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Tag: pull

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By Dr. Alexander Jimenez DC, APRN, FNP-C 0 Comments Chiropractic Care, Physio, Work Injury , , , , , , , , , , , , , , , , , , ,

Pulled Muscle: Understanding the Healing Process

What are the recommendations for a pulled muscle injury to fully recover?

Pulled Muscle Recovery Time

A pulled muscle, medically known as a strain, occurs when muscle fibers are stretched too far and sometimes tear. A pulled muscle injury typically starts to heal within days. Mild injuries can heal completely in one to three weeks, but more serious strains or tears, depending on the severity, can take six to 12 weeks or longer. (Fernandes T. L., Pedrinelli A., & Hernandez A. J. 2015)  Rest, hydration, healthy foods, and slowly returning to activity can help expedite healing time.

Timeline

The timeline for recovering from a pulled muscle depends on the injury’s severity.

Pulled muscles are typically categorized into three grades based on the degree and size of pulled muscle fibers, as follows (Hospital for Special Surgery, 2024)

Grade 1 (mild)

  • Heals in a few days.
  • A microscopic tear or stretch in the muscle fiber.
  • It might feel sore, but you can still use the muscle.

Grade 2 (moderate)

  • Heals in four to six weeks.
  • A partial tear in the muscle causes noticeable pain and swelling, making it harder to move or use the injured muscle.

Grade 3 (severe)

  • Heals in several months
  • This type of muscle strain causes a complete tear, also known as a rupture.
  • It results in intense pain, significant swelling, and inability to use the muscle.
  • Surgery may be required in some cases.
  • Larger muscles, such as the hamstrings and quadriceps, may take longer to heal than smaller muscles due to their increased size and greater weight-bearing loads.

Body Parts More Susceptible To Injury

The following are more susceptible to muscle strains, pulls, or tears (Nölle L. V. et al., 2022)

  • Neck – levator scapulae and trapezius
  • Shoulders – rotator cuff muscles
  • Lower back – erector spinae
  • Groin – adductors
  • Front of the thigh – quadriceps
  • Behind the thigh – hamstrings
  • Calves – gastrocnemius and soleus

Healing Stages and Factors

Pulled muscles heal in three predictable stages, though the timing and progression may vary by individual and injury severity (Baoge L. et al., 2012).

Inflammatory Stage (zero to three days)

  • When pulling a muscle, the body reacts instantly with an inflammatory response that may include swelling, redness, bruising, and pain.
  • Rest is important during this stage to prevent the injury from getting worse.

Repair Stage (three to 21 days)

  • Damaged muscle fibers are repaired and regrow during this stage.
  • Collagen fills in any tears to rebuild damaged muscle tissue.
  • Gentle movement and easy activity can help the fibers line up properly and reduce stiffness.
  • Start slowly moving a pulled muscle as soon as possible, but avoid too much activity too soon, as it can delay and prolong healing.

Remodeling Stage (three weeks to one year)

  • Repaired tissue gets stronger and adapts to regular movement.
  • Scar tissue may form.
  • Gradually adding more activity, stretching, and strengthening exercises helps treat a pulled muscle and return to full strength and function but should be done carefully to avoid re-injury.

Faster Healing

To help speed up recovery from a pulled muscle, try these simple strategies: (Baoge L. et al., 2012) (Laumonier T. & Menetrey J. 2016)

Rest

  • Avoid activities that cause pain, but move the muscle gently to prevent stiffness.
  • Prolonged rest can slow healing, so maintain a balance between rest and exercise.

Ice

  • Add ice for 10–20 minutes for the first 48 hours to reduce swelling and pain.
  • Ice helps control inflammation by limiting blood flow to the injured area.

Compression

  • Use compression stockings or wrap the injured part in bandages to help reduce swelling.
  • Ensure the binding is not too tight so circulation is not cut off.

Elevation

  • Raise the injured area above heart level throughout the day.
  • This helps reduce swelling by allowing fluids to drain away from the injury site.

Heat

  • After the first two to three days, heat therapy increases blood circulation and improves flexibility, helping the muscle heal.

Eat Healthy

  • Get enough protein for muscle repair.

