Many patients with musculoskeletal injuries get confused about the difference between a strain and sprain. Your physical therapist can show you the difference between what a sprain and a strain is and how to properly treat each of these distinct injuries.
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Muscle Strains
Strainsare injuries that affect muscles or tendons, the thick bands that attach muscles to bones. They occur in response to a quick tear, twist, or pull of the muscle.Strainsare anacute typeof injury that results from overstretching or over contraction. Pain, weakness, andmuscle spasmsare common symptoms experienced after a strain occurs.
Ligament Sprains
Sprainsare injuries that affect ligaments, thick bands of cartilage that attach bone to bone. They occur in response to a stretch or tear of a ligament. Sprains are an acute type of injury that results from trauma such as a fall or outside force that displaces the surrounding joint from its normal alignment.
Sprains can range from a mild ligamentous stretch to a complete tear. Bruising, swelling, instability, and painful movement are common symptoms experienced after a sprain occurs.
Causes
How can you tell if you have strained a muscle? Typically, the muscle you strain will hurt when you try to contract it. For example, if you strain your hamstring, you will likely feel pain when you try to use thehamstring muscleto bend your knee.
Overstretching a muscle that has suffered an acute strain may also cause pain. Stretching your hamstrings in the days following a hamstring muscle strain will likely be painful, indicating that your muscle is strained.
Strain and Sprain Severity Grades
There are different grades of muscle strains, ranging from grade I to grade III.
If your healthcare provider or PT determines that you have a muscle strain, he or she may consider obtaining diagnostic images like an MRI to determine the full nature of the injury.
Ligament sprains grading follows along similarly to muscle strain grades.
When to See a Healthcare Provider
If you suffer an injury like a sprain or strain, how do you know when you need to see your healthcare provider. Generally speaking, a visit to a practitioner after any trauma is a good idea; there may be hidden problems that you simply cannot diagnose without the aid of a medical professional.
You should absolutely see your healthcare provider if:
Bottom line: if your pain and symptoms limit your ability to comfortably move around after your injury, check in with your healthcare provider.
Diagnosing Sprains and Strains
Examination of your injury may also reveal tenderness to palpation, bruising, and swelling. Your healthcare provider may also perform diagnostic imaging tests including an X-ray, which will show the bones near your injury, or an MRI to look at soft tissue near your injury.The MRI will likely show a muscle strain and can reveal the severity of your injury.
Manyspecial tests, like theanterior drawer testfor the ACL in your knee or the drawer test in your ankle, rely on pulling on your joint to test if excessive mobility is present. These give your healthcare provider clues that a ligament sprain may be present. An MRI is typically necessary to determine if a sprain is a grade I, II, or III.
Muscle Strain Treatment
Initial treatment for a muscle strain is rest. Depending on the severity of the strain, your rest period may be from one week to four or six weeks. During this time, ice may be applied to help ease the pain and swelling.
Once some healing has taken place, you may benefit from PT exercises to start to gently stretch the injured muscle tissue. This helps it become healthy, pliable tissue again. Your PT can show you the best stretches for your specific condition.
It’s important to perform the appropriate movements at the right time and apply the optimal level of stretching (depending on your recovery phase) that will facilitate healing without causing damage.
Strengthening exercises may also be performed to start to rebuild muscle tissue near the strain area.Exercises should be started gently and gradually progressed. Your goal is to improve the force-generating capacity of your injured muscle so you can return to your previous level of function.
Muscle strains typically heal completely in about six to eight weeks. Severe strains may take longer, and minor strains may be healed in just a few weeks. Again, follow the advice of your healthcare provider or physical therapist to be sure you do the right treatment for your muscle strain.
Ligament Sprain Treatment
If you have a ligament sprain, you may benefit from physical therapy to help you fully recover. Your physical therapist will use various techniques to improve your pain, swelling, and overall range of motion and strength around the area where your ligament is sprained.
Initial treatment for a sprain includes following the R.I.C.E. principle.Rest the affected joint, and place ice on it with compression and elevation. (Some PTs recommend following theP.O.L.I.C.E. principleof protection, optimal loading, ice, compression, and elevation.)
Gentle range of motion exercises are usually started a few days after a sprain injury. Slowly moving your affected joint passively and actively can help keep things moving while they are healing. You may be required to wear a brace during the initial phases of healing for a ligament sprain.
Performing strengthening exercises to help support the joint where the ligament is injured may be necessary. For severe grade III sprains, surgery may be necessary to stabilize your injury and to allow you to get back to normal activity.
Typically, recovery from both muscle strains and ligament sprains takes about four to eight weeks. Your exact healing time may vary based on the severity of your injury.
Prevention Of Sprains and Strains
Many patients as if there is a way to prevent muscle strains and ligaments sprains from happening. There may be. Research indicates that performing eccentric exercises, like theNordic Hamstring Curlor theAlfredson Protocolfor the Achilles tendon, may have a protective effect for muscles and tendons.Eccentric exercise occurs when your muscle is contracting while it is lengthening. The mechanism of action for this protective effect is not yet fully understood.
You may be able to prevent ligament sprains through neuromuscular training with your physical therapist. Your PT can teach you to jump and land properly which can keep your body in an optimal position to prevent sprains.Improving lower extremity proprioceptionhas also been shown to prevent ankle sprains.
