What is the difference between a strain and a sprain?

Posted by Jacqueline Carpenter on 27th Dec 2016

If you have ever played a sport growing up, slipped and fell on ice during the winter, or caught a limb in tight spaces, you may have endured a strain or a sprain at some point in your life. Your ankle, your shoulder or another joint began to ache, bruise and swell after a fall. Perhaps you were injured, but never went to the doctor for treatment and just let it heal on its own. But, would knowing what ailment you suffered help you heal faster? Is there any difference in the treatment of the two?

As a reminder, a ligament is the connective tissue that connects two or more bones at a joint; for example, the anterior cruciate ligament (ACL) connects the femur to the tibia and helps stabilize the knee. A tendon is connective tissue that connects a muscle to the bone. A sprain is classified as an injury, either a tear over overstretching, to a ligament or multiple ligaments. Whereas, a strain is classified as an injury to a muscle or a tendon, when the tendon is stretched or torn. Both ailments are caused by either an excessive force on the ligament/tendon or an unnatural twisting or pulling of the connective tissue. Sprains commonly occur when people fall and land on an arm or the side of their foot, twist a knee, or even when overextending during exercise. A strain might occur if a person slips on the ice, lifts a heavy object or lifts in an awkward position, or repetitive motions, as with athletes. Strains can occur over the course of a few days or even over a few weeks.

  • Grade 1 sprain (mild): Slight stretching and some damage to the fibers (fibrils) of the ligament.
  • Grade 2 sprain (moderate): Partial tearing of the ligament. There is abnormal looseness (laxity) in the joint when it is moved in certain ways.
  • Grade 3 sprain (severe): Complete tear of the ligament. This causes significant instability and makes the joint nonfunctional.
    • May require surgery

Example of the motion causing an ankle sprain (AAOS)

Luckily, treatments for both strains and sprains (mild-moderate) are the same: Rest, Ice, Compression and Elevation (R.I.C.E.). According to Gabe Mirkin, the originator of the mnemonic, and countless other sources R.I.C.E. has been a trusted way to help heal a strain or sprain injury. It is also recommended to take and anti-inflammatory medication or pain medication to help in the initial stages of injury.

  • Rest the injured area. It may be wise to use crutches or a cane to prevent sudden re-injuries
  • Place Ice or a cold pack on the injured area for brief periods of time.
  • If pain occurs due to cold, shorten the amount of time of exposure or increase the temperature of the cold pack. This should be repeated frequently throughout the healing process.
  • Compress, apply pressure, to the injured site using bandages, braces, splints, or sleeves.
  • The application of compression helps reduce swelling and promotes the healing process.
  • Attempt to Elevate the injured site, typically above the heart.
  • Elevating above the heart can decrease blood flow to the affected area, which helps decrease pain, swelling and inflammation.

There are additional steps to treat the sites. Once you have managed the pain and the swelling by following R.I.C.E., it is recommended to begin gently exercising the injured area. By moving the muscles and joints, you can promote the body to turn on its own additional healing processes. Do not exercise too much, too fast or you may re-injure the site and prolong recovery.

Treatment decisions for strains and sprains must be made on an individual basis and may rely on expert opinions. This information is provided as an educational service and is not intended to serve as medical advice. It is important to seek advice from a physician if chronic pain occurs and before starting any medical treatments.

Sources:

  • 1.AAOS. (2016). Sprains, strains, and other soft-tissue injuries. http://orthoinfo.aaos.org/topic.cfm?topic=A00111
  • 2.Fong, D.T.P., Hong, Y., Chan, L.K. et al. (2007) A systematic review on ankle injury and ankle sprain in sports. Sports Medicine. 37:73.
  • 3.Mayo Clinic. (2016). Sprains and Strains. http://www.mayoclinic.org/diseases-conditions/spr...
  • 4.National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2014). What are sprains and strains? https://www.niams.nih.gov/health_info/sprains_str...

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