What are the recommendations for a pulled muscle injury to fully recover?
Pulled Muscle Recovery Time
A pulled muscle, medically known as a strain, occurs when muscle fibers are stretched too far and sometimes tear. A pulled muscle injury typically starts to heal within days. Mild injuries can heal completely in one to three weeks, but more serious strains or tears, depending on the severity, can take six to 12 weeks or longer. (Fernandes T. L., Pedrinelli A., & Hernandez A. J. 2015) Rest, hydration, healthy foods, and slowly returning to activity can help expedite healing time.
Timeline
The timeline for recovering from a pulled muscle depends on the injury’s severity.
Pulled muscles are typically categorized into three grades based on the degree and size of pulled muscle fibers, as follows (Hospital for Special Surgery, 2024)
Grade 1 (mild)
Heals in a few days.
A microscopic tear or stretch in the muscle fiber.
It might feel sore, but you can still use the muscle.
Grade 2 (moderate)
Heals in four to six weeks.
A partial tear in the muscle causes noticeable pain and swelling, making it harder to move or use the injured muscle.
Grade 3 (severe)
Heals in several months
This type of muscle strain causes a complete tear, also known as a rupture.
It results in intense pain, significant swelling, and inability to use the muscle.
Surgery may be required in some cases.
Larger muscles, such as the hamstrings and quadriceps, may take longer to heal than smaller muscles due to their increased size and greater weight-bearing loads.
Body Parts More Susceptible To Injury
The following are more susceptible to muscle strains, pulls, or tears (Nölle L. V. et al., 2022)
Neck – levator scapulae and trapezius
Shoulders – rotator cuff muscles
Lower back – erector spinae
Groin – adductors
Front of the thigh – quadriceps
Behind the thigh – hamstrings
Calves – gastrocnemius and soleus
Healing Stages and Factors
Pulled muscles heal in three predictable stages, though the timing and progression may vary by individual and injury severity (Baoge L. et al., 2012).
Inflammatory Stage (zero to three days)
When pulling a muscle, the body reacts instantly with an inflammatory response that may include swelling, redness, bruising, and pain.
Rest is important during this stage to prevent the injury from getting worse.
Repair Stage (three to 21 days)
Damaged muscle fibers are repaired and regrow during this stage.
Collagen fills in any tears to rebuild damaged muscle tissue.
Gentle movement and easy activity can help the fibers line up properly and reduce stiffness.
Start slowly moving a pulled muscle as soon as possible, but avoid too much activity too soon, as it can delay and prolong healing.
Remodeling Stage (three weeks to one year)
Repaired tissue gets stronger and adapts to regular movement.
Gradually adding more activity, stretching, and strengthening exercises helps treat a pulled muscle and return to full strength and function but should be done carefully to avoid re-injury.
Avoid activities that cause pain, but move the muscle gently to prevent stiffness.
Prolonged rest can slow healing, so maintain a balance between rest and exercise.
Ice
Add ice for 10–20 minutes for the first 48 hours to reduce swelling and pain.
Ice helps control inflammation by limiting blood flow to the injured area.
Compression
Use compression stockings or wrap the injured part in bandages to help reduce swelling.
Ensure the binding is not too tight so circulation is not cut off.
Elevation
Raise the injured area above heart level throughout the day.
This helps reduce swelling by allowing fluids to drain away from the injury site.
Heat
After the first two to three days, heat therapy increases blood circulation and improves flexibility, helping the muscle heal.
Eat Healthy
Get enough protein for muscle repair.
Maintain Hydration
Drink plenty of water to help with circulation and muscle lubrication.
Massage and Physical Therapy
These hands-on interventions can improve circulation, help reduce scar tissue, and restore range of motion.
Over-the-counter Medications
If needed, over-the-counter nonsteroidal anti-inflammatory medications like Advil or Motrin (ibuprofen) and Aleve (naproxen sodium) can help with pain and swelling.
Only use as directed.
These steps can help promote faster healing and expedite returning to normal daily activities.
When to Resume Normal Activity
Individuals may need one to two weeks to recover before resuming normal activity for mild strains. However, for more severe injuries, it could take four to six weeks or longer to return to all daily activities. (Harvard Health Publishing, 2023) It’s essential to gradually return to daily activities to avoid reinjury, which can delay and prolong healing. Follow these recommendations to recover from a pulled muscle safely and quickly (Kraemer W., Denegar C., & Flanagan S. 2009)
Once the pain has subsided, the swelling has decreased, and the muscle feels better, start with low-impact exercises.
Slowly resume normal activities, avoiding overexerting the injured area.
Gradually increase activity levels and stop if there is any pain.
Avoid strenuous activities that place excessive stress on the injured muscle until the muscle is completely healed.
Contact a Healthcare Provider
While most pulled muscles heal with home care, seek medical attention if: (Penn Medicine, 2023)
Pain persists or worsens after seven to 10 days.
This can indicate a more serious injury, such as a severe torn muscle.
Significant pain, loss of motion and strength, and swelling disrupt daily activities or show signs of worsening despite rest and self-care.
