How Do I Prevent—And Treat—A Muscle Strain?
During the pandemic, more people have been exercising on their own rather than with intramural teams or at the gym. That means if you run into trouble, you’re also on your own. If you have a muscle strain or sprain, you may want to know what to do—and when you really need to seek professional help. Melissa Leber, MD, Director of Emergency Department Sports Medicine at The Mount Sinai Hospital, answers some of your questions.
How do you strain a muscle?
A muscle strain happens when you pull, tear, or stretch a muscle. Strains sometimes happen from overuse, but often they’re caused by an injury. Muscle strains and sprains can trigger pain, swelling, and even bruising. You can strain or sprain almost any muscle in the body, but the ones we see most often affect the calf muscle (called the gastrocnemius), the ankle, or the lower back. We also see a lot of strained rotator cuffs, quads, and hamstrings.
How should I treat a muscle strain?
If you think you have strained or sprained a muscle, you should immediately stop what you are doing. Then, plan to rest the injured area and apply ice. Ice should not be applied directly to the skin, but rather wrapped in a towel. It should be held in place for about 20 minutes and then taken off. This can be repeated for the first 24 hours after an injury. After an injury you can also take an anti-inflammatory medication such as ibuprofen or naproxen, if you are allowed. If you can’t bear weight or if you can’t use your affected muscle at all, you should seek emergency care by at the nearest emergency room or urgent care facility. Otherwise, give it a day or two to see if the muscle gets better.
I have not worked out in six months. How can I prevent straining a muscle when restarting my fitness regimen?
Muscle strains and sprains are common—but they aren’t inevitable. To prevent straining your muscles, vary the frequency and variety of your workout. You don’t want to do the same thing over and over again because that can ask too much of the muscle. While you might not feel any pain in the moment, you could still be damaging the muscle. Then, later on, you could start to feel pain seemingly out of nowhere.
You’ll also want to vary the intensity of your workout. You can’t go hard day after day after day. Give your body at least one day off a week. One way to vary the intensity of your exercise is to practice interval training. This means performing a series of high intensity workouts interspersed with rest periods.
When should I see a doctor about my injury?
If you are still in pain after treating at home for two to three days, you should make an appointment with a physician who might take an x-ray or perform a musculoskeletal ultrasound to gauge the severity of your injury.
Also, in addition to strains and sprains, a torn muscle can develop a hematoma. This happens when blood collects at the site of the torn muscle causing pain, swelling, and discoloration of the area. While many hematomas can be treated at home with RICE (rest, ice, compression, elevation), more severe injuries will need a medical intervention. If you suspect that you have a hematoma and have severe pain and/or your injury expands over one to two days, seek medical attention.
In a little less than one month, I’ll be running my 10th marathon. This race – 26.2 miles from Hopkinton, Mass. to Copley Square in Boston, otherwise known as the Boston Marathon – took me tens of thousands of miles to qualify for. A lot of blood, sweat and tears went into those miles, and with them, some nutritional missteps. It’s true, sometimes even dietitians screw up when it comes to nutrition (we also eat cake, FYI). 
