For most of us the ‘pulled muscle’ is an unlikely problem, though I commonly see people complaining of
or having been diagnosed, as such. This suggests that the 'diagnoser' is
out of their depth on this subject. A pulled muscle is especially
unlikely in the back or neck. I admit these may actually feel like a
tear in the muscle, but that tends not to be the reality of it.
These sorts of pains are invariably an irritation or
‘locking’ of the small facet joints at the rear of the spine, with
associated local muscle spasm & pain. In the upper back, irritation
of the costo vertebral or rib joints are another source of pain. These
are often particularly sore when taking a deep breath. The main source
of pain in these instances is from the joint and its enclosing capsule,
giving sharp pain locally and/or referred pain to an associated area.
The local muscular spasm pain is more of an ‘ache’. When muscles are
constantly contracted the flow of fluids in & out are restricted and
you get a build up of metabolites (waste products) within the muscle,
causing inflammation & irritation. The muscle is also being starved
of nutrients, including oxygen and this is known as ischaemic muscle
pain.
Pain in the upper back/chest, especially should be
checked out by a ‘primary health care professional' to establish if it
is a musculo-skeletal problem or it is referred pain from one of the
internal organs. Osteopaths are qualified to do this and incidentally I
have seen more than one person who has had their gall bladder removed to
find the pain has persisted. Once the rib joint problem was addressed,
however, the pain disappeared!
Those that do ‘pull’ or tear muscles are usually
high class athletes pushing the boundaries of human physical capability.
The proverbial ‘pulled hamstring’ for example in a track athlete or
footballer. You may have seen it on TV - they are completely unable to
weight bear on the leg, as the hamstrings are the main hip extensors
& knee flexor muscles and you cannot stand up if you can’t extend
your hip.
There are a few exceptions that us ‘mere mortals’
may be unlucky enough to encounter, such as a snapped biceps tendon. In
the upper arm, as the name suggest this muscle has two tendons (at the
shoulder) and two bellies that join together at the lower single tendon
that attaches to the upper forearm. It, therefore, flexes both shoulder
and elbow. Uncommonly, the longer of the two upper tendons snaps under
load, often causing great pain at the time. Also, a bruise may appear,
that migrates down the arm with gravity, before dispersing. The muscle
bellies appear ‘bunched up’ in a sort of ‘Popeye’ effect.
Usually the shoulder is able to adapt and work around this and no effort
is made to surgically re-attach the tendon. The shoulder may, however,
be more prone to problems, such as, ‘frozen shoulder’ (adhesive
capsulitis), ‘impingement’ or ‘rotator cuff’ problems. Regular
stretching will prevent any such problems and if one has arisen, then
manual treatment, such as, osteopathy would be appropriate.
Another example, would be a partial or complete
rupture of the Achilles Tendon. Reported to feel like being shot in the
calf These often need to be repaired surgically, if severe, and followed
up with manual treatment for rehabilitation. If this sort of thing
happens spontaneously (i.e. Without physical trauma), it indicates a
weakness of the area or of the connective tissues in general. Causes
include:- hereditary (genetic, postural, attitude toward exercise),
lifestyle (i.e. ‘Stress’, fatigue, lack of stretching)), nutritional
deficiencies (poor diet, quality of food or depleted nutritional status
due to stress) and/or chronic dehydration (surprisingly common).
To sum up - pulled tendons & muscles occur
only rarely and in the larger bellied muscles, not typically in neck
& back muscles. These are multiple small bellied muscles, that work
as a group and attach to the many individual vertebrae.
Muscle strain is another possibility
Common causes include:-
Overdoing weights in the gym causes tiny
micro-tears in the muscles. This occurs when there is tremor under
load, pain and residual deep muscle ache for a day or two after. This
is definitely not a case of - ‘No pain, no gain’. Micro trauma to
the muscles does not increase bulk and is detrimental to their health
& efficiency.
Excessive demand on unprepared muscles will similarly
cause strain. Examples of this are poor lifting technique i.e. without
bending knees, bracing yourself and with ‘cold’ muscles. Badminton
commonly causes this sort of strain for the following reasons:- It is
very popular with the ‘middle aged’ that often play once a week, do
no other exercise in between, forget or don’t bother to stretch
before/after play. The same could be said for ‘Sunday footballers’,
although a bad tackle may actually cause tearing (rupture), typically of
the knee ligaments.
Poor posture, such as, being slumped in a poorly
designed car seat for hours. The curve of the lumbar spine doesn’t
appreciate being bent the wrong way for hours on end! For long trips -
sit up properly, buy yourself a lumbar support cushion if necessary and
take breaks. Also, being round shoulder throws the head in front of the
line of gravity, so that the muscles at the back of the neck are having
to work a lot harder to keep the head upright. These problems usually
present as an ache in two bands either side of the spine. Although
aggravated by poor posture, there are usually some underlying stiff
vertebral joints, forcing the other areas of the spine to work harder.
This is usually easily remedied with treatment and the right stretches
if it’s a long term problem.
Maintaining an awkward position has a similar effect
as above and can be treated likewise. Examples include working under the
bonnet of a car or in a cramped space.
©Andrew
C. Woodhouse BSc (Hons) Ost