It is difficult to move the affected area, or the muscle cannot bear weight, suggesting a more severe injury.
There are signs of infection, including redness, warmth, increased swelling, or fever, especially if the skin is cut or broken near the injured area.
There is unusual bruising or a visible deformity, which could indicate a bone fracture requiring professional evaluation.
A healthcare provider may recommend imaging studies, such as MRI, ultrasound, or X-rays, to assess the extent of the injury, rule out fractures, or check for muscle tears.
Injury Medical Chiropractic & Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Say Goodbye to Pain with Chiropractic Care
References
Fernandes, T. L., Pedrinelli, A., & Hernandez, A. J. (2015). MUSCLE INJURY – PHYSIOPATHOLOGY, DIAGNOSIS, TREATMENT, AND CLINICAL PRESENTATION. Revista brasileira de ortopedia, 46(3), 247–255. https://doi.org/10.1016/S2255-4971(15)30190-7
Hospital for Special Surgery. J. N. R., MD. (2024). Muscle Strain: Causes, Symptoms, Treatment. https://www.hss.edu/conditions_muscle-strain.asp
Nölle, L. V., Mishra, A., Martynenko, O. V., & Schmitt, S. (2022). Evaluation of muscle strain injury severity in active human body models. Journal of the mechanical behavior of biomedical materials, 135, 105463. https://doi.org/10.1016/j.jmbbm.2022.105463
Baoge, L., Van Den Steen, E., Rimbaut, S., Philips, N., Witvrouw, E., Almqvist, K. F., Vanderstraeten, G., & Vanden Bossche, L. C. (2012). Treatment of skeletal muscle injury: a review. ISRN orthopedics, 2012, 689012. https://doi.org/10.5402/2012/689012
Laumonier, T., & Menetrey, J. (2016). Muscle injuries and strategies for improving their repair. Journal of Experimental Orthopaedics, 3(1), 15. https://doi.org/10.1186/s40634-016-0051-7
Harvard Health Publishing. (2023). Muscle strain. https://www.health.harvard.edu/staying-healthy/muscle-strain-a-to-z
Kraemer, W., Denegar, C., & Flanagan, S. (2009). Recovery from injury in sport: considerations in the transition from medical care to performance care. Sports Health, 1(5), 392–395. https://doi.org/10.1177/1941738109343156
Penn Medicine. (2023). Strains. https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/strains
For individuals experiencing musculoskeletal pain symptoms like lower back pain and shoulder pain, can incorporating cupping therapy help bring relief and manage pain?
Cupping Therapy
This ancient treatment is gaining public acceptance, and awareness has heightened, with various individuals and athletes being seen with round marks on their shoulders and backs. It is a pain treatment that, like acupuncture, comes from traditional Chinese medicine, or TCM. The therapy involves placing glass, silicone, or bamboo cups on the skin to create suction. The treatment is an alternative medicine technique used to relieve musculoskeletal pain. The suction is believed to promote healing (Cleveland Clinic, 2023)
Increasing Blood Circulation
The suction draws blood to the area, which can help reduce inflammation and promote healing.
Releasing Muscle Tension
The suction can stretch and pull on muscles, which can help relieve pain and tightness.
Breaking Up Adhesions
The suction can help break up scar tissue and adhesions that can cause pain and restricted movement.
Detoxifying the Body
Some practitioners believe that cupping can help remove toxins from the body.
It is typically performed by a trained practitioner who places the cups on the skin and leaves them in place for several minutes. The cups can be placed on various body areas, including the back, neck, shoulders, and legs. (Cleveland Clinic, 2023)
Benefits
Pain relief, especially for muscle and joint pain
Reduced inflammation
Improved circulation
Increased range of motion
Detoxification
Procedure
The medical practice involves creating skin suction using glass, ceramic, or plastic cups. How it’s done:
Preparation
The practitioner cleans the area where the cups will be placed.
They may apply oil or massage cream to the skin for easier movement of the cups.
Techniques
Dry
The practitioner heats the inside of the cup with a flame or pump, creating a vacuum.
The cup is then placed on the skin, which adheres due to the negative pressure.
The cup remains on the skin for several minutes, allowing the suction to draw blood and tissue into the cup.
Wet
Like the dry technique, the practitioner makes small incisions in the skin before applying the cup.
This allows blood to flow into the cup, creating a more intense suction.
Aftercare
The cups are removed, and the practitioner may apply pressure to the area to stop bleeding.
The patient is advised to avoid strenuous activity and hot showers for a few hours after the treatment.
The benefits of therapy include opening pores, stimulating blood flow, filtration, and balancing energy flow through the body. It’s often combined with massage and acupuncture. (Cleveland Clinic, 2023)
It also aims to alleviate symptoms of systematic diseases like diabetes and hypertension. However, more research is needed to see and fully analyze the effects of the treatment. (Aboushanab T. S., & AlSanad S. 2018)
Risks
The therapy is generally safe when done correctly and by a licensed professional. However, there is some risk of side effects like skin discoloration and scarring. Reports of rare side effects include bleeding inside the skull from cupping on the scalp and anemia from repeated wet techniques. (National Center for Complementary and Integrative Health, 2018) Other side effects can include:
Bruising
It can cause temporary bruising at the site of the cups.
