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C h a p t e r 7
Managing Soccer Injuries and Athlete Health s
STRAINS
Strains occur within a muscle-tendon unit, and are caused by traumatic overextension
or continued overuse. Strains may be accompanied by generalized or point specific
pain and swelling. They can be slow to heal and may become chronic if weakness or
inflexibility is not corrected. Possible causes of strains include weak opposing muscle
groups, poor flexibility, inadequate warm-up, fatigue, or a sudden violent contraction.
First-degree strains, known as muscle pulls, involve a slight stretching of the muscle
tissue. Symptoms are spasm of the injured muscle, pain upon contraction or stretching,
and moderate pain to the touch. Recovery can range from 2–3 days to 2 weeks.
With a second-degree strain, the muscle stretches and there is some tearing of muscle
fibers. Immediate pain and loss of function, along with a popping or snapping sound,
usually occur. These torn fibers can cause a palpable gap in the muscle, a lump,
swelling and discoloration from hemorrhage within the muscle. Recovery time for a
moderate strain is 3–4 weeks.
In a third-degree, or severe strain, the muscle fibers are torn or even completely
ruptured. Symptoms include extreme pain and muscle spasm, a palpable defect
(indentation), swelling, discoloration and partial or total loss of function. Severe
strains require immediate medical treatment. Ice should immediately be applied to the
injured area followed by several days of ice massage treatments. Allow only unresisted
range-of-motion exercises until the internal bleeding stops. An elastic wrap, putting
pressure on the injury, should be worn during this time. When the bleeding stops,
administer contrast treatments such as ultrasound and ice. A severe strain is usually a
season-ending injury.
The most common muscle strains involve the hamstrings (muscles in the back of
the leg that bend the knee), the adductors (muscles on the inside of your thigh,
commonly referred to as the groin), the quadriceps (muscles on the front of the thigh
that straighten the knee), the sartorius (a muscle that runs from the outside of the hip
across the front of the thigh and attaches on the inside of the thigh by the knee), and
the calf muscles.
The treatment of muscle strains is very similar to the management of a joint sprain.
Follow the previously described PRICE method. Once the injury begins to heal, gentle
stretching may begin.
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