Maintain Hydration

  • Drink plenty of water to help with circulation and muscle lubrication.

Massage and Physical Therapy

  • These hands-on interventions can improve circulation, help reduce scar tissue, and restore range of motion.

Over-the-counter Medications

  • If needed, over-the-counter nonsteroidal anti-inflammatory medications like Advil or Motrin (ibuprofen) and Aleve (naproxen sodium) can help with pain and swelling.
  • Only use as directed.

These steps can help promote faster healing and expedite returning to normal daily activities.

When to Resume Normal Activity

Individuals may need one to two weeks to recover before resuming normal activity for mild strains. However, for more severe injuries, it could take four to six weeks or longer to return to all daily activities. (Harvard Health Publishing, 2023) It’s essential to gradually return to daily activities to avoid reinjury, which can delay and prolong healing. Follow these recommendations to recover from a pulled muscle safely and quickly (Kraemer W., Denegar C., & Flanagan S. 2009)

  • Once the pain has subsided, the swelling has decreased, and the muscle feels better, start with low-impact exercises.
  • Slowly resume normal activities, avoiding overexerting the injured area.
  • Gradually increase activity levels and stop if there is any pain.
  • Avoid strenuous activities that place excessive stress on the injured muscle until the muscle is completely healed.

Contact a Healthcare Provider

While most pulled muscles heal with home care, seek medical attention if: (Penn Medicine, 2023)

  • Pain persists or worsens after seven to 10 days.
  • This can indicate a more serious injury, such as a severe torn muscle.
  • Significant pain, loss of motion and strength, and swelling disrupt daily activities or show signs of worsening despite rest and self-care.
  • It is difficult to move the affected area, or the muscle cannot bear weight, suggesting a more severe injury.
  • There are signs of infection, including redness, warmth, increased swelling, or fever, especially if the skin is cut or broken near the injured area.
  • There is unusual bruising or a visible deformity, which could indicate a bone fracture requiring professional evaluation.

A healthcare provider may recommend imaging studies, such as MRI, ultrasound, or X-rays, to assess the extent of the injury, rule out fractures, or check for muscle tears.

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Say Goodbye to Pain with Chiropractic Care

References

Fernandes, T. L., Pedrinelli, A., & Hernandez, A. J. (2015). MUSCLE INJURY – PHYSIOPATHOLOGY, DIAGNOSIS, TREATMENT, AND CLINICAL PRESENTATION. Revista brasileira de ortopedia, 46(3), 247–255. https://doi.org/10.1016/S2255-4971(15)30190-7

Hospital for Special Surgery. J. N. R., MD. (2024). Muscle Strain: Causes, Symptoms, Treatment. https://www.hss.edu/conditions_muscle-strain.asp

Nölle, L. V., Mishra, A., Martynenko, O. V., & Schmitt, S. (2022). Evaluation of muscle strain injury severity in active human body models. Journal of the mechanical behavior of biomedical materials, 135, 105463. https://doi.org/10.1016/j.jmbbm.2022.105463

Baoge, L., Van Den Steen, E., Rimbaut, S., Philips, N., Witvrouw, E., Almqvist, K. F., Vanderstraeten, G., & Vanden Bossche, L. C. (2012). Treatment of skeletal muscle injury: a review. ISRN orthopedics, 2012, 689012. https://doi.org/10.5402/2012/689012

Laumonier, T., & Menetrey, J. (2016). Muscle injuries and strategies for improving their repair. Journal of Experimental Orthopaedics, 3(1), 15. https://doi.org/10.1186/s40634-016-0051-7

Harvard Health Publishing. (2023). Muscle strain. https://www.health.harvard.edu/staying-healthy/muscle-strain-a-to-z

Kraemer, W., Denegar, C., & Flanagan, S. (2009). Recovery from injury in sport: considerations in the transition from medical care to performance care. Sports Health, 1(5), 392–395. https://doi.org/10.1177/1941738109343156

Penn Medicine. (2023). Strains. https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/strains

By Dr. Alexander Jimenez DC, APRN, FNP-C 0 Comments Athletes, Exercises , , , , , , , , , , , , , , , , , , ,

Push-Pull Workout: A Comprehensive Guide

Can a push-pull workout routine be an option for individuals who want focused training on specific muscle groups and balanced muscle development throughout the body?

