Muscle strains are among the most frequently encountered injuries in athletic and general populations. These injuries occur when muscle fibers are overstretched or torn and vary in severity and recovery outcomes depending on their location, depth, and the individual patient’s condition.
For medical professionals managing musculoskeletal complaints, understanding the types of muscle strains, recovery protocols, and the potential of regenerative therapies is critical for optimizing care.
Muscle strains are generally classified into three grades:
● Grade I (Mild): Minor stretching or microscopic tearing of muscle fibers. Pain and swelling are mild, and function is largely preserved.
● Grade II (Moderate): Partial tearing of the muscle. Pain, swelling, and reduced function are more pronounced.
● Grade III (Severe): A complete rupture of the muscle, often accompanied by significant loss of function and noticeable muscle deformity.
Some of the most clinically relevant types include:
This affects the muscles between the ribs and is often caused by sudden twisting, lifting, or prolonged overuse. Patients may report sharp pain exacerbated by breathing, coughing, or upper-body movement. Diagnosis involves clinical evaluation and sometimes imaging to rule out rib fractures or pleuritic conditions.
This common back injury occurs due to poor lifting mechanics, acute overload, or repetitive strain. It presents with localized pain, muscle stiffness, and restricted motion in the lower back. Physical examination typically reveals tenderness in the affected musculature without neurological deficits.
In sports settings, these strains occur during activities involving acceleration, deceleration, or sudden directional changes. They range from tightness to complete muscle rupture and often require extended rehabilitation.
Recovery typically follows a structured progression from acute management to rehabilitation:
1. Acute Phase (First 48-72 hours):
○ Rest and immobilization to prevent further injury
○ Cold therapy to reduce inflammation
○ Compression and elevation if swelling is present
○ NSAIDs may be prescribed cautiously to control pain and swelling
2. Rehabilitation Phase:
○ Gentle stretching and range-of-motion exercises
○ Gradual introduction of strengthening protocols
○ Neuromuscular training to restore functional capacity and prevent re-injury
3. Return-to-Activity Phase:
○ Sport-specific or job-related drills
○ Monitoring for residual weakness or compensation
○ Continued physical therapy if deficits remain
In recent years, regenerative medicine has shown potential in enhancing recovery from muscle injuries, particularly in moderate to severe strains that are slow to heal.
Mesenchymal stem cells (MSCs), often derived from bone marrow or adipose tissue, have demonstrated capabilities in modulating inflammation and promoting tissue regeneration. Preclinical studies suggest that MSCs may reduce fibrosis and accelerate muscle fiber repair in traumatic muscle injuries (Gilley et al, 2023).
PRP therapy involves autologous platelet concentration that releases growth factors aiding cellular repair when injected into injured tissue. Its utility in muscle strains has been explored and has yielded promising outcomes in reducing recovery time and enhancing tissue strength (Boivin et al., 2021).
Emerging therapies using extracellular vesicles are under investigation for their anti-inflammatory properties and ability to enhance cellular communication and tissue healing. While not yet standard, they are drawing attention as potential adjuncts in managing soft tissue injuries.
Clinicians should consider regenerative approaches for patients who:
Treatment planning should always be evidence-informed, and patient expectations must be aligned with the current clinical evidence. Combining regenerative therapies with traditional rehabilitation may optimize functional recovery.
Conclusion
Muscle strains represent a spectrum of injuries with varied recovery trajectories. While conventional treatments remain foundational, regenerative options are becoming viable adjuncts in enhancing tissue healing, minimizing downtime, and improving outcomes.
Integrating these therapies into practice requires healthcare providers to understand the indications, mechanisms, and ongoing legislative developments that impact access and regulation. Visit the Florida Stem Cell Bill to learn more about current legislation shaping the availability of regenerative care in Florida.
References
Boivin, J., Tolsma, R., Awad, P., Patel, P., & Li, Y. (2021). The biological use of platelet-rich plasma in skeletal muscle injury and repair. The American Journal of Sports Medicine, 51(5), 1347–1355. https://doi.org/10.1177/03635465211061606
Gilley, R. J., Wold, D. J., Miller, A. C., Stojadinovic, A. M., Johnson, S. D., Gross, M. M., Bush, N. A., & Hampton, R. C. (2023). Mitochondria transplant therapy improves regeneration and restoration of injured skeletal muscle. Journal of Cachexia, Sarcopenia and Muscle, 14(1), 193–204. https://doi.org/10.1002/jcsm.13153