Skin Irritation
Some people may experience skin irritation or burns from the suction.
Infection
There is a small risk of infection if the cups are not properly sterilized.
Injury Medical Chiropractic & Functional Medicine Clinic
It is important to consult with a healthcare professional before trying any new treatment, especially if you have any underlying health conditions. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Aboushanab, T. S., & AlSanad, S. (2018). Cupping Therapy: An Overview from a Modern Medicine Perspective. Journal of acupuncture and meridian studies, 11(3), 83–87. https://doi.org/10.1016/j.jams.2018.02.001
National Center for Complementary and Integrative Health. (2018). Cupping. Retrieved from https://www.nccih.nih.gov/health/cupping
Can stretching quadriceps help relieve stiffness and pain and improve flexibility for individuals with consistently tight quadriceps?
Quadriceps Stretches
Walking, running, biking, and other daily activities can tighten the quadriceps muscles. The quadriceps are four muscles in the front of the thigh that extend the leg and strengthen the knee. Stretching the quadriceps may be a part of a home or gym exercise program or physical therapy treatment to maintain quadricep flexibility. Resting the quadriceps with an exercise program can greatly maximize mobility and prevent injury.
Tight quadriceps may sometimes result from injuries such as patellofemoral stress syndrome or iliotibial band friction syndrome. The quads may also become tight for individuals with spinal stenosis or other related problems with the lower back. (International Sports Sciences Association, 2023) Ely’s test, also known as the Duncan-Ely test, is one way to determine whether your quadriceps are tight. It is a physical examination used to assess the flexibility and potential spasticity of the rectus femoris muscle (a quadriceps muscle) by passively flexing the patient’s knee. Lie on your stomach and try to touch your foot to your buttocks. If you can’t, the rectus femoris, one of the main muscles, may be tight and benefit from quadricep stretches. (Olivencia, O. et al., 2020)
Safety and Precautions
Before trying this or any other exercise program, consult a healthcare provider to ensure exercise is safe for you and your conditions. A professional can help diagnose any overuse injury that might be causing tight quadriceps. Quadriceps stretches will be a little more comfortable after warming up. A few minutes of walking or biking will warm the quadriceps muscles to stretch more easily.
Stretches
To stretch the quadriceps, try the standing, side-lying, and prone quadriceps stretch once fully warmed up and after a workout. Individuals who frequently experience quadriceps tightness should stretch them daily. Incorporate all or some of these stretches into a cool-down or off-day flexibility routine.
Standing Stretch
The standing quadriceps stretch can be done anywhere in the office, gym, or outside. All you need is a place to stand. Here is how:
While standing, hold onto a countertop or back of a chair to help with balance.
Bend your knee by grasping your ankle.
Move your foot toward your buttocks.
Gently pull on your ankle to bend your knee as far as possible.
Maintain position for 30 seconds.
Return to the standing position.
Repeat the exercise 3 to 5 times with each leg.
Stop stretching if there are any sharp pains.
Side-Lying Stretch
The side-lying quad stretch lengthens the quadriceps. On the floor in a supported position can help focus on the stretch. Here’s how:
Lie on your side.
Bend the knee of your top leg as far as you can, gently pulling with your hand.
Maintain position for 30 seconds.
Return to the starting position.
Repeat the exercise 3 to 5 more times with each leg.
Prone Stretch
Stretch the quadriceps while lying on your stomach. In this position, the floor helps to stabilize the pelvis, minimizing rocking and maximizing the stretch. To do the stretch:
Lie on your stomach.
Bend your knee back as far as you are able.
Grab your ankle to pull your foot toward your buttocks.
Maintain position for 30 seconds.
Return to the starting position.
Repeat the exercise 3 to 5 more times with each leg.
If you have difficulty reaching your ankle, pull the leg up, wrap a towel or strap around the ankle, and use it to pull. This can help stretch the quadriceps effectively even if you cannot reach the ankle easily.
Injury Medical Chiropractic & Functional Medicine Clinic
Consult a healthcare provider or physical therapist to learn the recommended quadriceps stretches or other strengthening exercises. Keeping the quadriceps healthy will help keep the knees moving and maximize functional mobility. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Chiropractic Care For Leg Instability
References
International Sports Sciences Association. (2023). How to Release Tight Quads in 2 Simple Steps. ISSA. https://www.issaonline.com/blog/post/how-to-release-tight-quads-in-2-simple-steps
Olivencia, O., Godinez, G. M., Dages, J., Duda, C., Kaplan, K., Kolber, M. J., Kaplan, & Kolber (2020). THE RELIABILITY AND MINIMAL DETECTABLE CHANGE OF THE ELY AND ACTIVE KNEE EXTENSION TESTS. International journal of sports physical therapy, 15(5), 776–782. https://doi.org/10.26603/ijspt20200776
Could making their own cervical neck roll help relieve pain and improve sleep for individuals who have neck pain after sleeping or during sleep?
