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Treatment for Pulled Muscles and Common Sports Injuries

What happens after the first 48 to 72 hours?

by Brad Walker | First Published September 17, 2001 | Updated August 2, 2018

Part 2
In last months issue we talked about the initial treatment for sports injuries, like running injuries and other common pulled muscle complaints. Soft tissue injuries to be specific. If you missed last months issue, or would like to refresh your memory, you can read part 1 of this article here.

Last month, we discussed how critical the first 48 to 72 hours are to a full, and complete recovery. If you followed the advice from part 1, the R.I.C.E.R. regimen will have kept any bleeding and swelling to a minimum, and the injury will have already started the repair process.

If you suffer from sports injuries or are seeking to prevent their occurrence it is important to follow the information in this article. In addition, adding a few simple stretches to your fitness program will also help. To get started on a safe and effective stretching routine that’s just right for you, check out the Ultimate Guide to Stretching & Flexibility.

After the first 48 to 72 hours

What happens after the first 48 to 72 hours? Lets take a quick look at how your soft tissue (muscle, tendon, ligament, etc.) repairs itself.

When any sort of damage occurs to the soft tissues, like a strain or sprain, the body immediately goes into a process of repair. Where the individual fibers have been ruptures, or torn, the body begins to bind the damaged fibers together using a fibrous protein called collagen. Or, as it’s more commonly known, scar tissue!

You see, when a muscle is torn, you would expect that the body would repair that tear with new muscle. In reality, this doesn’t happen. The tear, or rupture, is repaired with scar tissue.

Now this might not sound like a big deal, but if you have ever suffered a soft tissue injury, you’ll know how annoying it is to keep re-injuring that same old injury, over and over again. Untreated scar tissue is the major cause to re-injury, usually months after you thought that injury had fully healed.

Scar tissue is made from a very tough, inflexible fibrous material. This fibrous material binds itself to the damaged soft tissue fibers in an effort to draw the damaged fibers back together. What results is a bulky mass of fibrous scar tissue completely surrounding the injury site. In some cases it’s even possible to see and feel this bulky mass under the skin.

What is scar tissue?

When scar tissue forms around an injury site, it is never as strong as the tissue it replaces. It also has a tendency to contract and deform the surrounding tissues, so not only is the strength of the tissue diminished, but flexibility of the tissue is also compromised.

So what does this mean for the athlete? Firstly, it means a shortening of the soft tissues which results in a loss of flexibility. Secondly, it means a weak spot has formed within the soft tissues, which could easily result in further damage.

Lastly, the formation of scar tissue will result in a loss of strength and power. For a muscle to attain full power it must be fully stretched before contraction. Both the shortening effect and weakening of the tissues means that a full stretch and optimum contraction is not possible.

Now, if you’ve taken the advice from part 1, and used the R.I.C.E.R. regimen to treat the initial reaction to a soft tissue injury, you’re well on your way to a complete recovery. If however, you didn’t use the R.I.C.E.R. regimen, you’re behind the eight-ball, so to speak. Let me explain.

From last months issue we learnt that when an injury occurs the body responds by sending large amounts of blood to the injury site. If this isn’t controlled, with the R.I.C.E.R. regimen, it will result in massive bleeding, swelling and pain. More importantly, it will also result in a large formation of bulky, painful scar tissue.

As we know from last month, the R.I.C.E.R. regimen will help to control the bleeding, swelling and pain, but more importantly, it will also control the formation of scar tissue. When the R.I.C.E.R. regimen is used correctly, there will only be a minimal formation of scar tissue, which allows for optimal return of flexibility and strength.

How to get rid of scar tissue

So, how do we put the finishing touches on your recovery? How do we get rid of that annoying formation of scar tissue?

Firstly, you must keep active! Don’t listen to anyone who tells you to do nothing. Now is the time to start active rehabilitation. Most of the swelling will have subsided after the first 48 to 72 hours and you are now ready to start light activity.

Light activity promotes blood circulation and also activates the lymphatic system. The lymphatic system is vital in clearing the body of toxins and waste products, which can accumulate in the body following a sports injury. Activity is the only way to activate the lymphatic system.

Before we move on, a quick word of warning. Never, Never, Never do any activity that hurts the injured area. Of course you may feel some discomfort, but NEVER, NEVER push yourself to the point where you’re feeling pain. Listen to your body. Don’t over do it at this stage of the recovery, you’ve come too far to blow it now.

