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The Difference Between a "Strain" and a "Sprain"

These two relatively common injuries can often occur in the context of exertion, training, or sports of any kind. While symptoms like pain, swelling, and immobility in the damaged area make these two injuries look similar, there is a key difference between them. The most significant difference between them is that a strain results from tearing the tendon, which connects the muscle to the bone, while a sprain results from damaging the ligament, which connects one bone to another at the joint.

What is a strain?

Muscle strains are when impact or physical exertion causes the muscle fiber to pull or tear. It’s the result of the muscle not being properly prepared for physical activity. This can mean one of two things: the muscle is under-utilized and thus not strong or flexible enough to safely accomplish what it was being made to do, or the muscle is overexerted and thus not rested enough to safely accomplish was it was being made to do. In either case, the fibers or tendon of the muscle will weaken and rip, causing intense pain and limiting range of motion. Strains commonly occur in the hamstring or lower back muscles.

Preventing Strains

The key to preventing muscle strain is regular intervals of training and sufficient rest. Regular exercise is crucial to developing the muscle strength and stability that keeps muscle strain from occurring. However, rest is also crucial, as rest allows your muscles to rebuild and maintain the strength that you’ve developed. Exercising at a level appropriate to your fitness and regular recovery will make sure that you will be able to utilize your muscles safely and effectively. In the case of chronic muscle strain that result from repetitive motions or conditions, good posture or form is crucial to preventing injury.

Degrees of Muscle Strains

The degree of a muscle strain is often described in three levels of increasing intensity.

  • First Degree – There is little tearing or stretching of the muscle tissue, but a full range of mobility is still possible. The muscle may feel stiff, but can still bear weight.
  • Second Degree – There is some muscle tearing that causes limited motion. Muscle swelling is also common in second degree muscle strains.
  • Third Degree – There is extensive tearing of the muscle, which severely limits the use of the muscle or makes the muscle completely immobile.

Symptoms

  • Pain in the damaged area
  • Muscle spasms
  • Muscle weakness
  • Swelling / inflammation
  • Muscle cramps
  • Limited movement
  • Bruising or discoloration

What is a sprain?

In contrast, a sprain is damage to the ligament that keeps a joint together. Ligaments are crucial to movement because they stabilize the joint that they are attached to. Sprains commonly occur in the joint that does the most activity. For example, basketball players will most likely sprain their ankles because of the constant foot and leg movement required in the sport. Sprains also commonly occur from overstretching a joint, as when weight is applied to an outstretched arm. Sprains also often result from “rolling” your ankle or landing on the side of your foot, which pulls and damages the ligament on the outside of the foot. Preventing sprains like this simply involve regularly exercising the stability muscles around your joints and stretching your ligaments gently to promote flexibility. Stable muscles combined with flexible ligaments can prevent mild sprains and lessen the impact of severe strains.

Sprains rarely require surgery. Ligaments will often heal on their own if you rehabilitate the joint correctly. However, without rehabilitation or proper physical training of the muscles around the joint, sprains can become a chronic occurrence. Certain people also have a predisposition to ankle strains. For example, according to The American Orthopaedic Foot and Ankle Society, people with a “hindfoot varus” have a natural heel posture that turns the foot slightly inward, making sprains more likely.

Symptoms

The intensity of the symptoms will depend on the degree of damage in the joint, but all sprains do share common symptoms.

  • Feeling the joint “pop” or tear
  • Joint instability (or immobility in severe cases)
  • Mild swelling

Treating Sprains and Strains

Treating both sprains and strains requires following the same principles. The American College of Sports Medicine (2011) outlines a recovery program for treating these injuries known as the P.R.I.C.E. principle. These steps include protecting the injury from further harm (P), resting and restricting activity that would involve the damaged area (R), applying ice (I), keeping the injured area compressed with bandages (C), and elevating the injured area (E).

The first 48-72 hours are crucial to the recovery process, so it is important to restrict activity during the first few days after the injury to allow for the healing process to begin. Icing for 20 minutes every hour or every few hours will help the swelling and promote healthy recovery. The severity of the injury, either strains or sprains, will dictate how long the patient must wait before returning to activity. Mild strains and sprains might only require a few days of healing, while severe strains will require several weeks of healing before returning to your normal routine. Consult with your physician before you begin any strenuous activity after an injury.

This article contains general information about medical conditions and treatments. The information is not advice and should not be treated as such. The information is not intended to replace the advice or diagnosis of a physician.

If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider.

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