Push-Pull Strength Training

A “push-pull” workout is a training style in which you split your exercise routine into separate days dedicated to “push” exercises (targeting muscles like the chest, shoulders, and triceps) and “pull” exercises (targeting muscles like the back and biceps). This allows focused training on each muscle group by isolating their primary movement patterns—pushing away from the body or pulling towards it. The workout often accompanies a separate leg day to complete the full-body workout. This routine comes from bodybuilding. Bodybuilders use this method to maximize their workouts and rest periods. By splitting their workouts into push exercises one day and pull exercises another, they can work out more often without overtraining. (Castanheira R. P. M. et al., 2017)

Upper Body Push Exercises

These exercises involve all the movements that push the weights away from your body. These exercises typically focus on the quads, outer thighs, chest, shoulders, and triceps. (Collins P. 2009)

Pushups

  • Push-ups are a versatile bodyweight exercise that engages multiple muscle groups, including the chest, shoulders, triceps, and core.

Chest Presses

  • Chest presses are exercises that target the pectoral muscles (chest muscles).
  • They can be performed with various equipment and techniques, providing a comprehensive workout for the chest.

Chest Flies

  • Chest flies are a weightlifting exercise that targets the pectoral muscles (chest muscles).
  • They are performed by lying on a bench and extending the arms outward with weights in each hand.
  • The weights are then lowered in an arc motion until they are slightly below chest level before being raised back to the starting position.

Overhead Presses

  • An overhead press is a weight-training exercise that involves pushing a weight above your head.
  • Also known as a shoulder, military, or strict press.

Lateral Raises

  • Lateral raises are an isolation exercise that targets the lateral deltoid muscle on the shoulder’s side.
  • They raise the arms laterally (out to the sides) while slightly bending at the elbows.

Bent Arm Lateral Raises

  • A bent-over lateral raise is a weightlifting exercise that strengthens the rear deltoids, the muscles on the back of the shoulders.
  • It also works other upper and lower body muscles, including the trapezius, rhomboids, triceps, hamstrings, and lower back.

Front Raises

  • Front raises are a weight training exercise that targets the shoulder muscles.
  • They can also help build strength and stability in the upper body.

Dips

  • Dips are an upper-body exercise that uses your body weight to strengthen your triceps and chest.

Triceps Extensions

  • Triceps extensions are resistance exercises that target the triceps muscles in the back of the upper arm.
  • They involve extending the arms at the elbows while keeping the shoulders stationary.

Skull Crushers

  • Skull crushers are a weightlifting exercise that targets the triceps muscles in the upper arms.
  • They are performed by lying on a bench or floor, holding a weight (such as a dumbbell or barbell) overhead, and then lowering it towards the forehead while keeping the elbows slightly bent.
  • This exercise helps to strengthen and build muscle mass in the triceps.

Upper Body Pull Exercises

Pull exercises are movements where you are pulling the weight toward your body. These exercises primarily use the biceps, hamstrings, glutes, and back muscles. A routine set up in which you do a push routine one day and a pull routine the next without working the same muscles two days in a row.

Barbell Rows

  • Often referred to as a “bent-over row” due to the hinged position of your body during the movement.
  • A barbell row is a weightlifting exercise in which you bend over at the hips, grasp a barbell with an overhand grip, and pull the weight toward your stomach.
  • This exercise primarily targets the upper back muscles, including the latissimus dorsi, while also engaging the core and posterior chain muscles.

One Arm Rows

  • A variation of the bent-over row, a one-arm row, also known as a single-arm dumbbell row, is an upper-body exercise that targets the back muscles using a dumbbell and a bench.

Double arm rows

  • A “double arm row” is a rowing exercise in which you simultaneously pull a weight toward your body using both arms, typically with a barbell or dumbbell.
  • This exercise engages your upper back muscles, including the latissimus dorsi, trapezius, and rhomboids.
  • To effectively target the back muscles, you maintain a bent-over position. Essentially, it’s the opposite movement of a chest press, but you use both arms simultaneously.

Barbell High Rows

  • A barbell high row, also known as a wide row, is an exercise that uses a barbell to work the upper and mid back muscles.