To complete your recovery and remove most of the unwanted scar tissue, you now need to start two vital treatments. The first is commonly used by physical therapists (or physiotherapists), and it primarily involves increasing the blood supply to the injured area. The aim is to increase the amount of oxygen and nutrients to the damaged tissues.

Physical Therapists accomplish this aim by using a number of treatments to stimulate the injured area. The most common methods used are ultrasound, TENS and heat.

Ultrasound uses high frequency sound waves to stimulate the affected area, while TENS (or Transcutaneous Electrical Nerve Stimulation) uses a light electrical pulse to stimulate the injured area. And heat, in the form of a ray lamp or hot water bottle, is also very effective in stimulating blood flow to the damaged tissues.

Secondly, to remove the unwanted scar tissue it is vital that you start a course of deep tissue sports massage. While ultrasound and heat will help the injured area, they will not remove the scar tissue. Only massage will be able to do that.

Either find someone who can massage the effected area for you, or if the injury is accessible, massage the damaged tissues yourself. Self massage has the advantage of knowing just how hard and deep you need to massage.

To start with, the area will be quite tender. Start with a light stroke and gradually increase the pressure until you’re able to use deep, firm strokes. The more you massage the effected area the harder and deeper you will be able to push.

Use deep, firm strokes, moving in the direction of the muscle fibers. Concentrate your effort at the direct point of injury, and use your thumbs to get in as deep as possible to break down the scar tissue.

How to work around an injury

I broke my toe a little while back; the long one next to my big toe on my right foot. I was pulling my boat up onto the trailer at a local boat ramp, and my foot slipped forward and my toe caught on something. It didn’t hurt much when I did it, but by the time I’d washed the boat down and put it away, my toe had turned a yellow-ee purple color and it was starting to throb.

I stuck some ice on it and sat on the couch with it propped up on a few pillows. There’s not much else you can do for a broken toe: I’ve broken my toes a few times in the past and the only advice I’ve ever got from a doctor is… strap it to the toe next to it.

I wasn’t too worried. I tend to heal quite quickly, and let’s face it; it’s only a toe. It wasn’t going to stop me from doing much… But it did stop me from doing one of my favorite pastimes; running.

So what do you do when an injury stops you doing the sport you love? Answer: You work around it.

As an “Ex” professional athlete, I’ve had my fair share of injuries, and you learn pretty quickly that you can’t do the same activity day in, day out. You need variety! You need to let your body rest from some activities and give it different activities to keep your conditioning up and work on areas that would normally be ignored.

So, what have I done to keep active and stay in shape while my toe heals? Quite a few things actually…

I like to swim, so I’ve added some deep water running to my usual swim training. I’ve also been meaning to do more core stability exercises, so I’m doing more of those. And I’ve added a few new upper body strength training workouts. And of course, I’ve added some extra flexibility training to work on a few tight spots that I’ve noticed recently.

A few final points

Just a few final points before we finish up. Be sure to drink plenty of fluid during your injury rehabilitation. The extra fluid will help to flush a lot of the waste products from your body.

Also, I recommend you purchase a special ointment to use for your massage called Rub-on-Relief. This special ointment is extremely effective in treating soft tissue injuries, like sprains, strains and tears. It includes all-natural ingredients, has zero side effects and best of all, it’s quite cheap. You can purchase this ointment from the link above.

Now, if you’ve come this far, you’ve done well. If you’ve applied the information in this article and part 1 you should be well on your way to a complete recovery. However, there is one final stage of treatment before you’re back to 100%.

In next months issue we’ll take a look at the last stage of your rehabilitation. This phase of your rehabilitation will look at regaining the fitness components that may have been lost during your recovery.

Brad Walker - AKA The Stretch CoachAbout the Author: Brad is often referred to as the "Stretch Coach" and has even been called the Stretching Guru. Magazines such as Runners World, Bicycling, Triathlete, Swimming & Fitness, and Triathlon Sports have all featured his work. Amazon has listed his books on five Best-Seller lists. Google cites over 100,000 references to him and his work on the internet. And satisfied customers from 122 countries have sent 100's of testimonials. If you want to know about stretching, flexibility or sports injury management, Brad Walker is the go-to-guy.