This article is a transcribed edited summary of a video Bob and Brad recorded in July of 2020.
For the original video go to: https://www.youtube.com/watch?v=kmj0YIOJsgY&t=500s
Bob: Today we’re going to go over 10 signs you have tore a muscle and then we’re going to show you how to treat it at home. We actually might mention the treatment method earlier on.
Brad: Yeah, we’ll mix it up a little.
Bob: So, when we’re talking about torn muscle, we’re talking about a non-contact injury to your muscle. It’s not like a motor vehicle accident where you get whipped around, physical trauma.
Brad: Like football where you got hit. We’re talking about where you’re taking off running from first base to second base on a weekend game and it gets you limping.
Bob: So, it’s also called a strain or a pulled muscle. I’m going to show you this picture I drew here.
Brad: This is a good picture. You really should start an art class.
Bob: So, here we go. This is representing a muscle. I want to show this where it transitions and becomes a tendon and then the tendon attaches to the bone.
Brad: I could tell this was a bone.
Bob: Very good! Looks like a bone that you have in a cartoon, right? So, tears usually occur right where the muscle starts transitioning to becoming a tendon. That’s where the tears occur. Now, these can be micro-tears. You can pull some of the fibers. You can also tear a good percentage of it. They actually do grade the muscle tears.
Brad: Actually, a lighter grade or a not so serious of a pull can be quite painful initially. So, the pain level doesn’t always correlate with the severity of the pull.
Bob: Right, exactly. You can also tear the muscle, mid muscle. Very common like in the calf muscle and even in the quad. I’ll go over the grades right now, Brad. So, if 10% of the fibers or less are involved, it’s a grade one, or stage one. If it’s 10-90% of the fibers are involved, it’s a two. And if over 90% of the fibers are involved, torn or avulsed, where its actually pulled away, then it’s a grade three.
Brad: That’s kind of broad actually.
Bob: It’s very broad.
Brad: And that’s really only, you don’t need to know that you’re not going to judge as a laid person. That can be difficult to judge as a PT or doctor even.
Bob: I think that’s why they make it so broad, Brad, so that it’s like, oh, you only got a few fibers torn, you’re a grade one. Oh, you know, it seems pretty severe but not enough for surgery, probably a grade two. You know it’s pretty bad, grade three, you may need to have surgery. I’m sure in most cases you do. So, for treatment, I want to go over that real quick,
Brad. You know, there’s PRICE, which is an acronym. You’re going to have protection. You want to protect it, like if it’s a lower extremity, you’re probably going to want to use crutches or some type of a gait aid to take the stress off the muscle.
Brad: If it really hurts to walk or put weight on it, you have to use some crutches or walk less or modify something. You don’t want to irritate it.
Bob: Which goes right along with the next one, PR rest. You’re not going to want to go out and try to do your usual activity as far as athletic goes. Ice, especially the first couple days to help take the swelling down because swelling’s fine, unless it gets a little too crazy, then it makes healing harder.
Brad: Cold pack for 20 minutes, three or four times a day can go a long way.
Bob: Compression often helps with the swelling too. You might wrap it with an ACE wrapper.
Brad: ACE wrapper, compression garment.
Bob: Then the elevation. Which again, also helps.
Brad: Elevated so the swelling can flow down, heal, get back and recirculate.
Bob: Now, I’ve torn three muscles in my lifetime, Brad.
Brad: You count? You keep track?
Bob: I kept track of it. One, I tore my pec muscle, pectoralis muscle, working with a patient, I was trying to stretch them, believe it or not.
Brad: Really!
Bob: Another one I tore was my tricep.
Brad: What happened to the patient?
Bob: They were fine, but I wasn’t fine. Another one was my tricep, I do dips and I hurt it on that. The last one was, you remember this one, I did this a couple years ago. Last year, my calf.
Brad: Oh, yeah.
Bob: In each case, this was the scenario. It would get better, I think I’m out of the woods, and then I would do something, like with a patient, I’d stretch that patient again, tear it right up again. And with dips, I’ll do dips, and my tricep would tear again. So, what finally helped with all of those is the number one treatment that worked with this, is doing some type of massage, especially like cross fiber. You’re breaking up the scar tissue, you’re helping it heal, and it heals stronger than.
Brad: Right, and the work from this is Cyriax.
Bob: Yes, Dr. Cyriax.
Brad: He’s a surgeon, I think he’s passed.
Bob: Oh, a long time ago. He passed 30 years ago at least.
Brad: So, this is a long time. This is nothing new.
Bob: No, no. He was considered the father of orthopedic medicine and he came up with a lot of different techniques, but this was one of the cross-fiber friction massage. Again, this happened in my calf, that’s a bigger, thicker muscle. Using your own hands or fingers to try to massage it is very fatiguing. So, we are going to, just as a coincidence here, we’re going to recommend something.
Brad: Well, actually Cyriax does recommend doing a cross friction massage for up to 20 minutes, which I can’t hardly do five minutes with my fingers before they start to fatigue, but sometimes that’s helpful for sure. But if you can go longer, great. And that’s where this mechanical massage device or gun, they’re becoming very popular for a good reason because they work well.
