Muscle Strain Treatment: What to Do and How Long It Takes

01What

What is a muscle strain?

A strain occurs when muscle fibres are stretched too far or torn, usually from sudden overload, overstretching or fatigue. It differs from a sprain, which is an injury to a ligament. Strains are graded from 1 to 3 according to the amount of fibre damage, and commonly affect the hamstrings, calf, quadriceps, groin, back and shoulder. See the specific guides for hamstring, calf, hip flexor and lower back.

02Symptoms

Symptoms

• Sudden pain during activity, sometimes with a “pop” or tearing sensation.
• Tenderness over the muscle and pain on stretching or contracting it.
• Swelling and bruising, which may appear after a day or two.
• Weakness, stiffness and difficulty using the muscle.
• Muscle spasm.
• Pain that eases with rest.

03Grades

Grades of strain

• Grade 1: a few fibres damaged; mild pain, minimal loss of strength; heals in 1–3 weeks.
• Grade 2: partial tear; moderate pain, swelling, some loss of function; heals in 4–6 weeks.
• Grade 3: complete tear or rupture; severe pain, large bruise, a gap or bulge and major loss of function; may need surgery and takes months.

04PEACE

The first days: PEACE

• P – Protect: unload the injured area for 1–3 days, avoiding painful movements, but do not immobilise for long.
• E – Elevate: raise the limb above the heart when possible to reduce swelling.
• A – Avoid anti-inflammatories: they may interfere with tissue healing; use paracetamol for pain if needed.
• C – Compress: an elastic bandage or sleeve can reduce swelling and provide support.
• E – Educate: understand that rest is brief and active recovery speeds healing.
• The older “ice” advice offers short-term pain relief but does not speed recovery, and it is optional.

05LOVE

After the first days: LOVE

• L – Load: start gentle movement and weight-bearing as pain permits.
• O – Optimism: a positive outlook and confidence improve recovery.
• V – Vascularisation: pain-free cardiovascular exercise (cycling, walking, swimming) boosts blood flow.
• E – Exercise: restore mobility, strength and balance with progressive exercises, ideally guided by a physical therapist.

06Pain

Pain relief

Paracetamol (acetaminophen) is a safe first choice. Anti-inflammatory tablets such as ibuprofen are commonly used, but there is concern that they might slow muscle repair, so many clinicians suggest avoiding them in the first days unless needed, and using the lowest dose for the shortest time. Topical anti-inflammatory gels can be an option. Do not combine multiple products containing the same active ingredient, and check with a pharmacist if you have stomach, kidney or heart conditions or take blood thinners.

07Rehab

Exercises and returning to activity

• Start with gentle range-of-motion and isometric holds within comfortable limits.
• Progress to isotonic strengthening with light resistance, then heavier loads and eccentric work.
• Add functional and sport-specific movements once strength is nearly symmetrical.
• Return to full activity when you are pain-free, strong and have full movement.
• Warm up properly and build up gradually to prevent re-injury.
• A physical therapist can tailor a programme and monitor progress. See also stretches (Spanish).

08Avoid

What to avoid

• Returning to sport too early.
• Aggressive stretching or massage of a fresh tear.
• Heat, alcohol and vigorous activity in the first 48–72 hours.
• Prolonged complete rest or immobilisation.
• Ignoring pain that does not improve.

10Cases

Three common situations

A tight, sore calf after a run: likely a mild strain; protect for a day or two, then gentle loading.

A sudden pop in the thigh with a large bruise: likely a moderate or severe tear; seek assessment.

Recurrent strains in the same muscle: review training load, strength, warm-up and technique with a professional.

11Older adults

Strains in older adults and in teenagers

Muscles and tendons become less elastic with age, and tendon ruptures (such as the Achilles or quadriceps tendon) are more likely after 40, often with a sudden pop and loss of function; these need prompt assessment. In growing teenagers, the weak point is the growth plate where tendons attach to bone, so a sudden severe pain after sprinting or kicking can be an avulsion fracture rather than a simple strain. Children and teenagers with significant pain after a sports injury should be assessed by a doctor.

12Summary

Key points to remember

Protect a strained muscle for a few days, then load it progressively. Use paracetamol for pain, avoid early anti-inflammatories and heat, and return gradually. Seek help for severe symptoms. Our physical therapy team can design a safe recovery plan.

This guide is for general information and does not replace an assessment by your own doctor or physical therapist.