or games. This fatigue can predispose a player to injury. 

• Adductor muscles - inner thigh

• Hip flexor muscles - front of the hip

• Quadriceps muscles - these powerful muscles of the front thigh are responsible for straightening the knee and are active during running, kicking and jumping.

• Hamstring muscles - these muscles are located at the back of the thigh and are most active during running, particularly sprinting, which is when they are most often injured.