Sleep Cervical Neck Roll
Neck pain can lead to sleep loss, leading to various health problems. Neck pain and everything that comes with it can limit the ability to work, drive, or sleep normally. A cervical roll may be one way to keep your neck in the optimal position while sleeping. Many with neck pain require extra support from their pillow. A cervical pillow can provide that support.
For individuals who develop neck pain, a visit to a chiropractic physical therapist can help manage symptoms. Treatments and modalities like traction may be necessary to relieve pressure on cervical nerves. (Gudavalli M. R. et al., 2015) Steps to self-manage neck pain may include performing specific neck exercises and maintaining proper posture (Hesby B. B. et al., 2019). Using the right pillow with the right support can help keep the neck in correct alignment, decrease or eliminate neck pain, and get you back to normal activities.
Neck Support During Sleep
The neck comprises seven vertebrae bones, normally forming a slight curve called lordosis. Maintaining a forward curve in the neck is important when treating neck pain, as it can help relieve pressure on spinal discs and nerves. A cervical roll, also known as a neck roll or cervical pillow, is a small pillow placed in the pillowcase that supports the neck while sleeping. The cervical roll provides the right amount of support for the neck and maintains alignment while lying down. (Gross A. R. et al., 2013)
Individuals can purchase a cervical roll online or at a store or pharmacy.
Individuals can also contact a physical therapist to help them obtain a cervical roll.
Making Your Own
Making a cervical roll is simple to do. Here’s how:
Using a hand towel.
Fold it in half.
Slide the towel into the pillowcase along the lower edge.
Be sure the towel is tucked in so it doesn’t slip out.
Individuals can place tape around it so it stays in the rolled shape.
The towel roll will also help support the neck when lying on one side or the other, filling in the space between the head and shoulder. Sleeping on the stomach is usually not recommended for neck pain. Exercise and postural correction training are essential components of treatment for neck pain, and finding the right sleeping posture can help quickly eliminate pain. (Harvard Publishing, 2022)
If neck pain persists, worsens, or is accompanied by arm weakness or numbness and tingling, a visit to a healthcare provider may be necessary to assess the cause. A visit to a local chiropractic physical therapist can also help. They can immediately show you how to treat neck pain.
Injury Medical Chiropractic & Functional Medicine Clinic
A cervical roll can give your neck the right support while sleeping. This can help you quickly and safely manage neck pain and return to your previous level of function. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
The Road To Recovery: Chiropractic Care
References
Gudavalli, M. R., Salsbury, S. A., Vining, R. D., Long, C. R., Corber, L., Patwardhan, A. G., & Goertz, C. M. (2015). Development of an attention-touch control for manual cervical distraction: a pilot randomized clinical trial for patients with neck pain. Trials, 16, 259. https://doi.org/10.1186/s13063-015-0770-6
Hesby, B. B., Hartvigsen, J., Rasmussen, H., & Kjaer, P. (2019). Electronic measures of movement impairment, repositioning, and posture in people with and without neck pain-a systematic review. Systematic reviews, 8(1), 220. https://doi.org/10.1186/s13643-019-1125-2
Gross, A. R., Kaplan, F., Huang, S., Khan, M., Santaguida, P. L., Carlesso, L. C., Macdermid, J. C., Walton, D. M., Kenardy, J., Söderlund, A., Verhagen, A., & Hartvigsen, J. (2013). Psychological Care, Patient Education, Orthotics, Ergonomics, and Prevention Strategies for Neck Pain: A Systematic Overview Update as Part of the ICON Project. The open orthopaedics journal, 7, 530–561. https://doi.org/10.2174/1874325001307010530
Harvard Health Publishing. (2022). Say “good night” to neck pain. https://www.health.harvard.edu/pain/say-good-night-to-neck-pain
For individuals experiencing lower back pain and sciatica symptoms, can using a lidocaine patch help?
Lidocaine Patch
Lidocaine patches are in a drug class called local anesthetics (MedlinePlus, 2025) (Food and Drug Administration, 2022). They relieve pain in small body areas by blocking the nerves from sending pain signals. The Food and Drug Administration approved lidocaine 5% or 1.8% patches for relieving postherpetic neuralgia (PHN) pain. These lidocaine patches are prescription-only (Food and Drug Administration, 2022). They are available either by prescription or over the counter and are commonly used for back pain and other areas. Over-the-counter lidocaine, 4% patches, can be used to relieve minor aches and pains, including back pain. However, further research is needed to recommend the use of lidocaine patches as an effective method of pain relief. (Department of Veterans Affairs/Department of Defense, 2022) (North American Spine Society, 2020)
The Patch
They are available in prescription and over-the-counter forms. Over-the-counter forms come as a 4% patch in various brands, such as (MedlinePlus, 2025)
Aspercreme
Lidocare
Salonpas
Prescription-only patches come in 5% or 1.8% patches and are approved to relieve long-term nerve pain from shingles in adults. Zlido is a brand name for a 1.8% lidocaine patch. Five percent lidocaine patches are available generically. (DailyMed, 2018) (Food and Drug Administration, 2021) The safety and effectiveness in children are unknown. (Food and Drug Administration, 2022)
Other Lidocaine Forms
As a local anesthetic, it is available in several other forms, including:
Spray
Topical cream
Lotion
Liquid
Ear drops
Eye gel
Injection
It is also available as a short-term intravenous infusion for abnormal heart rhythm. (DailyMed, 2025)
Effectiveness
Clinical trials have shown that the patches effectively relieve chronic low back pain. However, these studies were nonrandomized and did not include a control group to compare against the treatment group. (Santana J. A., Klass S., & Felix E. R. 2020) The results may be subject to potential biases. For this reason, further evidence is needed to support lidocaine patches’ effectiveness in reducing low back pain. (North American Spine Society, 2020) High-quality randomized and controlled clinical trials are necessary to study the effectiveness. (North American Spine Society, 2020) (Santana J. A., Klass S., & Felix E. R. 2020)
Clean and dry the affected area before placing the patch.
