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Sprain versus Strain Injuries
Causes, Symptoms and Treatments

Sprain versus Strain Injuries

The words sprain and strain are often used interchangeably when talking about soft tissue injuries. They may appear similar, but the underlying injury is different.

A SPRAIN happens when ligament tissue has been stretched or torn. Ligaments are a tissue that attaches bone to bone and helps keep structures stable. The most common areas for sprains are the ankles, knees and wrists.

Sprains usually happen suddenly because of falling awkwardly, sports injuries or car accidents. When you twist, push, hit or quickly and unexpectedly move a joint in a non-typical way, ligament damage and a sprain can be the result.

A STRAIN happens when a muscle or tendon is damaged. Tendons are a tissue that attaches muscle to bone. The most common areas for strains are the elbows, hamstring muscles and lower back.

Strains are often caused by stressing the area over time. Repetitive movements, exercising the same muscles without enough rest or repeated heavy lifting are often the cause of strains. Strains are also referred to as "torn" or "pulled" muscles.

Sprains and Strains of the Elbow Joint

Both injuries tend to have swelling, pain in the affected joint, create reduced flexibility and make it difficult to use the joint's full range of motion. The primary differences are that sprains also tend to have bruising, while strains may produce muscle spasms.

Immediate treatment can best be summed up in the word PRICE, but those letters don't mean what you think.

P=PROTECT the injured body part from further harm.

R=REST for a day or two, while your body heals.

I=IGNORE icing. That's right, don't bother icing the injured part unless a doctor specifically prescribes it. Clinical studies have shown that icing can reduce short-term pain, but it slows down muscle healing.

C=COMPRESSION. Make sure compression bandages are applied appropriately. You want to avoid non-elastic bandages that don't flex. They can reduce the blood flow too much, potentially causing ischemia. Use elastic bandages that stay in place, but that can still expand and contract with your muscles.

E=ELEVATE the injured body part to slow blood flow to the affected area. It should only be done short-term as a way to reduce painful swelling. Long-term elevation should only be done under the direction of a doctor, because good circulation is critical for long-term recovery.

Both sprains and strains can be serious. If you experience any of these six signs, you need to go see a doctor.

1. If you've got any numbness or tingling.
2. If the pain is bad enough you have to limp.
3. If the pain interrupts your sleep or interferes with your daily activities.
4. If the pain continues to get worse over time.
5. If you develop fever or chills, a possible sign of infection.
6. If the pain doesn't go away in a day or two.

A doctor will typically order an X-ray, to make sure there aren't broken bones or fractures. If the X-ray's not clear, you might also be asked to get an MRI. An MRI can give very detailed images of the joint, potentially showing very small fractures or breaks in the bone an X-ray might miss.

If you don't have any breaks or injuries to the bone, your doctor will likely diagnose you with a sprain or strain. The treatment for a moderate injury is rest for the first 2-3 days, then return to limited activities. Take extra precautions to protect the joint for the next 1-2 months.

More severe sprains or strains can take much longer to heal. You may be prescribed physical therapy to regain range of motion and build strength.

The most severe sprains or strains may require surgery to repair damaged or torn ligaments, tendons or muscles. Healing properly requires long-term protection of the damaged area and physical therapy. Plan on it taking up to a year for full recovery.

Your best way of dealing with either problem is prevention. Learn how to move properly in competitive contact sports. Make sure workout routines include minor supporting muscles, not just the big “vanity” muscles. Give your body plenty of rest between workouts. Don't try to push yourself too far when you're just starting. Be extra cautious on wet, slippery or icy surfaces.

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