Muscles are highly vascularized and innervated contractile structures, whose function is to contract and elongate to produce movement and thus be able to fulfill the different vital functions. On this occasion we will show you in detail a very common muscle injury that generates a lot of pain and disability: the rupture of muscle fibers or muscle tears.
What is muscle tear or rupture of muscle fibers?
Muscle fiber tears, also known as muscle tears, is an injury to the muscle where the fibers that make up the muscle are torn. The muscle tear causes a very intense pain that forces the person who suffers from it to suspend the activity that they perform, and go to see their doctor since contracting the muscle puts the injured area in tension. When a fiber or fibrillar rupture occurs, it is always preceded by a specific and localizable acute pain. People who suffer from them sometimes describe these pains as if they had received a “stone”, especially when they are caused in the back of the leg or “calf”, specifically in the gastrocnemius muscle or gastrocnemius, hence the rupture of the twin fibers is called “stone syndrome”.
Muscle tears actually is?
What athlete hasn’t had a muscle tear at least once? This injury is very common in athletes. The most common location is in the lower limbs, in muscles such as: calves, hamstrings and quadriceps; although it can also occur in the upper limb at the level of: biceps, pectoral, triceps and latissimus dorsi.
His recovery is usually fast and the muscle heals on its own. For a good return to sports activity, and prevention of future injuries, physiotherapy treatment is required.
Why does muscle tear or fibrillar rupture occur?
Muscle tear or rupture of muscle fibers is an injury that can occur in 3 ways:
- In a direct way, as a result of a contusion or blow. Obviously, a direct blow to a muscle causes the breaking of its fibers, which can be classified as a muscle strain.
- A second direct form, in which the muscle is stretched beyond its natural ability to stretch.
- In an indirect way, as a consequence of a sudden elongation of the muscle generally produced by a rapid and strong contraction of the same. This is the most common way in which muscle strain or rupture of muscle fibers usually occur.
Determining factors in the severity of a muscle tear or rupture of muscle fibers
The severity of fibrillar rupture is determined by these six factors:
- Location of the lesion.
- Size of the muscle tear or rupture of muscle fibers.
- Tear morphology (ie, the shape the tear takes).
- Age of the person with the muscle tear (the older the age, the more serious the injury).
- Coexisting diseases (such as metabolic diseases)
- General health status.
Classification of muscle tear or rupture of fibers of a muscle
There are many types of classification of these fibrillar tears but, in general, they are determined by the number of muscle fibers that are torn in the injury. There may also be very small tears, measured in millimeters (also called fibrillary micro-tears) or larger fiber breaks also known as ” muscle tears ” that can range from several centimeters in length to complete muscle rupture.
How long can it take to heal a muscle tear or fibrillar rupture?
The recovery time of a muscle injury of these characteristics varies considerably depending on several factors: the type and size of the muscle tear, the treatment received and aspects of the person who suffers it (state of health, weight, age, sex, etc. .). And very important the time it takes to go to the doctor.
In general terms, assuming that an adequate rehabilitation process is carried out and that the periods given may be different depending on the characteristics of each individual, muscle tears have these approximate healing times:
- Grade 1 or mild: eight to ten days
- Grade 2 or moderate: three to four weeks
- Grade 3 or severe: one to three months
In this article, I will take a typical case as a reference, such as a grade 2 or moderate fiber rupture in the lower extremity, which, receiving correct treatment, can be resolved in 15 or 20 days.
Differential diagnosis – How do I know if I have a fiber rupture or a muscle tear?
The first thing to do when a muscle fiber rupture or tear is suspected is to carry out a correct differential diagnosis to determine if there really is a muscle tissue rupture, or on the contrary it is a minor problem. such as a muscle strain or contracture. Generally, in cases of small or mild fibrillar ruptures, they can be confused with muscle contractures or strains and, for this reason, adequate rest and treatment are sometimes not carried out, which usually leads to a worsening of the previous fibrillar rupture and the generation of of an even greater muscle strain. For these cases it is essential to make a good diagnosis, which usually includes an ultrasound.
However, simply by means of a simple examination and taking into account the clinic or symptoms and signs of the patient, it can be concluded that we are dealing with a fiber rupture and not a mere muscle contracture. In relation to this, the different tests that are objective and reliable can be applied to determine the injury.
