Understanding Sprains & Strains
A sprain is a stretch or tear to a ligament (a band of tissue that connects two or more bones to a joint). A strain, however, is an injury to a muscle or tendon (cords of tissue that connect muscle to bone). The severity of a sprain or strain can be identified by the extent of tissue tearing and its impact on physical movement.
Sprains most commonly occur in ankles, knees, and wrists. The most common areas for a strain are the foot, back, and the hamstring muscle.
A sprain or strain can be caused by a twist, pull, or force to the body that stretches or tears the ligament, muscle, or tendon.
An acute strain can be the result of a trauma, sports injury, improperly lifting heavy objects, or overstressing the muscles. Acute sprains can occur after a fall, a sudden twist, or a force to the body that pushes a joint out of its place and stretches or tears the ligament supporting that joint. Typically, sprains occur when people fall and land in an awkward or unsteady position.
Chronic strains or sprains are usually the result of overuse: repetitive movement of the joints, muscles, or tendons.
Signs & Symptoms
The signs and symptoms of sprains include pain, swelling, bruising, and limited joint motion. A pop or tear may be felt when the injury occurs. People with a strain may experience pain, limited motion, muscle spasms, and muscle weakness. They also can have swelling or inflammation. All symptoms can vary in intensity, depending on the severity of the sprain or strain.
Diagnosing a Sprain or Strain
Doctors will examine the injury for redness, swelling, bruising, and sensitivity. They will also observe joint or muscle mobility and range of motion. In addition, the physician will obtain information about the incident that may have caused the injury, and the level of pain. This information will help the doctor to diagnose the severity of the sprain or strain.
Levels of Severity for Sprains or Strains:
Grade 1 (mild) – little tearing, pain or swelling; mild tenderness, full range of motion
Grade 2 (moderate)– partial tearing, with limited motion and moderate to severe pain and swelling
Grade 3 (severe) –completely torn tissue; joint or muscle is unstable; severe pain and swelling
An x-ray may be needed to help the physician determine whether it is a sprain, strain, or fracture. Magnetic resonance imaging (MRI) is occasionally used to determine the severity of a tear in tissue, or can help rule out other injuries.
Treatment for a Sprain or Strain
Treatments for sprains and strains are similar and begin with trying to decrease swelling and pain. Doctors usually advise patients to use the ‘RICE Therapy’: rest, ice, compress, and elevate the area for the first 24 to 48 hours after the injury. They may also recommend an over-the-counter or prescription medication to help reduce pain and inflammation.
Your healthcare provider may advise you to not put weight on an injured area for 48 hours.
Apply an ice pack to the injured area for 20 minutes at a time, four to eight times a day.
Compression, such as bandages or wraps, of an injured area may help reduce swelling.
Keep the injured body part elevated on a pillow, above the level of the heart, to help decrease swelling.
For people with a moderate or severe sprain, a cast or splint may be applied. Severe sprains and strains may require orthopedic surgery to repair the torn ligaments, muscle, or tendons. If the strain is moderate to severe, it is important to be evaluated by a healthcare provider promptly.
See a healthcare provider for your sprain or strain if…
- You feel severe pain and cannot put any weight on the injured joint
- The injured area looks crooked or has lumps and bumps (other than swelling)
- You are unable to move the injured joint or muscle
- Feel numbness in any part of the injured area
- Redness or red streaks spread out from the injury
- The area has been injured before
- You have concerns about the severity of the sprain or strain
Tips for Prevention:
In order to lower your risk of a strain or sprain:
- Rest when muscles are tired or in pain
- Maintain a healthy diet and weight
- Safely navigate walkways and stairwells to prevent falls
- Run on even surfaces
- Wear shoes that fit and replace athletic shoes as soon as the tread or heel wears down
- Stretch daily
- Wear protective equipment when exercising or playing sports