A Guide To Muscle Tears

Why Muscles Tear: Structures and Mechanisms

Think of your muscle as a large rope made of many smaller bundles of fibres. These fibres are made of smaller repeating units called sarcomeres. These are made of two proteins, actin and myosin, which slide past each other to make the muscle contract and create movement. 

When a muscle is stretched too far, like during a sudden movement, these units can be damaged. Instead of a clean break, the fibres tear and fray away from their connection points, much like a rope fraying at the ends. 

How Muscle Tears Heal: 3 Stages of Recovery

 Your body immediately starts a three-stage process to heal the tear. 

1. The Clean-up Crew: 
– Specialised cells called neutrophils arrive first to clear away all the frayed, broken-off bits of muscle fibre. 
– They are followed by macrophages, which remove the parts of the muscle that are damaged but still attached. 

2. The Rebuilding Crew: 
– Satellite cells, which are like muscle stem cells, arrive to regenerate and repair the damaged muscle fibres. 
– Fibroblasts also come to the site to lay down collagen, which is the protein that forms scar tissue. 

3. Scar Tissue Formation: 
– Scar tissue is essential for healing, as it acts like a patch to hold the torn muscle together. 
– However, it’s crucial to get the right balance. Too much scar tissue can make the muscle stiff and less effective, while too little can leave it weak and prone to being injured again. 

Injury Management

To encourage the best possible muscle tear healing and create a strong, functional scar, we focus on a strategy called POLICE: 

– Protect) Protect the injured area from further harm. 
– Optimal Loading) This is the most important part. Instead of complete rest, we need to apply the right amount of stress to the muscle at the right time. 
– Ice) Can be used to help manage pain. 
– Compress) Using a bandage can help control swelling. 
– Elevate) Raising the injured limb can also help reduce swelling.  

Why is Optimal Loading so Important? 

Completely resting the muscle can cause it to become weak. Gentle, controlled movement and exercise are vital because they send signals to your cells to rebuild and become stronger. This process is called “mechanotransduction”.   

Loading the muscle activates specific pathways in your body that: 
– Increase the production of new muscle proteins (like actin, myosin, and another called titin, which helps with elasticity). 
– Help to remodel the collagen and form a strong, organised scar. 

The goal is to find the “sweet spot” — loading the muscle enough to stimulate healing without overloading it and causing another injury. A specific exercise programme helps to achieve this.  

An alternative method for recovery of muscle tears is through hydrotherapy. Hydrotherapy uses hydrostatic pressure to assist blood flow and lymphatic drainage whilst allowing controlled strengthening to occur. It promotes muscle repair with minimal risk by influencing muscle usage, nerve function and reducing inflammation. (Amruta, 2025)

A Note on Collagen

Collagen is a key protein that provides strength and structure to many parts of your body, including your skin, tendons, ligaments, and bones. There are different types of collagen. The type found in muscles (Type III) is more flexible and helps with support and repair, while the type in tendons and ligaments (Type I) is stronger to resist pulling forces. Your recovery programme will help your body produce and organise this collagen effectively. 

References: 

Amruta (2025) Profile: Hydrotherapy to Reduce Inflammation and Repair Muscle. Available at: https://nottinghamphysio.com/hydrotherapy-to-reduce-inflammation-and-repair-muscle/ (Accessed: 16 June 2026). 

Chargé, S.B.P. and Rudnicki, M.A. (2004) ‘Cellular and molecular regulation of muscle regeneration’, Physiological Reviews, 84(1), pp. 209–238. doi: https://doi.org/10.1152/physrev.00019.2003  

Damm, T.B. and Egli, M. (2014) ‘Calcium’s Role in Mechanotransduction during Muscle Development’, Cellular Physiology and Biochemistry, 33(2), pp. 249–272. doi: https://doi.org/10.1159/000356667  

Johnson, A.L., Kamal, M. and Parise, G. (2023) ‘The Role of Supporting Cell Populations in Satellite Cell Mediated Muscle Repair’, Cells, 12(15), pp. 1-18. doi: https://doi.org/10.3390/cells12151968  

Laumonier, T. and Menetrey, J. (2016) ‘Muscle injuries and strategies for improving their repair’, Journal of Experimental Orthopaedics, 3(15), pp. 1-9. doi: https://doi.org/10.1186/s40634-016-0051-7  

Mackey, A.L. and Kjaer, M. (2017) ‘Connective tissue regeneration in skeletal muscle after eccentric contraction-induced injury’, Journal of Applied Physiology, 122(3), pp. 533–540. Doi: https://doi.org/10.1152/japplphysiol.00577.2016  

Tidball, J.G. (2005) ‘Inflammatory processes in muscle injury and repair’, American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 288(2), pp. 345–353. doi: https://doi.org/10.1152/ajpregu.00454.2004  

Tu, M.K., Levin, J.B., Hamilton, A.M. and Borodinsky, L.N. (2016) ‘Calcium signalling in skeletal muscle development, maintenance and regeneration’, Cell Calcium, 59(2–3), pp. 91–97. doi: https://doi.org/10.1016/j.ceca.2016.02.005  

Yin, H., Price, F. and Rudnicki, M.A. (2013) ‘Satellite Cells and the Muscle Stem Cell Niche’, Physiological Reviews, 93(1), pp. 23–67. doi: https://doi.org/10.1152/physrev.00043.2011