Member Case Study: Muscle Pull and Stretching

author : AMSSM

comments : 0

I've read different protocols on stretching versus not stretching. Any advice? I don't want to injure myself more, and I want it to heal ASAP!

Question from goobergirl98
I seriously pulled my quad a few days ago playing softball (don't ask...I'm very bitter). I've read different protocols on stretching versus not stretching. Any advice? I don't want to injure myself more, and I want it to heal ASAP! I've been icing after activity, and stretching and heating some in-between and before stretching.
 

Answer by Jeffrey B. Kreher, MD, FAAP

Member AMSSM

Medicine & Science in Sport & Exercise study of hamstring (not quadriceps) strain rehabilitation found a more intensive stretching program that leads to quicker return to full range of motion and rehabilitation period (Malliaropoulos et.al.). If a quick return to play is desired, I would highly recommend working together with either a physical therapist or athletic trainer.

There are many varied thoughts on prevention and rehabilitation of muscle strain injuries. More work has been done on prevention of quadriceps strain than on rehabilitation. However, nearly all rehabilitation programs focus on what is called a “functional progression” of recovery. Most often there is a static stretching component (holding a muscle in an elongated state) and a proprioceptive neuromuscular facilitation component (contracting the opposing muscle to place the target muscle in stretch, followed by a static contraction of the target muscle.)

Rehabilitation should progress in a pain-free manner. Generally speaking, with proper rehabilitation an athlete will attain full, pain-free range of motion with a stronger muscle. If done properly, stretching during rehabilitation does enhance range of motion recovery. Neuromuscular activation (and hence strength) is greater with resistance training. Therefore, later in the recovery pain-free strengthening exercises should be done.

Finally, it is unclear from your question if there was any contusion component to your injury. If you bruised the muscle rather than simply strained/pulled, rehabilitation recommendations would be different.

Jeffrey B. Kreher, MD, FAAP
Pediatrics & Internal Medicine
Primary Care Sports Medicine

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date: August 12, 2008