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“I think I’ve pulled a muscle.”

This is a common thing to say when you feel a sudden pain or tenderness. But how do you tell if you’ve pulled a muscle? And even more importantly, what can you do for a pulled muscle?

First, a quick vocabulary lesson. “Pulled muscle” is a lay term. The medical term is “muscle strain.”

However, don’t confuse strain with sprain. Sprains involve ligaments, while strains involve muscles and/or tendons.

For mild strains and sprains, the treatment is much the same. Sprains are just often more common in places like your ankles, your wrists, and your neck. So, it’s not critical that you know which you have for basic home care.

What Is a Pulled Muscle?

A pulled muscle, or muscle strain, happens when you stretch a muscle or tendon too much, too suddenly, or too forcefully. Severe strains can partially or completely tear a muscle or tendon.

Common ways people pull muscles include:

• Falling or tripping.
• Having a direct blow during contact sports.
• Making a quick movement that requires jumping or twisting.
• Overstretching, especially on cold muscles.
• Overuse of a muscle or muscle group (like calf strains in runners).

You can pull any muscle. But you’re most likely to pull muscles in your lower back, neck, hips, or legs.

What Does a Pulled Muscle Feel Like?

Sometimes, you know right away that you’ve had an injury. You do something and feel pain immediately or soon afterward. For example, you step into a lunge and feel a pop in your hamstring.

These are acute injuries. With acute injuries, there’s usually a cause and effect. “I did this, and then I felt this.”

You can also pull muscles because of overuse. This happens when you’re repeatedly straining the muscle. Many times, the injury happens because of an imbalance.

For example, if your quadriceps are stronger than your hamstrings, you’re more likely to pull your hamstring. Muscle tightness can also lead to eventual muscle strain. This is especially true in your hips.

Muscle strain/pulled muscle symptoms include:

• Muscle weakness.
• Popping or snapping sensation.
• Sudden and severe pain.
• Swelling and bruising around the area.

Keep in mind that with an overuse strain, there isn’t always one incident you can point to that caused it. It can feel like lingering pain that gets worse with activity. Or you might wake up with pain and not know for sure what caused it.

What Do You Do for a Pulled Muscle?

Most people with pulled muscles will heal on their own, at home. But for some muscle or tendon pulls, you might need to see someone.

Possible options for this include urgent care, emergency care, or a same-day ortho clinic or office visit. (UPMC offers these walk-in ortho clinics in several locations.)

You should seek medical attention for a pulled muscle if:

• Your pain is severe (edging toward a seven or eight out of 10).
• Your pain isn’t getting better.
• You heard a popping sound when the injury happened.
• You have severe weakness, as if your leg or hip will “give out.”
• You have persistent numbness or tingling (which can signal other injuries).
• You have signs of infection, like a fever or warmth and redness around the injury.

How can I treat a pulled muscle at home?

Most of the time, you can treat pulled muscles that aren’t severe with basic home care.

Here’s what this looks like:

• Elevation — For leg injuries, prop up your injured leg so you’re raising it above your heart.
• Stay off an affected limb — If you pulled a muscle in your leg (quadriceps, hamstrings, calves), you might need to stay off the limb. Crutches can help.
• Take a break — If you can trace your pulled muscle to an activity, like running or tennis, take a break from that activity.
• Take over-the-counter (OTC) pain relievers — If it’s safe for you, taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) can help. Acetaminophen (Tylenol) can also ease pain.
• Use ice — Apply ice for 20 minutes at a time throughout the day to help reduce swelling. Make sure you don’t apply heat right after an injury. This can make swelling worse.
• Wrap the injury — Gently wrap the pulled muscle in a compression bandage or an elastic wrap. (This works best with leg injuries.)

When Will My Pulled Muscle Heal?

With mild muscle pulls, people usually feel better in one to two weeks. Moderate strains can take longer, usually three to four weeks.

Severe strains, which usually include muscle or tendon tears, can take several months to heal. For these injuries, you might need surgery and physical therapy to rehab.

As you’re healing your pulled muscle, here are some tips:

• Don’t rely too much on pain medicine — Pain medicine, like over-the-counter (OTC) NSAIDs, can help bring down inflammation and reduce pain. But they can also mask problems. It’s why you don’t want to take them long-term.
• Don’t stretch the muscle immediately after injury — This is often your first inclination. But stretching can make the injury worse.
• If you like, apply heat, but only after three days — Some injuries, like pulled muscles in your back, can respond better to heat. But you should ice first after the initial injury. Heat can help promote healing, but it’s best only after some swelling has gone down.
• Keep moving as you’re able — Most of the time, lying in bed all day is not what your body needs. Movement can serve the same purpose as medicine as long as you’re careful not to re-aggravate the injury. For example:
  • For a strained hip, try gentle stretches.
  • For a strained leg muscle, try swimming.
  • For a strained neck or lower back, try walking.
• Ease back into activity — When your pulled muscle starts to feel better, you can resume some of your activities. But don’t push too much, too fast. You risk reinjuring your muscle.
• Physical therapy can really help — You can self-refer for physical therapy at UPMC. Sometimes, a few visits can help identify muscle weaknesses or imbalances. Your physical therapist (PT) can create a program for you to continue at home.

Ultimately, if you are not significantly better in a week or getting worse, seek out the opinion of your PCP or local UPMC orthopedic urgent care center.