Have you ever injured a muscle or a tendon or sprained an ankle? Most people who exercise have had one or more injuries that impacted their ability to exercise at some point in their life. Fortunately, most are not serious and will heal over time. We tend to lump these kinds of injuries into the category of strains or sprains. But, in reality, the two are distinct injuries. Do you know the difference and is the treatment for the two entities different?
What is a Strain?
A strain is an injury to a muscle or a tendon, the thick bands of connective tissue that connect muscles to bones. Strains usually involve stretching a tendon or muscle too far, to the point that the tendon becomes inflamed. In some cases, the tendon may develop a tear, either a partial or a full tear.
The most common movements that cause a muscle or tendon strain is twisting a muscle or a movement that forces the muscle to stretch too far and then contract. For example, people who participate in sports that require jumping are at high risk of developing hamstring strains. Sprinting also carries a high risk of straining a hamstring muscle if you don’t warm up beforehand or try to sprint when your muscles and connective tissue are not yet conditioned enough to handle the stress. In terms of the upper body, people who play sports that involve throwing, such as baseball and tennis are at high risk of straining a muscle or tendon.
In contrast, a sprain is an injury to a single ligament or more than one ligament, the connective tissue that connects a bone to another bone. The ankle is one of the most common sites of a sprain. The sprain can occur when you twist a foot while playing sports or when you misstep and your foot turns too far inward, placing excessive stress on the ligaments that support the outside of your ankle. Like a strain, the ligament can simply overstretch or it can tear.
By now, you’re probably wondering how to tell if you have a sprain or strain, whether you need to see a doctor, and what you can do at home to treat it.
Signs and Symptoms of Sprains and Strains
With a sprain, you might experience the sudden onset of pain and swelling around a joint. Some people hear a pop at the moment a sprain happens. It’s also not uncommon to experience bruising at the site of a sprain. In contrast, a muscle or tendon strain is less likely to cause bruising or swelling. In contrast, a strained muscle or tendon usually doesn’t cause bruising. Instead, it triggers muscle spasms or cramping and may cause weakness as well. Like sprains, strains can happen suddenly when you overstretch or tear a tendon or muscle. This might happen when you’re lifting something, jumping, sprinting, or throwing something. However, muscle strains can also develop gradually from repetitive movements.
How Do You Treat Strains and Sprains?
Although sprains and strains involve different tissues, the treatment for each is similar. Physical therapists use mnemonic RICE, which stands for:
Ice, compression, and elevation are primarily directed toward easing the swelling. In general, swelling is more common with a sprain than a strain. The RICE plan is what physicians recommend for the first three days after a sprain or strain, particularly a sprain with swelling. Apply an ice pack every 3 hours for the first 2-3 days. For compression, an elastic bandage applies counterpressure to reduce the swelling.
When should you see a physician? If you have problems bearing weight or moving the affected area or if you have numbness, locking of the joint, a limb gives way when you bear weight, or you have significant swelling, it’s a good idea to seek medical evaluation.
There are different grades of sprains. A grade one sprain will usually heal without medical intervention, but a grade two sprain may need short-term immobilization initially with a brace or cast. Once the swelling and pain subsides, it’s important to do gentle, range-of-motion exercises that help restore joint function. Physical therapy is also helpful.
Grade three sprains are the most severe because the ligament is completely torn. Some cases may require surgery. Sprains are more likely to cause problems than strains, as injuring or tearing ligaments can negatively impact joint stability longer-term. An example is a shoulder or ankle sprain.
People with an ankle sprain that doesn’t completely heal can develop chronic ankle instability. Because the joint is unstable, these individuals can have intermittent pain and swelling and are at higher risk of injuring the ankle again. Repeated ankle sprains can also lead to ankle instability. This can even cause issues with balance.
Unlike sprains, which can sometimes require immobilization or even surgery, muscle and tendon strains usually heal with rest, although it can take weeks and sometimes months for the discomfort to completely subside. The most common strains are back strains and strain of a hamstring muscle.
As far as exercise, pain determines how much you’re able to do. Avoid doing exercises that worsen the discomfort. Stay active by doing activities that don’t exacerbate the symptoms. Whether you exercise or not, you need to stretch the affected limbs to avoid stiffness.
Try to Avoid Getting One in the First Place!
You’re more likely to experience a strain or sprain if your body isn’t yet conditioned to do the workout you’re asking it to do. For example, build up a baseline level of conditioning before trying to sprint to avoid a hamstring strain. Always do a dynamic warm-up before doing a workout and stretch afterward. Make sure the training you do is balanced and that you’re working the agonist and antagonist muscles equally to avoid muscle imbalances. Also, pick your shoes carefully. Poorly fitting shoes and ones that don’t provide adequate support and increase the risk of injury. If you have had repeated ankle sprains, your physician may recommend wearing an ankle brace when exercising to reduce the risk of a repeat ankle injury.
The Bottom Line
Strains and sprains are both common, and sprains, particularly high-grade ankle sprains, have the potential to cause the greatest problems as they impact joint stability. The best approach is to take precautions to lower the risk of strains and sprains. If you get one, be aware of when you need to see a doctor and when you can treat it at home.
OrthoInfo.com. “Sprains, Strains and Other Soft-Tissue Injuries”
Up-to-Date. “Ankle Sprains”