Apply to the affected body area as directed.
Wash your hands after touching the patch.
Remove the patch after what is usually recommended after eight hours.
How Quickly Does It Work?
The amount of medication absorbed into the blood depends on how long the patch is placed on the body and how much is covered with the patch. In a study, healthy participants wore three lidocaine patches on their backs for 12 hours on and 12 hours off during 24 hours. Lidocaine levels were highest at 11 hours. At the end of the 24 hours, there was still some lidocaine left in the bloodstream. (Food and Drug Administration, 2022)
Individuals with PHN may notice a difference in pain intensity after four hours of using the patch. (Rowbotham, M. C. et al., 1996) (Food and Drug Administration, 2022) Experts may suggest using patches for four weeks for those who experience pain after their shingles rash disappears. However, if there is still pain after these four weeks, it is recommended to see a pain specialist. (Gross, G. E. et al., 2020)
Side Effects
Common side effects are typically mild skin reactions where the patch is. These reactions are usually temporary and will disappear within a few minutes or hours. Examples include: (Food and Drug Administration, 2022)
Severe allergic reactions are rare, but it is possible.
Symptoms include breathing problems, itchiness, and rash.
Methemoglobinemia
Methemoglobinemia is a condition that makes it hard for red blood cells to carry oxygen.
Individuals may experience symptoms of blue-looking skin, headache, lightheadedness, shortness of breath, abnormal heart rhythm, or seizures.
Using too many lidocaine patches to cover large parts of the body or using the patches longer than 12 hours within 24 hours may cause side effects that may include heart-related effects, such as a slow heart rate and low blood pressure. Individuals may also experience the following side effects (Food and Drug Administration, 2022)
Hot or cold sensation
Numbness
Dizziness
Ringing ears
Lightheadedness
Mood changes
Drowsiness to unconsciousness
Vision changes
Seizures
Tremors
Vomiting
Injury Medical Chiropractic & Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Sciatica Causes and Treatments
References
National Library of Medicine. MedlinePlus. (2025). Lidocaine transdermal patch. Retrieved from https://medlineplus.gov/druginfo/meds/a603026.html
Food and Drug Administration. (2022). Lidoderm label. Retrieved from https://www.accessdata.fda.gov/spl/data/eedfe43b-1019-19a0-e053-2995a90a7696/eedfe43b-1019-19a0-e053-2995a90a7696.xml
Department of Veterans Affairs/Department of Defense. (2022). VA/DoD clinical practice guideline for the diagnosis and treatment of low back pain. Retrieved from https://www.healthquality.va.gov/guidelines/Pain/lbp/VADoDLBPCPGFinal508.pdf
North American Spine Society. (2020). Evidence-based clinical guidelines for multidisciplinary spine care: diagnosis and treatment of low back pain. https://www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LowBackPain.pdf
National Library of Medicine. DailyMed. (2018). Label: lidocaine patch. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5c66f3b9-6e04-47ab-8d94-21e89ceec154
Food and Drug Administration. (2021). Ztlido label. Retrieved from https://www.ztlido.com/wp-content/uploads/2022/12/ZTlido-LABEL.pdf
National Library of Medicine. DailyMed. (2025). Lidocaine-lidocaine hydrochloride injection, solution. Retrieved from https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=f1b26274-a55e-4321-b96c-ce0df830f205
Santana, J. A., Klass, S., & Felix, E. R. (2020). The Efficacy, Effectiveness and Safety of 5% Transdermal Lidocaine Patch for Chronic Low Back Pain: A Narrative Review. PM & R: the journal of injury, function, and rehabilitation, 12(12), 1260–1267. https://doi.org/10.1002/pmrj.12366
Rowbotham, M. C., Davies, P. S., Verkempinck, C., & Galer, B. S. (1996). Lidocaine patch: double-blind controlled study of a new treatment method for post-herpetic neuralgia. Pain, 65(1), 39–44. https://doi.org/10.1016/0304-3959(95)00146-8
Gross, G. E., Eisert, L., Doerr, H. W., Fickenscher, H., Knuf, M., Maier, P., Maschke, M., Müller, R., Pleyer, U., Schäfer, M., Sunderkötter, C., Werner, R. N., Wutzler, P., & Nast, A. (2020). S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia. Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology: JDDG, 18(1), 55–78. https://doi.org/10.1111/ddg.14013
Learn about the clinical approach of identity formation and its role in facilitating personal insight and emotional well-being.