How to differentiate if you have a fiber rupture / tear or a muscle contracture or spasm?
So that you can make a correct differential diagnosis and an adequate exploration, I advise you to watch this video where a physiotherapist will explain what you must take into account to know if it really is a fibrillar rupture:
Before continuing with this article, I must comment that what is advised in it are general and practical recommendations to improve fiber breakage, but in no case can it replace the treatment and advice of a professional, for this reason I advise anyone who has suffered this type of injury, and even more so if they are muscle tears, that he go to a physiotherapist so that, through a correct anamnesis (manual and palpatory ultrasound image tests) he can diagnose the type, location and size of the tear and then treat and advise you in a specific and personalized way. Obviously, each fibrillar rupture is different from another, and therefore the treatment must be adapted to each case.
Partial tears of the muscles: Which are the most common?
The following are the muscle fiber breaks or tears that occur most frequently in the body:
Hamstring tear. This type of tear occurs mainly in sports that require a contraction of the hamstrings to slow down sharply in a race. It happens especially in sports such as athletics or football.
Calf tear. Also called “stone syndrome”, as mentioned above. It is the rupture of the twins, muscles located in the calf, especially when it is required to handle a load greater than it can withstand (in jumps, for example).
Rotator cuff tear. The rotator cuff is a set of muscles that keep the head of the shoulder attached to the glenoid cavity of the scapula. The rotator cuff tendon insertion is very small, and susceptible to rupture due to repetitive stress.
Tear of lumbar paravertebral muscles. They always tell us that when lifting weight from the ground it is necessary to bend down and bend the knees and they are right: when you try to lift a load by flexing the trunk, small muscles that are found along the spine are forced: the paravertebral muscles.
Routine for treating strains, muscle tears and fiber breaks
Sports injuries such as sprains, strains or broken fibers are very common in the practice of sports and few people know the proper treatment they should carry out to heal or improve these injuries faster and better.
Recommendations for the acute phase
1) Application of cold in the first phase of treatment after a muscle tear or fiber rupture
The most recommended when we have a fiber break or muscle tear is the application of ice on the area where the break has occurred. The application of cold in the area generates a vasoconstriction of the capillaries and broken vessels, to reduce inflammation by reducing bleeding in the area and will favor subsequent repair processes. In this way, we will reduce the negative effects of an inflammatory process and excessive bleeding.
We must also bear in mind that in the case of fiber breaks where the fascial tissue that surrounds the muscle has not been broken, the bleeding and inflammation can be encapsulated, increasing the pressure in the area of the break and generating even more pain. and inflammation. For all these reasons, the application of cold in the area in the first moments is a fundamental aspect to reduce recovery times.
2) Draining massage
It is highly recommended, in the early stages, since performing a draining massage ( manual lymphatic drainage and other draining massage techniques ) help to evacuate the excess inflammation that occurs, thus improving the pain characteristic of the first few days. and laying the foundations for a correct subsequent recovery.
3) Red clay: application in muscle tears or fiber breaks
A very advisable remedy for the first days after the generation of a fiber breakage or tear is the application of a red clay plaster on the affected area. In the same way that happens with the draining massage, the application of this plaster aims to improve and drain the excess extravasated fluid that occurs in these cases, accelerating the start-up of the physiological processes of recovery and regeneration of the muscular injury.
How to prepare red clay?
It is bought in powder at the herbalist and mixed with water to make a paste. A small splash of red wine vinegar (approximately 50 ml) is included in the mixture, although for very sensitive skin it is advisable to do without the vinegar in the mixture as it can irritate the skin. It is applied generously on the affected area and, immediately afterwards, it is covered with absorbent paper and a bandage is made to keep it firmly in place. I recommend sleeping all night with it, and in the morning removing it, repeating the process 3 or 4 nights (the application time of the plaster will also depend on the severity of the break).
4) Kinesio taping or neuromuscular bandage for muscle tears or fiber breaks
The application of kinesiotaping or neuromuscular bandage on the fibrillar rupture will help reduce the hematoma that occurs after the muscle tear. In addition, there are other applications for pain, which contributes to functional recovery in a short time and, if the bandage is well applied, the results are visible in about three days.
