Muscle strains in the lower back can occur for a number of reasons and may be a weak point waiting to happen. It is very important that muscle strains are treated properly as imbalances in the back can lead to problems later on.
Symptoms of a back muscle strain
A strain or tear to a muscle in the lower back will cause a sudden sharp pain with possible swelling or bruising over the area of the muscle rupture. The patient will have difficulty moving and is likely to be in considerable discomfort.
Back muscle strain explained
Muscle strains are graded 1, 2 or 3 depending on how bad the injury is:
Grade 1 injuries will have tightness in the back. The patient may be able to walk properly and will not have much swelling.
Grade 2 back muscle strains will probably result in the patient being unable to walk properly. They may get occasional sudden twinges of pain during activity and may notice some swelling. Pressing in over the site of injury will be painful.
Grade 3 injuries will result in the patient being unable to walk properly. They will be in severe pain and significant swelling will appear immediately. Contracting the back muscles will be painful and might produce a bulge in the muscle. The patient can expect to be out of competition for 3 to twelve weeks or more.
Muscle strains or ruptures can occur in the back just like they can anywhere else in the body. A muscle strain or tear in the back is usually caused by a sudden movement or lifting something that is too heavy. The low back pain, however, is often a long time coming on as the muscles in the back gradually tighten up due to bad posture and overuse.
These muscles go into spasm and do not get enough blood through them resulting in weakness. So when someone complains of low back pain when they bend down to pick up a piece of paper and tear a muscle in the back, it is not just the piece of paper that caused it but a gradual build up of tension over weeks and months.
If you have suffered a direct blow to a muscle, particularly one near a bone then you must treat it as a contusion.
Grade 1 treatment
Grade 1 back muscle strains should be actively rested. For example, ease down training for a week or two but no need to stop unless there is a pain. If you are aware at the time of injury then apply ice or cold therapy for the first 24 hours to ease pain and
Change activities to those which do not cause pain. Running is likely to aggravate a back muscle strain. Use a heat retainer or back brace until you feel no pain. See a sports injury professional or therapist who specializes in back problems.
A sports injury therapist or back specialist may use sports massage techniques to speed up recovery as can ultrasound therapy and electrical stimulation. A kinesiology taping can help activate muscles and support the lower back. An osteopath or chiropractor specializes in joint manipulation techniques which can help. They should prescribe a rehabilitation and strengthening program which may include a course of
Grade 2 treatment
Treatment of grade 2 back muscle strains involves rest from all activities. Apply ice or cold therapy in the acute stage with is usually the first 24 to 48 hours. Ice can be applied for 10 to 15 minutes every hour if not directly to the skin. Use a wet tea towel or commercially available cold wrap. See a sports injury professional for rehabilitation advice.
A professional therapist will use sports massage, and joint mobilization and manipulation to help speed up the recovery process. A full rehabilitation program including mobility exercises, core strengthening exercises or pilates
Grade 3 treatment
If a grade 3 or severe back muscle strain is suspected then apply ice or cold therapy and seek medical attention immediately. A period of complete rest, possibly bed rest may be required.
After the acute stage, the therapist may apply sports massage, joint manipulation, ultrasound and electrical stimulation as well as prescribe a full back rehabilitation program. If the injury is particularly severe then a surgeon will operate to repair the torn muscle.
It is particularly important that all back muscle strains are fully rehabilitated with professional advice as longer-term problems from muscle imbalance can result.
The following guidelines are for information purposes only. We recommend seeking professional advice before beginning rehabilitation.
Lower back stretch
- Lie on your back.
- Pull knees up to chest as far as they will go.
- Hold for 10+ seconds, repeat 5 times.
- This exercise stretches the muscles around the lumbar vertebrae.
- Standing upright, lift one arm above your head.
- Lean over to one side as far as is comfortable.
- Hold for 10-20 seconds.
Pulling knee up
- Lie on your back with both legs out straight.
- Raise one knee gently up to the chest and bring the head up to meet it.
- Lower the knee back down and repeat with the other leg.
- Repeat the exercise 10 times on each leg.
- Start on your hands and knees.
- Arch your back upwards, like an angry cat, hold for a couple of seconds and then arch the back downwards, like a happy cat.
- Repeat this exercise 10 to 20 times.
- Lie on your back as above with the knees bent.
- Slowly lower both knees to the left whilst turning the head to the right.
- Bring the knees up again and to the right whilst looking left.
- Repeat this movement 10 times.
The above exercises can be performed as soon as pain will allow - usually 48 hours following injury. If any of the exercises hurt then do not continue and seek professional advice.
Exercises should be performed at least every day, two or even three times a day if possible, especially in the first two weeks of rehabilitation. These exercises should continue long after the injury has healed to prevent it from reoccurring.
Basic sports massage techniques for the lower back which can help relax the muscles and improve their overall condition following a muscle strain.