Introduction
Many individuals deal with musculoskeletal, autoimmune, gut, or body issues that can affect their daily routine and how they perceive themselves when getting checked out by their doctors. Many healthcare professionals can help assess individuals with these pain-like symptoms causing overlapping risk profiles by creating a safe and positive experience with a clinical approach. By creating a secure environment, many individuals can have good experiences when pain-like issues are affecting their bodies. By delving into today’s article, we are going to look into identity formation, the four identity statuses, and the various areas of identity development.
Theories & Types of Identity Formation
A lot of individuals have an identity, but have they always had one? Everyone’s identity is a conglomeration of the characteristics, values, and attributes they consider significant and use to define themselves. People’s identities are developed as they mature and gain knowledge about the world; they are not forced upon them. Adolescence is the first period when individuals notice a significant change toward identity creation and self-exploration.
A major concern in theories of teenage development is identity building. Identity formation, for instance, was emphasized as the main sign of effective development throughout adolescence in Erikson’s 1968 classic theory of developmental phases. Teenagers who struggle to define their identities may have role confusion, which suggests that they need to do more self-discovery and are unclear of their place in the world.
The Four Identity Statuses
Many healthcare providers will hear their patients describe identity formation during adolescence as it involves decision points and commitments regarding belief systems (e.g., religion, politics) and occupations. The four modes of reacting to late identity crises during the adolescent phase were described, measured, and validated so that individuals could figure out their identity status. (Marcia, 1966) The four described identity statuses are:
Foreclosure: An individual commits to an identity without exploring options.
Identity diffusion: When individuals neither explore nor commit to any identities.
Moratorium: A state in which individuals actively explore options but have not made commitments.
Identity achievement: When individuals have explored different options and made identity commitments.
For example, teens may commit to an identity without exploring if they are content with the values, culture, and religion they were raised in. Teens in foreclosure status may adopt large parts of their parents’ identities or the identity parents have put them on. However, when teens achieve identity, they can explore the world for themselves and decide how they identify due to those experiences. This causes them to relinquish their claims of infantile sources of gratification, thus renouncing lingering fantasies of competence. (Marcia, 1967) At the same time, many people have experienced things that led to a crisis. The thing is that a crisis doesn’t necessarily mean a negative event; it’s simply branching out from what’s comfortable to discover who they are.
Understanding The Effects Of Personal Injury- Video
Various Areas of Identity Development
As a stage in the adolescent life cycle, identity development happens to many people. For many, the search for identity begins in the teenage years. During these years, adolescents are more open to taking on different behaviors and appearances to discover who they are. In an attempt to find their own identity and discover who they are, adolescents tend to cycle through several identities to find one that suits them best. Multiple factors like family life, environment, and social status can make it difficult to develop and maintain an identity. Some studies suggest that this process might be more accurate to identity development rather than formation but confirm this is a typical change process in people’s thoughts about themselves.
Several different areas of identity development are described:
Religious identity: Teens’ religious views are similar to those of their families. Many may question specific customs, practices, or ideas in their parents’ faith, but a few may completely reject their families’ religion. This is due to the dynamic of the parent-adolescent relationship with religion, which exerts positive effects on adolescent adjustments. (Kim-Spoon et al., 2012)
Political identity: Adolescents’ political identity is influenced by their parents’ political beliefs. In the 21st century, a new trend shows decreased political affiliation among young adults. However, many adolescents tend to be more liberal than their elders on social issues. This is because many adolescents encounter events that trigger their civic interest and challenge their beliefs and moralities. (Stattin et al., 2017) Like in other aspects of identity formation, adolescent individuals are predicted by their parents’ involvement and current events when there is an interest in politics.
Vocational identity: Adolescents in earlier generations envisioned themselves working in a particular job and often worked as apprentices or part-time in such occupations. This is a rare case for many people in today’s world. Vocational identity is also related to ego identity by correlating with a successful transition from school to work, allowing individuals to be more confident in their decision-making ability, especially in environmental ambiguities. (Koo & Kim, 2016) Still, vocational identity takes a bit longer to develop since many workplaces require specific skills and knowledge that require additional education or are acquired on the job. Additionally, many job opportunities held by teens are not in occupations many will seek as adults.
Ethnic identity: Ethnic identity refers to how many individuals come to terms with who they are based on ethnicity or racial ancestry. According to the U.S. Census 2012, Americans under 18 are from historically marginalized ethnic groups. Many people who identify under BIPOC (Black, Indigenous, people of color) have discovered their ethnoracial identity as an important part of their identity formation as teens.
Gender identity: Gender identity involves an individual’s sense of gender and can be similar to or different from their biological sex regardless of age group. Gender identity greatly influences many adolescents during these years of self-discovery and can impact other areas of identity, like religion and politics.
