How To Tell If You Need To See A Doctor For Your Dumb Muscle Injury

Photographed by Megan Madden.
There you were on the treadmill, just catching up on The Bachelor, when your foot came down just a liiiiittle too far to the right and ouch — your ankle is not going to easily forgive for this one. But figuring out exactly how much you messed up that joint is a little more complicated than you'd think. According to the American College of Sports Medicine (ACSM), there are actually three levels of muscle injury severity — and each one feels a little bit different.

First, a little vocabulary lesson: Although we tend to use the phrase "pulled muscle" for pretty much every kind of muscle injury, strains and sprains are not the same thing. If you have a muscle strain, you've torn the actual muscle fibers or the tendons that connect the muscle to bone. But if you have a sprain, you've injured one of your ligaments, which are strong bands of tissue that connect bones to each other and make up your joints.

So, in general, a strain will cause pain when you try to use the torn muscle (think: sore hamstrings after overextending your leg on your morning jog). But a sprain will cause pain and instability in the affected joint (think: wobbly ankle after you step off the curb in a weird way).

But all strains and sprains aren't the same either. Doctors judge how severe your issue (strain or sprain) is based on three levels (also called "degrees" or "grades") of injury:

Level 1
At the mildest level, you'll only have minor tearing. You may feel pain when you try move your poor injured limb in its full range of motion and a little bit of tenderness if touched. But you'll still be able to function (almost totally) normally.

You usually don't have to see a doctor for first degree strains and sprains. As the Mayo Clinic explains, they're treatable with the classic RICE method (rest, ice, compression, elevation), over-the-counter painkillers, and time. But some injuries can be deceptive, so if you're not starting to feel better within 24-72 hours or your pain gets worse, it's time to call the doc.

Level 2
When you actually tear your muscle tissue significantly, your movement will be limited and painful (but still possible). At this level you'll also see some swelling or an indentation at the site of the tear. And, if you're dealing with a sprain, your joint will be somewhat unstable.

You can still treat these moderate injuries at home with the same methods as a first degree strain, but they may take longer to heal. You'll also need to go back to your normal activities with some extra care and, possibly, physical therapy. If you rush back into your weightlifting routine too quickly, for instance, you might re-injure yourself. Instead, the ACSM advises that a gradual approach is best.

Level 3
According to the ACSM guidelines, at this point, you'll have very limited or no range of motion. You'll feel severe pain when the injury actually happens, but the pain may subside immediately after. If it's a sprain, you won't be able to put weight on the joint, you'll see a lot of swelling, and the pain will be intense.

If you think you have a third degree sprain or strain, definitely see a doctor. You may need imaging tests (such as an MRI or X-ray) to make sure you don't have any broken bones. And, even if you didn't damage your bones, you might end up with crutches and a cast to help keep things stable as they heal. Once healed, you'll probably need some form of physical therapy to get back to your normal activities.

Regardless of the severity of your muscle damage, if you develop a fever or your swelling isn't going away, see a doctor ASAP. You might actually be dealing with an infection or a broken bone. And, of course, if something feels inexplicably off after an injury, it's a good idea to check in with your doctor anyways (not just the internet) even if you only have a minor strain. The sooner you figure out what's up, the sooner you can get back to the treadmill — but enjoy a little downtime first.
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