The tears most often take place during the eccentric phase of a muscles movement. To illustrate what is meant by the eccentric phase, imagine a person using a dumbbell to strengthen their bicep muscle. As they pull the weight upward they are in the concentric phase. As they lower the weights they are in the eccentric phase.
Tim Noakes in “The Lore of Running” writes, “Chronic muscle tears (or muscle knots) are probably the most common injuries seen in elite long-distance runners.”
How to recognise the injury.
The pain starts gradually.
It can at first hurt only after exercise.
After a period of time the pain will start during exercise.
It is at first possible to run through it, however after a period of time it will become impossible to run through.
The pain is normally localised to one of the big muscle groups such as the buttock, groin, hamstring or calf muscle.
The pain goes away with rest.
Chronic muscle tears do not improve until correct treatment is applied, as opposed to tendon injuries, which mend with rest.
What causes the injury?
When the eccentric loading exceeds the muscle’s eccentric strength, a small section of the muscle is strained and develops an inflammatory response. The strain will consist of microscopic tears. The body then begins an inflammation response with swelling and localised pain. This is similar to your oil light going on in your car. This is the time to take things seriously and cut back on mileage, ice the injury site, go for a massage and possibly take a few anti-inflammatories.
If you choose to run through the injury you will take it to the next phase which is a larger tear, more inflammation, the build-up of scar tissue and a knot or trigger point forming around the injured site. At this stage you running will become more and more painful. You also at this stage run the risk of changing your running gait to compensate thus placing strain on other muscle groups.
A physiotherapist or soft tissue massage specialist should be able to locate and diagnose the tear. The tears do not show up with X rays.
Most people involved in sport science agree that drugs and cortisone injections do not help heal the problem. The only thing that works is massage made up of both trigger point release and cross frictional massage. Getting these injuries sorted out comes with a certain amount of pain. Stretching and strengthening exercises are advised after recovery.
A chronic muscle tear will only resolve if the cross-frictions are applied to the injury site (in this case the tender knot in the muscle) and applied with the correct pressure. You will need between 5 – 10 treatment sessions. The ability to run longer distances without pain will be proof that you are on the right track.