Self-Concept
Self-concept and self-esteem are the two primary facets of identity formation. The capacity of an individual to have views and beliefs established with confidence, consistency, and stability throughout the course of their life is the central premise of self-concept. Cognitive growth in early adolescence leads to increased self-consciousness, awareness of others and their opinions, the ability to think about abstract future possibilities, and the ability to weigh many alternatives at once. As a consequence, many teenagers will stop using straightforward, global, and concrete self-descriptions when they are younger. As kids, they use physical characteristics like gender, hair color, or whether they’re quick to identify themselves.
Many teenagers have the ability to imagine many “possible selves” that they may become, and the decisions they make may have long-term effects or possibilities. Exploring these options may cause individuals to make sudden changes in how they show themselves when the teenager selects or rejects traits and actions. In addition, when combining their combinational operation with their degree of identification, both men and females exhibit strong positive connections. (Wagner, 1987) This in turn means directing the real self in the direction of the ideal self. The ideal self differs from person to person; many individuals aspire to be the person they want to be, while many others dread becoming the person they do not want to be. Many may find this unsettling, but it may also serve as motivation by demonstrating consistent conduct that aligns with the ideals and distinguishes the feared potential selves.
Our ideal and frightened selves may be simultaneously explored and discovered. In an effort to create their own identities, many young people may observe characteristics in their family members, friends, or other community members and begin to consider what they like and dislike at the same time. Teenagers learn to identify the factors that impact their conduct and how others see them, which leads to a further distinction in their self-concept known as differentiation. Differentiation seems to be completely established by mid-adolescence and peaks when students enter the seventh or ninth grade. Nowadays, identifying contradictory material in one’s self-concept is a frequent cause of anxiety. Nonetheless, by promoting their exploration and growth, it might help a lot of teenagers.
Self-Esteem
Self-esteem is the other component of identity building. By definition, one’s ideas and emotions about one’s identity and self-concept constitute one’s self-esteem. Many views contend that a strong desire to preserve, defend, and improve oneself is a component of self-esteem. Contrary to common opinion, little evidence supports these views, suggesting that teenage self-esteem has significantly declined. The two sexes have distinct levels of self-esteem; women have higher levels of self-esteem when they have supportive friendships. However, women have poor self-esteem when they are unable to meet someone with similar interests and hobbies or when they are unable to get the acceptance of their friends.
Males have varied levels of self-esteem. Males are more focused on defining authority and establishing and claiming their independence regarding self-esteem. This, in turn, enables men to effectively have high self-esteem via the influence of their peers and friends. However, a male’s poor self-esteem may be further exacerbated by a lack of romantic abilities or the inability to sustain another person’s attachment.
Conclusion
Numerous medical experts may use a clinical approach to identity development to provide a secure environment and a satisfying experience for people when evaluating the pain-like sensations impacting their bodies. Additionally, by offering a variety of alternatives in their individualized treatment plans to improve their health and well-being, a thorough awareness of the significance of identity development helps foster positive relationships with patients.
Injury Medical & Functional Medicine Clinic
We associate with certified medical providers who understand the importance of identity formation when assessing individuals dealing with various pain-like symptoms within their bodies. When asking important questions to our associated medical providers, we advise patients to implement small changes to their daily routine to reduce the pain-like symptoms associated with body pains. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.
References
Kim-Spoon, J., Longo, G. S., & McCullough, M. E. (2012). Parent-adolescent relationship quality as a moderator for the influences of parents’ religiousness on adolescents’ religiousness and adjustment. J Youth Adolesc, 41(12), 1576-1587. https://doi.org/10.1007/s10964-012-9796-1
Koo, H.-Y., & Kim, E.-J. (2016). Vocational Identity and Ego Identity Status in Korean Nursing Students. Asian Nursing Research, 10(1), 68-74. https://doi.org/10.1016/j.anr.2015.11.001
Marcia, J. E. (1966). Development and validation of ego-identity status. J Pers Soc Psychol, 3(5), 551-558. https://doi.org/10.1037/h0023281
Marcia, J. E. (1967). Ego identity status: relationship to change in self-esteem, “general maladjustment,” and authoritarianism. J Pers, 35(1), 118-133. https://doi.org/10.1111/j.1467-6494.1967.tb01419.x
Stattin, H., Hussein, O., Ozdemir, M., & Russo, S. (2017). Why do some adolescents encounter everyday events that increase their civic interest whereas others do not? Dev Psychol, 53(2), 306-318. https://doi.org/10.1037/dev0000192
Finger pulley injuries are unique digital injuries distinct from sprains or dislocations. They occur specifically in rock climbers and occasionally in baseball pitchers. What are the symptoms, diagnoses, and treatments available?
Finger Pulley Injury
A finger pulley injury, common in activities like climbing, involves damage to the fibrous bands (pulleys) that hold tendons against bones. This causes pain, swelling, and potentially bowstringing of the tendons.
Finger pulleys are structures that hold tendons against the bones of the fingers.
Injury symptoms include pain, swelling, and a popping sound heard at the time of the injury.
