Pulled Muscle (Muscle Strain): Symptoms and Recovery

A pulled muscle (muscle strain) is a tear in part of a muscle, often from a sprint or a sudden effort. It causes sharp pain, like being hit by a stone, and sometimes a bruise. For the first days you protect it, rest it, use ice, a support bandage and raise it. Most mild strains get better within a few weeks. This guide is by Dr. Pedro Yelamo Vera, a GP licensed in Spain (Colegiado No. 484814280).

What is a pulled muscle?

It is an injury where some muscle fibres tear. In Spain people often call it a rotura de fibras, a tirón or a desgarro muscular. Doctors grade it:

• Grade 1 (mild strain): the muscle is overstretched with very few torn fibres. It hurts, but you can move.
• Grade 2 (partial tear): part of the muscle tears. There is strong pain, swelling, sometimes a bruise, and loss of strength.
• Grade 3 (full tear): the muscle tears right through or comes away from the tendon. You may feel a gap. A specialist often needs to see it.

What does a pulled muscle feel like?

• Sudden pain at the moment of effort.
• Pain when you tense or stretch that muscle.
• Swelling and sometimes a bruise that shows the next day.
• Weakness or a limp.

The muscles most often hurt are the calf (sometimes called "tennis leg"), the hamstrings at the back of the thigh, the quadriceps at the front, and the groin muscles.

Is it a knot, a strain or a tear?

• Muscle knot or spasm (contractura): the muscle is tight and sore but not torn. It comes on slowly, after effort or poor posture, and gets better with heat and gentle stretching.
• Mild strain (distensión): overstretched with little tearing. Moderate pain, and you can still walk.
• Tear (rotura de fibras): sudden, sharp pain in one spot, often with a bruise and weakness.

If you are not sure, a doctor can tell by examining the muscle. Sometimes an ultrasound scan is needed.

What should I do in the first few days?

• Protect: avoid the movement that hurts. Crutches can help if you limp a lot.
• Rest: do not put weight on it if it hurts, but do not keep it totally still.
• Ice: for up to about 20 minutes at a time, wrapped in a towel, several times a day. Never put ice straight on the skin.
• Compress: wear a stretchy bandage in the day. It should not be so tight that it hurts or goes numb.
• Raise: keep the leg above the level of your heart, on a pillow.

For pain, paracetamol or an anti-inflammatory gel can help. Follow the leaflet. Ask your pharmacist if you can take an anti-inflammatory tablet such as ibuprofen.

Should I use ice or heat on a pulled muscle?

Ice first, heat later. For the first 2 to 3 days, ice eases pain and swelling. Heat in those days makes the bleeding inside the muscle and the swelling worse. So do alcohol and massage. After that early phase, gentle heat can help the muscle relax before you stretch it. For a muscle knot with no tear, heat usually helps from the start.

How long does a pulled muscle take to heal?

It depends on the grade. Most mild strains are better in about two weeks. A partial tear can take several weeks, and a full tear months. Going back to sport too soon is the most common reason it happens again.

How do I get back to sport?

• When the pain allows, start moving the muscle gently so it does not stiffen.
• Add stretches that do not hurt, then strength exercises.
• Do not run or make hard efforts until you can walk with no limp and no pain.
• A physiotherapist (fisioterapeuta) can guide you back, above all after a grade 2 or 3 tear.

When to see a doctor

• It is not better after a few days of home care, or it is getting worse.
• The pain is severe, or the bruise is large and growing.
• You cannot walk more than a few steps or move the area.
• You have a fever or feel unwell.
• You keep injuring the same muscle.

When to go to A&E or call 112

• You heard a crack and the area looks the wrong shape or bent at an odd angle.
• The area is numb, tingling, cold, or blue or grey.
• You felt a kick at the back of the heel and cannot stand on tiptoe. This may be a torn Achilles tendon.
• Your calf is swollen, red and painful with no clear injury. This may be a blood clot.
• Shortness of breath or chest pain: call 112.

Frequently asked questions about a pulled muscle

Getting a medical assessment

If you have hurt a muscle and want a doctor's advice, you can book a video consultation with Dr. Pedro Yelamo Vera, a physician registered in Spain. You can also read about joint pain, back pain and naproxen. A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.

This guide is general information. It does not replace the package leaflet or the advice of your doctor or pharmacist.