Muscle injuries can be categorized into three muscle tear grades, as follows:
Grade 1: Mild damage to individual muscle fibers (less than 5% of fibers) that causes minimal loss of strength and motion. These injuries generally take about 2-3 weeks to improve and resolve.
Grade 2: More extensive damage with more muscle fibers involved. However, the muscle is not completely ruptured. These injuries present with significant loss of strength and motion. These injuries may require 2-3 months before a complete return to sport or other strenuous physical activities.
Grade 3: Complete rupture of a muscle or tendon. These can present with a palpable defect in the muscle or tendon. However, swelling in the area may make this difficult to appreciate initially. These injuries sometimes require surgery to reattach the damaged muscle and tendon.
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An X-ray may be helpful to rule out a fracture or dislocation as the cause of pain. Occasionally the tendon can pull off a piece of bone where it attaches, this is called an avulsion fracture and can be seen on X-rays. However, pure muscle injuries cannot be seen on regular X-rays. An MRI can sometimes be helpful to determine where the injury has occurred and whether there is complete rupture or not. MRIs can also show collections of blood, called a hematoma, that sometimes occur following severe injuries.