Finger pulley injuries, or ruptures of the digital pulley, are seen almost exclusively in rock climbers. (Miro P. H. et al., 2021)
This activity stresses the digits when maneuvering along uneven surfaces while supporting the entire body’s weight. The injuries result from the mechanics of the finger tendons and joints and the position the fingers hold while rock climbing. Rock climbing has grown in popularity. The only other sport in which this injury has been described is baseball, in pitchers. The forces acting on the finger are very different in these activities, but both place high stress on the finger pulleys.
Digital Pulleys
Everyone has structures in their fingers called digital pulleys. These pulleys hold the tendons against the bones of the fingers. Each finger has eight pulleys, but only two are considered critical to prevent the finger tendons’ bowstringing (when one pulley gives out or ruptures). This can result in various injury outcomes, from a simple strain of the pulley to ruptures of multiple pulleys in a single digit. Pain, stiffness, and an inability to fully flex the finger can occur. (Carruthers K. H., Skie M., & Jain M. 2016) In severe situations, when the tendons are bowstringing, the tendon may lift away from the finger when making a fist.
Symptoms
Pain and Tenderness
Localized pain and tenderness at the finger’s base, particularly when gripping or bending. Pain on the palm side of finger and tenderness with pressure
Swelling
Swelling and bruising around the affected finger joint, especially on the palm side.
Stiffness and pain when bending the fingers or difficulty gripping. Difficulty forming a fist
Bowstringing
Visible displacement of the tendon from its normal position, causing a bulge at the finger’s base.
Most commonly, the middle or index digit is the injured finger. The two critical pulleys in the finger are designated the A2 and A4. (Carruthers K. H., Skie M., & Jain M. 2016) Individuals may see swelling, redness, and inflammation at the base of the finger (A2) and/or in the space between the two finger joints closest to the tip of the finger (A4). In rock climbers, either or both of those pulleys may be injured. In baseball pitchers, the injury is typically isolated to the A4 pulley.
Causes
Overuse and Repetitive Strain: Frequent or intense gripping or crimping, common in rock climbing and other activities, can cause pulley injuries.
Dynamic or Sudden Movements: Desperate or dynamic moves or poor technique can lead to injury.
Excessive Force: Pulleys can rupture when the force exerted on them is too great.
Mechanism of injury: The A2 pulley is the most commonly injured, followed by the A4 pulley.
Diagnosis
Emergency treatment is generally unnecessary. However, it is important to have suspected digital pulley injuries examined by a specialist within several days to a week after the injury. The most important aspect of an evaluation is determining whether the injury has caused the bowstringing of the tendons. Imaging tests may be performed to help with the diagnosis and plan treatment. An ultrasound is recommended as the initial imaging technique. (Miro P. H. et al., 2021)
If an ultrasound is inconclusive, an MRI may be advised. Sometimes, an MRI is performed with the finger held straight and then bent to see if the tendons are bowstringing. An X-ray can also help exclude other causes of finger pain, including sprains and fractures.
Treatment
Conservative Care
Immobilization, physical therapy, and pulley-protective measures, such as splints or taped fingers, are often used.
Surgery
Surgery may be necessary for severe grade IV injuries where conservative care fails.
Only in situations where there are multiple pulley ruptures or if there is delayed treatment should surgery be necessary.
Rehabilitation
Focuses on regaining flexibility, strength, and grip function through exercises and physical therapy.
If the tendons do not bowstring, treatment usually protects the injured finger until swelling and pain subside. If there is bowstringing of the tendons, more careful management of the injury is needed. Individuals who suspect a pulley injury rest or splint the finger and use nonsteroidal anti-inflammatory drugs as necessary for pain until they can get a medical evaluation. (Carruthers K. H., Skie M., & Jain M. 2016) Physical therapy, along with immobilization, the H-tape method, and a protective pulley splint, are recommended for most injuries. (Miro P. H. et al., 2021) Specialized splints and therapy techniques can allow the pulleys to heal properly.
Returning to activity varies significantly with the severity of the injury. With mild pulley strains, full activity can be resumed as soon as swelling and pain have subsided. Treatment for full ruptures being treated non-surgically is typically between one and three months. For individuals requiring surgical reconstruction of a pulley injury, restrictions may apply up to a year after the surgery.
Injury Medical Chiropractic & Functional Medicine Clinic
To prevent complications, a healthcare provider should evaluate pulley injuries as soon as possible. Treatment most often consists of physical therapy, but surgery may be necessary. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Sports Injury Treatments
References
Miro, P. H., vanSonnenberg, E., Sabb, D. M., & Schöffl, V. (2021). Finger Flexor Pulley Injuries in Rock Climbers. Wilderness & environmental medicine, 32(2), 247–258. https://doi.org/10.1016/j.wem.2021.01.011
Carruthers, K. H., Skie, M., & Jain, M. (2016). Jam Injuries of the Finger: Diagnosis and Management of Injuries to the Interphalangeal Joints Across Multiple Sports and Levels of Experience. Sports Health, 8(5), 469–478. https://doi.org/10.1177/1941738116658643
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Digital Pulleys
