Acute Soft Tissue Injury Treatment

What to do after a Muscle Strain or Ligament Sprain?

Article by J.Miller, Z.Russell

Sprain or Strain?

If you suffer a soft tissue injury, the best advice we can give you is to…

Seek Prompt Medical Advice!

The research is very conclusive.  Early accurate assessment and prompt appropriate treatment is much better than delay. Plus, what may appear to be a simple muscle, ligament, or soft tissue injury can include a hairline fracture, bone bruising or dislocation.

Prompt Treatment will Benefit You in many ways:

  • Less pain quicker
  • Reduced drug intake
  • Quicker return to function: e.g. walking, work, sport
  • Less income loss from time off work
  • Less likelihood of future recurrence.

Early Management of a Soft Tissue Injury

During the time delay before you can seek a professional opinion, then follow the tips below:


Rest from painful exercise or a movement is essential in the early injury stage. We call this active rest. “No pain. No gain.” does not apply in most cases.  The rule of thumb is – don’t do anything that reproduces your pain for the initial two or three days.  After that, you need to get it moving, or other problems will develop. If you are unsure what to do, please get in touch with your physiotherapist for injury-specific advice.

Ice or Heat?


Ice is preferred for the initial two or three days post-injury. Apply ice for 20 minutes each two to three hours for the first few days until the “heat” comes out of the injury. Ice should also help to reduce your pain and swelling in traumatic soft tissue injuries, such as ligament sprains, muscle tears or bruising.


It is preferable to avoid heat (and heat rubs) in the first 48 hours of injury. The heat encourages bleeding, which could be detrimental if used too early. Once the “heat” has come out of your injury, heat packs can be used to stimulate blood flow. We recommend 20-minute applications a few times a day to increase the blood flow and hasten your healing rate. Heat will also help your muscles relax and ease your pain. Heat Wheat Packs are an excellent home solution for a multitude of conditions.

Should You Use a Compressive Bandage / Support?

Yes. If it is possible to apply a compressive bandage or elastic support to the injury, it will help to control swelling and bleeding in the first few days.  In most cases, the bandage/support will also help support the injury as the new scar tissue is laid down. This should help to reduce your pain.


Elevation of an injury in the first few days is beneficial. Think where your injury is and where your heart is. Gravity will encourage swelling to settle at the lowest point.  Try to rest your injury above your heart. Obviously, some injuries are impossible, or it would be detrimental to elevate, so please use your common sense and be guided by your pain.

When Should You Commence Treatment?

In most cases, “the early bird gets the worm”.  Researchers have found that the intervention of physiotherapy treatment for acute soft tissue injuries within a few days has many benefits.

Prompt Treatment Benefits include:

  • Relieving your pain quicker via joint mobility techniques, soft tissue massage, electrotherapy etc
  • Improving your scar tissue quality using techniques to guide the direction it forms
  • Getting you back to sport or work quicker through faster healing rates
  • Loosening or strengthening your injured region with individually prescribed exercises and techniques
  • Improving your performance when you do return to sport, work or simply daily life
  • Correct any biomechanical faults that may be affecting your movement, technique or predisposing you to injury.

What If You Do Nothing?

Research tells us that injuries left untreated do take longer to heal and have lingering pain.

They are also more likely to recur and leave you with:

  • abnormal scar tissue formation
  • joint stiffness
  • muscle weakness

It’s important to remember that symptoms lasting longer than three months become habitual and are much harder to solve.  The sooner you get on top of your symptoms, the better your outcome.

What Are Common Muscle Injuries?

Myalgia, or muscle pain, can have many sources. Here are some of the more common sources of muscle pain. Would you please click the links for more information?

Neck & Back Muscle Injuries

Lower Limb Muscle Injuries

Upper Limb Muscle Injuries

Haematoma-Related Myalgia

Fatigue-Related Myalgia

Systemic Causes of Myalgia

More Information: Myalgia

Common Muscle Injury FAQs

What are the 4 Types of Muscle Injuries?

How Long Does It Take For A Muscle Injury To Heal?

What Helps Muscle Strains Heal Faster?

How Can I Speed Up Muscle Recovery?

What is a Trigger Point In A Muscle?

Article by John Miller

How Long Does It Take For A Muscle Injury To Heal?

The recovery time for a muscle injury depends on the severity of the damage. For a mild strain, you may be able to return to normal activities within a few days or a week. For more severe strains, recovery can take several weeks and even months. In nasty cases, surgical repair and post-operative physiotherapy may be necessary.

With professional assessment and the treatment guidance of your physiotherapist, most muscle injuries recover entirely.

To avoid re-injury, please ensure that you have adequately rehabilitated your body for a return to sport or work. Follow your physiotherapist’s specific instructions. Don’t engage in high-risk physical activity until your muscles have healed and strengthened appropriately.

Common Treatments for Muscle Strain

The following options are available to your physiotherapist to assist the rehabilitation of your muscle strain. Please seek their professional advice prior to self-managing your injury to avoid aggravating your muscle strain. These are general guidelines only and should not be treated as individual treatment advice.

Acute Muscle Strain Treatment

Subacute Muscle Strain Treatment

Later Stage Muscle Strain Treatment Options

Other Factors to Consider

General Information

Massage Techniques

Article by John Miller

What Are The Muscle Injury Types?