Bob: It’s interesting, when these first came out, Brad and I would not endorse them because they were $400.
Brad: Yes, they worked well, but they were expensive.
Bob: They were really expensive. Well, hey, believe it or not, Bob and Brad have come out with their own massage gun. Can you believe it, somebody thinks enough of us that they put our name on a massage gun? Who would have ever thought?
Brad: I’m starting to blush.
Bob: Yes, this thing works fantastic. We’ve worked with this company before and they do the best. I love this air-filled massage tip, works really well.
Brad: Well, here’s the case you get with it. It’s got a bunch of different things, rechargeable to USB, and we’ve got different attachments.
Bob: So, enough on that Brad. Let’s get into the video now here. We’ve been spending enough time on that, but this does work really good and this is what made the difference for my healing, especially my calf. Boy, that was a bugger. So, the first thing, 10 signs. #1 If you have sudden intense pain while you’re stretching or while you’re at an athletic event. So that’s what you’re talking about, running to first base, lifting or sprinting, it’s kind of that what they call that, “oh, crap” moment. You know what happened.
Brad: Yeah, it’s like oh darn it, I’m hurt.
Bob: It’s generally, one muscle. If it’s like your whole leg, there might be more cramping or something like that. It’s not a series of muscles, it’s going to be one muscle. #2 You’re going to have local swelling. So, it’s going to look puffy and raised, it’s going to feel hot and flushed. You’ll see it, you’ll visually see that it’s swollen. #3 It’ll be tender in one spot, when you touch, using palpation.
Brad: Yeah, palpation: when you kind of push into the muscle.
Bob: Well, Brad kind of mentioned before: #4 you can actually have like a burning sensation when you tear a muscle.
Brad: Yeah, I definitely felt it with my hamstring this year. Actually, I was just jogging, and I was pretty fatigued, I had worked out too much.
Bob: I thought you tried to push it a little bit on the treadmill.
Brad: That was the other time, I injured my hamstring three times in the last year, so this is my concern.
Bob: This is a prime example. It doesn’t heal strong. So, you need to use the massager then.
Brad: I know, Bob, I know. I’m working on it, I’m experimenting.
Bob: #5 Pain with movement, obviously. It’s because you use the muscle, it’s going to hurt. #6 The sense that the muscle’s tight or stiff. The muscle’s trying to protect you or protect itself, so a lot of times, it kind of spasms a little bit even.
Brad: Your body’s saying, hey, slow down here.
Bob: It makes sense if you tore some fibers, you may have also tore some blood vessels. So, # 7 you’re going to see some bruising and discoloration.
Brad: Right, they call it ecchymosis. A lot of times, you won’t see it the day it happened. But, within a few days, all of a sudden you’ll see this purplish, black and blue come out. That’s just old blood that your body is going to recycle that.
Bob: What’s weird is that it descends a lot of times. A lot of times, it’ll be originally in your hamstring and all of sudden, you’ll find it down near your calf.
Brad: Gravity’s taken it.
Bob: #8 Muscle weakness. So, it’s going to depend on how bad it is, but if it’s really bad, you might actually have no muscle strength at all. That’s one of the tests.
Brad: Right! Well, it hurts.
Bob: Well, it hurts but if you tore your quad really bad, you wouldn’t even be able to straighten your knee at all. And calf, you just do the squeeze test, you remember that one?
Brad: The Holmen’s sign?
Bob: No, well, it’s like Holmen’s, but you squeeze it. #9 You’re going to have a limited range of motion. I can’t read what I wrote….
Brad: Why Bob!?!
Bob: Oh, #10 I was going to mention the common muscles that this happens in. So, hamstrings. Gastrocnemius or the calf muscle, very common. Groin. When people say the groin, it’s the hip abductor quite often, the muscles on the inside. The hip flexor, that rectus femoris. Right in front of the thigh and also, a lot of times, you can tear the lumbar paraspinals, the muscles in the lumbar area. Last time I thought I had that brief period where I just had a jolt of pain in my back. It must’ve been a tear because it got better so fast that it couldn’t have been a disk problem or anything.
Brad: Yeah, muscle versus disk. Yeah and that’s another story.
Bob: It’s very common to pull a muscle on the back.
Brad: We could do a video on that.
Bob: Yeah, we could. Then a lot of times, biceps. A lot of times they disconnect the tendon from the bone, so you’ll have to watch that, it’s going to gather down. Pecs too, very common.
Brad: Can’t forget the pecs.
Bob: So, there’s a lot of muscles you can pull and tear. So now, you’re going to know what to do when it happens. Remember, Brad and I can fix just about anything…
Brad: Except for…
Bob: A broken heart.
Brad: I definitely have to get going on my hamstrings. But you know, the massager feels good on there.
Bob: What kind of example are you setting?
Brad: What are you talking about?
Bob: You keep pulling your muscle and we’re telling people how to fix their muscle and you pulled it three times now.
Brad: Well, I’m becoming an expert at it. Practice makes perfect.
Bob: Brad the expert.
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