As a general rule, in fibrillary ruptures or muscle tears, relative rest should always be maintained; The most important thing in the first stages of the same is NOT to request the affected muscles and try, as far as possible, to put the muscles in a relaxed position. This will have two basic functions: to reduce tension and muscle tone and to approximate the ends of the fiber break, thus facilitating its recovery.
6) Gentle passive mobilization for the first phase of treatment after a muscle tear or fiber rupture
Two or three days after a fiber breakage or muscle tear, it is advisable to perform small and controlled passive mobilization exercises (always respect the sensations of pain) within the guidelines of relative rest we can mobilize the joints that are related to the affected muscles , this will cause a stimulating pumping effect of blood circulation.
Initial phase of recovery after fiber rupture or muscle tear (from day 5 to 10)
Recommendations for the recovery phase
1) Application of heat in the second phase of the treatment of muscle tear or fiber rupture
Once the fiber break goes through a consolidation process, in which the acute phase of inflammation, redness and heat has passed (which in moderate grade 2 fiber breaks is usually on day 4) we can apply local heat and soft on the area. In this phase we want to improve and encourage the healing processes of the muscle tear: the heat in the area will improve and activate the local circulation.
2) Active mobilization in the second phase of the treatment of muscle tear or fiber rupture
From day 4 or 5 it is advisable to start activating the damaged area with gentle movements. It must be done in a careful and controlled manner, since in the recovery phase the muscle will benefit from its active mobilization and contraction, this will improve and properly orient the muscle fibers, improving the healing process and avoiding fibrosis and muscle adhesions typical of these processes.
In the case of fiber rupture in the gastrocnemius or gastrocnemius muscle , they would be active mobilization exercises without load where the contraction is active but does not have to overcome an intense external force and, therefore, the contraction is slight, sufficient to stimulate the recovery process but whose traction is insufficient to affect the injury.
3) Circulatory drainage and muscle relaxation massage
In this phase, it is highly advisable to massage the muscles, with the aim of estimating blood circulation and evacuating the waste produced by the repair process, as well as relaxing muscle tone, sowing and fertilizing the ground for proper healing.
Partial recovery phase of a muscle tear or fibrillar rupture (from day 10 onwards)
In this phase, recovery is at an advanced stage and gentle stretching and muscle-load readjustment exercises can begin.
Recommendations for the partial recovery phase
1) Compression bandage for the third phase of the treatment of a muscle tear or fiber rupture
In this recovery phase, it is very interesting to apply a slightly compressive bandage to the area, prior to the light running exercise or the activation exercise of the injured muscle. In this phase it is recommended to carry out isometric contractions and exercises that do not imply an intense and sudden contractile effort of the damaged muscles; a good recommendation can be gentle exercises in the water.
2) Gentle stretches for the third phase of muscle tears or fiber breaks
From the tenth day, approximately, we can perform painless gentle stretching exercises; pain should always be a guide to perform all the exercises that are recommended. In cases of recovery from fiber breakage, and after the acute phase where there is pain at rest, the pain produced by any of the recommended exercises always indicates that healing is being attacked. Therefore, when stretching or performing some light activity to readapt the muscle, the painful sensation that we have should always be a guide to stop or moderate the exercise.
Stretching of the gastrocnemius and soleus muscles
3) Weight-bearing muscle readaptation exercises
In this phase (in the context of a fiber rupture or muscle tear in the lower limb) a light running exercise could be done, in addition to some other painless contraction exercise of the affected muscles, always bearing in mind that the times and intensity They should be moderate and soft.
Full recovery phase of a muscle tear or fiber rupture (from day 20 onwards)
This is the last phase of recovery, and it is in which readaptation to physical exercise takes on special relevance. It is usually the phase that precedes the performance of a normal sporting activity.
Recommendation for full recovery
1) More intense active exercises for the fourth phase of the treatment of muscle tear or fiber rupture
To seek a complete muscular readaptation, in this phase we must progressively increase the duration and intensity of physical exercise, always avoiding sudden intense ballistic-type contractions that can damage the muscles again. However, eccentric training is very useful in this phase.
We must not forget that although in this phase the muscle will be almost completely healed, we still run the risk of re-injuring the musculature. Therefore, we must be very careful when performing intense exercises such as kicking a ball and others that require a strong and sudden contraction of the muscles involved.