We categorise your muscles into three main types: skeletal, cardiac, and smooth muscles

  • Skeletal muscle is the most common muscle tissue type in the body. Plus, it is prone to injury. Skeletal muscles facilitate your body's movement and strength. The 4 types of skeletal muscle injuries include:
    • Muscle Strain/Soreness
    • Muscle Tear/Rupture
    • Muscle Contusion (Haematoma)
    • Rhabdomyolysis
  • Cardiac muscle forms your heart muscle walls.
  • Smooth muscle tissue is in the walls of hollow organs like the bladder, passageways like the airway and gastrointestinal (GI) tract.

Muscle Strain/Soreness

Muscle strains result in small or microscopic muscle fibre tears. We commonly refer to a muscle strain as a "pulled" muscle. This injury occurs when the muscle is mildly overstretched, or overused. Common muscle strain injuries include the hamstring, shoulder, neck and lower back.

Muscle strains result in muscle soreness, stiffness, weakness, swelling and spasms. They usually heal over a few days. Ice, anti-inflammatory medications, massage and gentle stretching may help the muscle injury heal faster.

Delayed-Onset Muscle Soreness (DOMS) is post-exercise-related muscle pain. DOMS develops after excessive and unaccustomed exercise. It is particularly prevalent if that exercise has an eccentric component. DOMS is myofibril tears (muscle strains). The microtrauma results in an inflammatory response with intramuscular fluid and electrolyte shifts.

We do know that biochemical markers (such as creatine kinase and lactic dehydrogenase) are in the blood of DOMS sufferers, which is consistent with muscle fibre disruption.

Swelling, altered muscle firing patterns and pain are the reasons why muscle strength, motions and function is impaired in DOMS sufferers.

Muscle Tear / Rupture

While a muscle strain refers to a microscopic injury to muscle fibres, a muscle tear is a more significant macroscopic injury. We can normally visualise the damaged fibres on an ultrasound scan or MRI. Much like muscle strains, the most common muscle tears occur in the lower back, neck, shoulder, and hamstring. It typically takes a substantial amount of force to cause this type of injury. Muscle fibres and the blood vessels that supply it tear.

Muscle tears usually cause a sudden onset of severe muscle pain, as well as bruising, weakness and swelling. Muscle tear sufferers should seek urgent medical attention to confirm the diagnosis and undertake a physiotherapist-guided rehabilitation to return to sport or work quicker, plus reduce the likelihood of reinjury. Patients with a torn muscle also often require follow-up care and rehabilitation with physical therapy.

The most severe extreme of a muscle tear is a complete rupture. Complete muscle rupture usually requires surgical repair and post-operative physiotherapy to optimise your return to function.

Muscle Contusion (Haematoma)

Muscle contusion may also be referred to as a muscle "haematoma". This injury occurs when a blunt object strikes the body and crushes underlying muscle tissue but does not break the skin. Common examples include being hit with a ball or being accidentally kneed e.g. "corked thigh". Contusions are typically painful, swollen, weak and result in a reduced range of motion, as a protection mechanism. Visible bruising is from damaged blood vessels that pools underneath the skin's surface.

While most mild contusion injuries often heal with ice, rest and time, more severe injuries sometimes require surgical intervention to address excessive pressure accumulated from internal swelling and bleeding.


Rhabdomyolysis is a severe condition when muscle fibres die and their contents release into your bloodstream. Your kidneys normally filter out these muscle byproducts. However, in rhabdomyolysis kidney failure can result and be fatal. Urgent medical attention is required.

Muscle pain, weakness and dark urine are the common symptoms of rhabdomyolysis.

Causes of rhabdomyolysis may be traumatic or non-traumatic. Examples of traumatic rhabdomyolysis include car accidents, crush injuries or lying unconscious on a hard surface for an extended period. Causes of non-traumatic muscle injury include heatstroke, infections, intense exercise, seizures, and the use of certain recreational drugs like cocaine and amphetamines.

If you have any of the symptoms please seek urgent medical assessment.

Article by John Miller

What Helps Muscle Strains Heal Faster?

Muscle Strain Treatment

Muscle strain treatment will vary depending on your health professional's accurate diagnosis. The severity of your muscle strain and what function or loads your injured muscle will need to cope with will impact the length of your healing and rehabilitation process.

Until you've been accurately diagnosed with a muscle strain, use the following guidelines:

  • Ice and a compression bandage.
  • Elevate the injured region swells.
  • If it's painful to walk, you should be using crutches.
  • Cease or reduce your exercise or activity level to where you feel no pain.

Muscle strain can take a few days to several weeks to rehabilitate successfully. Please seek the advice of your physiotherapist, doctor, or health care practitioner who specialises in muscle injuries, e.g. massage therapist, to guide your treatment.

Common Treatments for Muscle Strain

Many treatment options are available to your physiotherapist to assist the rehabilitation of your muscle strain. Please seek their professional advice.

Acute Muscle Strain Treatment

Subacute Muscle Strain Treatment

Later Stage Muscle Strain Treatment Options

Other Factors to Consider

General Information

Massage Techniques