Dumbell Pullovers

  • Dumbbell pullovers are a weightlifting exercise that targets the chest, back, and shoulder muscles.

Seated Rows with Resistance Bands

  • A “seated row with bands” is an exercise where you sit on the ground, loop a resistance band around your feet, and then pull the handles towards your chest, mimicking a rowing motion.
  • By squeezing the shoulder blades together, this motion primarily targets the upper back muscles, including the latissimus dorsi and rhomboids.
  • You are essentially performing a seated row movement using the tension of a resistance band instead of weights.

Lat Pulls with Resistance Band

  • Lat pulls with a resistance band are a back exercise that strengthens the latissimus dorsi muscles and can improve posture.

Back extensions

  • Back extensions are an exercise that strengthens and isolates the lower back muscles, also known as the erector spinae.

Seated Alternating Rows

  • A seated alternating row is an exercise that targets the upper back, biceps, and lats.
  • It can be performed using a resistance machine or with a band.

Renegade Rows

  • A renegade row is a full-body exercise that combines a plank with a dumbbell row.
  • It’s an advanced exercise that targets the upper body, back, shoulders, and core.

Biceps Curls

  • A bicep curl involves bending the arm at the elbow towards the body, strengthening the biceps, the large muscles in the front of the upper arm.

Home Equipment

Resistance bands and a quality pair of adjustable dumbbells are recommended for home training. These don’t take up much space and can be used for most upper-body exercises. To set up a more dedicated space for workouts, add a weight bench or a full home gym to increase your push-pull training options.

Benefits

Push-pull workouts are great for anybody, whether you’re a bodybuilder or just someone lifting weights to be strong and fit. This routine is usually spread out over three days of training, allowing for shorter workouts. These can help you stay committed despite a busy schedule and are easier than longer, total-body workouts. These exercises can also be done with a cable pulley system or resistance bands.

  1. Day 1 might be a push upper body workout.
  2. Day 2 might be a lower-body workout.
  3. Day 3 might be the pull upper body workout.

First, push-pull workouts allow you to work your muscles without overstressing them. (Castanheira R. P. M. et al., 2017) Second, although they are more frequent, push-pull workouts are shorter, so more can be done because your other muscles are resting. Third, push-pull routines are more interesting and contain more variety, as they can be done in various ways.

Alternating Workouts

Trainers recommend changing workouts every 6-12 weeks to avoid hitting a plateau, which can delay weight loss (American Council on Exercise, 2001). For example, you could do a push-pull routine for a few weeks and then switch to a different training method, pyramid training. Then, return to total body workouts, which you can do up to 3 non-consecutive days a week. Circuit training may be an option because the quick workouts allow you to get your cardio in simultaneously. (Haltom R. W. et al., 1999) With so many different training methods, there’s no need to do the same workouts repeatedly.

Injury Medical Chiropractic and Functional Medicine Clinic

For those who are easily bored with weight training and prefer a variety of exercises, this can be a refreshing way to stay focused and avoid burnout. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Transform Your Body

References

Castanheira, R. P. M., Ferreira-Junior, J. B., Celes, R. S., Rocha-Junior, V. A., Cadore, E. L., Izquierdo, M., & Bottaro, M. (2017). Effects of Synergist vs. NonSynergist Split Resistance Training Routines on Acute Neuromuscular Performance in Resistance-Trained Men. Journal of strength and conditioning research, 31(12), 3482–3488. https://doi.org/10.1519/JSC.0000000000001762

Collins, P. (2009). Functional Fitness. Germany: Meyer & Meyer Sport, Limited.

American Council on Exercise. (2001). Weight Loss Plateaus and Pitfalls. ACE. https://contentcdn.eacefitness.com/assets/education-resources/lifestyle/fitfacts/pdfs/fitfacts/itemid_69.pdf

Haltom, R. W., Kraemer, R. R., Sloan, R. A., Hebert, E. P., Frank, K., & Tryniecki, J. L. (1999). Circuit weight training and its effects on excess postexercise oxygen consumption. Medicine and science in sports and exercise, 31(11), 1613–1618. https://doi.org/10.1097/00005768-199911000-00018