2) Eccentric training
Eccentric training has shown great benefits after a muscle tear, as well as in their prevention. This is because in eccentric type contractions the musculature lengthens while maintaining sustained tension, this tension is much higher than in isometric and concentric type contractions. In addition, it facilitates the stimulation of repair cells in tendon and bone, as well as the parallel alignment of collagen fibers, so important for resistance to external forces that can cause a fibrillar rupture or muscle tear.
3) More intense stretching for the fourth phase of the treatment of muscle tears or fiber breakage
In this recovery phase, muscle stretching should be more intense, seeking a greater demand on them. Since a fundamental objective will be to recover lost muscle flexibility and elasticity, it is advisable that the stretching demands gradually approach the muscles of the unaffected opposite side, always applying the aforementioned rules of prudence and common sense.
4) Deep transverse fiber massage in case of adhesions or fibrosis (Cyriax type)
It is very common that, as a consequence of the repair and healing processes of a broken fiber or muscle tear, a callus or thickened scar is produced. This results in muscle fibrosis, as well as adhesions between muscle planes. To prevent these inconveniences from occurring, it is advisable to perform a Cyriax-type deep transverse massage during these phases . In this way, we will be able to break these adhesions and fibrosis, as well as improve the state of the muscle scar and the sliding between muscle planes.
In this article, as you will see, I give very generic recommendations and advice on how to solve a fibrillar rupture or muscle tear, but it is important to indicate that each fiber rupture is unique and peculiar and therefore must be evaluated by a physiotherapist to adapt and personalize the treatment in each case.
5) Diacutaneous fibrolysis or hooks to treat a muscle tear
After a severe fibrillar rupture in the muscle, fibrosis can form, these are areas where the connective tissue thickens, losing elasticity and generating adherence and fixations. This ultimately results in a loss of mobility, inflammation and pain, and can occur in soft tissues such as tendons, ligaments and muscle. As a blood spill (hematoma) occurs, a cross-linked fibrotic scar is formed that does not follow the parallelism of the muscle fibers, it could be said that it is a tangle of fibers.
With this instrumental physiotherapy technique that is diacutaneous fibrolysis, “scratching” maneuvers can be performed on these fibrotic tissues to improve their mobility, muscle and fascia. It is a highly effective technique for these muscle and tendon insertion areas.
Prevention: how to avoid muscle tears or fiber breakage?
Any injury that happens to our body is preventable. To prevent a fiber breakage or muscle tear you must take into account:
- If you do sports or intense physical activity, you should warm up beforehand. The warm-up should include all the joints, starting from the head and working down to the feet (follow this order: neck, shoulders, elbows, wrists, trunk, hips, knees, and feet). Warming up will prepare the muscles to react quickly and correctly to the stimuli of the activity to be performed. Remember that the stretching exercises that are included in a stretch seek to wake up the muscle.
- Do not overdo the activities you do: a fatigued muscle does not respond well to changes in direction nor is it capable of quickly handling the stimuli that we apply to it during exercise. Listen and respect what your body tells you, and give it time to recover. This will make you more and more resistant to injury.
- Never forget to drink water and electrolytes. With physical activity, many substances necessary for the body are lost, such as water and salts. The consumption of energy drinks is an excellent way to replenish all the lost substances.
- If you have been injured, respect the treatment phases. Every stimulus is meant to help your body regenerate itself, and the wrong stimuli can throw cells into disarray. When the tissue is disorganized, it does not remain as before, it is fragile and prone to breaking again.
Short Summary about muscle tear
- Muscle tear occurs as a result of an abrupt elongation of muscle fibers and its severity will depend on the location, size of the tear, age, general health of the person, etc.
- The healing time of the muscle tear will depend on the degree of the injury and the effectiveness of the applied treatment.
- The treatment of a muscle tear must be applied by a qualified professional, such as a physiotherapist. Under no circumstances should treatment techniques be used without their supervision, since contrary to what is desired, which is the rehabilitation of the injury, the situation may be aggravated.
- The treatment must be personalized, taking into account the characteristics of the injury (muscle tear).
- The treatment will be developed progressively as the recovery phases of the muscle tear progress.