Nonpharmacological management for muscle strain

Initial nonpharmacological management techniques for acute muscle strains are detailed in Features of nonpharmacological management techniques for acute soft-tissue limb conditions.

Grade 1 muscle strains usually resolve spontaneously and do not require rehabilitation.

For people with grade 2 muscle strains, exercise is important for rehabilitation of the injured muscle to prevent recurrence of injury. The optimal time to start exercise is unclear. Depending on the person’s functional impairment and expectation for recovery, referral to an appropriate physical therapist (eg physiotherapist) may be indicated. A supervised rehabilitation program is particularly important for people who participate in significant physical activity or who have specific functional goals.

To reduce the risk of injury recurrence, advise people who participate in significant physical activity to:

• return gradually to activity
• slowly increase the duration and intensity of their activities over the course of the healing process (usually 5 to 8 weeks)
• avoid returning to full preinjury activity until they achieve near-full preinjury flexibility and 85 to 90% of preinjury power in the affected muscle.

Rehabilitation programs for people with grade 3 injuries are detailed and complex and are not discussed further.