A Word From Verywell
If you are having pain or limited mobility after an injury, you should visit your healthcare provider and physical therapist to determine if a sprain or strain may be the cause of your condition. Understanding the difference between a sprain and a strain can ensure that you have the correct diagnosis for your condition. This can help guide the correct treatment. Working closely with your PT can help you return to your previous level of activity.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hamilton B, Valle X, Rodas G, et al.Classification and grading of muscle injuries: a narrative review.Br J Sports Med.2015;49(5):306. doi:10.1136/bjsports-2014-093551Petersen W, Rembitzki IV, Koppenburg AG, et al.Treatment of acute ankle ligament injuries: a systematic review.Arch Orthop Trauma Surg.2013;133(8):1129-41. doi:10.1007/s00402-013-1742-5Crema MD, Yamada AF, Guermazi A, Roemer FW, Skaf AY. Imaging techniques for muscle injury in sports medicine and clinical relevance.Curr Rev Musculoskelet Med.2015;8(2):154-61. doi:10.1007/s12178-015-9260-4Bourne MN, Timmins RG, Opar DA, et al.An Evidence-Based Framework for Strengthening Exercises to Prevent Hamstring Injury.Sports Med. 2018;48(2):251-267. doi:10.1007/s40279-017-0796-xVan den bekerom MP, Struijs PA, Blankevoort L, Welling L, Van dijk CN, Kerkhoffs GM.What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?.J Athl Train. 2012;47(4):435-43. doi:10.4085/1062-6050-47.4.14Stevens M, Tan CW.Effectiveness of the Alfredson protocol compared with a lower repetition-volume protocol for midportion Achilles tendinopathy: a randomized controlled trial.J Orthop Sports Phys Ther.2014;44(2):59-67. doi:10.2519/jospt.2014.4720Additional ReadingSchiftan, GS, etal.The Effectiveness of Proprioceptive Training in Preventing Ankle Sprains in Sporting Populations: A Systematic Review and Meta-Analysis. Journal of Science in Medicine and Sport. 18(3): May, 2015.
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hamilton B, Valle X, Rodas G, et al.Classification and grading of muscle injuries: a narrative review.Br J Sports Med.2015;49(5):306. doi:10.1136/bjsports-2014-093551Petersen W, Rembitzki IV, Koppenburg AG, et al.Treatment of acute ankle ligament injuries: a systematic review.Arch Orthop Trauma Surg.2013;133(8):1129-41. doi:10.1007/s00402-013-1742-5Crema MD, Yamada AF, Guermazi A, Roemer FW, Skaf AY. Imaging techniques for muscle injury in sports medicine and clinical relevance.Curr Rev Musculoskelet Med.2015;8(2):154-61. doi:10.1007/s12178-015-9260-4Bourne MN, Timmins RG, Opar DA, et al.An Evidence-Based Framework for Strengthening Exercises to Prevent Hamstring Injury.Sports Med. 2018;48(2):251-267. doi:10.1007/s40279-017-0796-xVan den bekerom MP, Struijs PA, Blankevoort L, Welling L, Van dijk CN, Kerkhoffs GM.What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?.J Athl Train. 2012;47(4):435-43. doi:10.4085/1062-6050-47.4.14Stevens M, Tan CW.Effectiveness of the Alfredson protocol compared with a lower repetition-volume protocol for midportion Achilles tendinopathy: a randomized controlled trial.J Orthop Sports Phys Ther.2014;44(2):59-67. doi:10.2519/jospt.2014.4720Additional ReadingSchiftan, GS, etal.The Effectiveness of Proprioceptive Training in Preventing Ankle Sprains in Sporting Populations: A Systematic Review and Meta-Analysis. Journal of Science in Medicine and Sport. 18(3): May, 2015.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Hamilton B, Valle X, Rodas G, et al.Classification and grading of muscle injuries: a narrative review.Br J Sports Med.2015;49(5):306. doi:10.1136/bjsports-2014-093551Petersen W, Rembitzki IV, Koppenburg AG, et al.Treatment of acute ankle ligament injuries: a systematic review.Arch Orthop Trauma Surg.2013;133(8):1129-41. doi:10.1007/s00402-013-1742-5Crema MD, Yamada AF, Guermazi A, Roemer FW, Skaf AY. Imaging techniques for muscle injury in sports medicine and clinical relevance.Curr Rev Musculoskelet Med.2015;8(2):154-61. doi:10.1007/s12178-015-9260-4Bourne MN, Timmins RG, Opar DA, et al.An Evidence-Based Framework for Strengthening Exercises to Prevent Hamstring Injury.Sports Med. 2018;48(2):251-267. doi:10.1007/s40279-017-0796-xVan den bekerom MP, Struijs PA, Blankevoort L, Welling L, Van dijk CN, Kerkhoffs GM.What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?.J Athl Train. 2012;47(4):435-43. doi:10.4085/1062-6050-47.4.14Stevens M, Tan CW.Effectiveness of the Alfredson protocol compared with a lower repetition-volume protocol for midportion Achilles tendinopathy: a randomized controlled trial.J Orthop Sports Phys Ther.2014;44(2):59-67. doi:10.2519/jospt.2014.4720
Hamilton B, Valle X, Rodas G, et al.Classification and grading of muscle injuries: a narrative review.Br J Sports Med.2015;49(5):306. doi:10.1136/bjsports-2014-093551
Petersen W, Rembitzki IV, Koppenburg AG, et al.Treatment of acute ankle ligament injuries: a systematic review.Arch Orthop Trauma Surg.2013;133(8):1129-41. doi:10.1007/s00402-013-1742-5
Crema MD, Yamada AF, Guermazi A, Roemer FW, Skaf AY. Imaging techniques for muscle injury in sports medicine and clinical relevance.Curr Rev Musculoskelet Med.2015;8(2):154-61. doi:10.1007/s12178-015-9260-4
Bourne MN, Timmins RG, Opar DA, et al.An Evidence-Based Framework for Strengthening Exercises to Prevent Hamstring Injury.Sports Med. 2018;48(2):251-267. doi:10.1007/s40279-017-0796-x
Van den bekerom MP, Struijs PA, Blankevoort L, Welling L, Van dijk CN, Kerkhoffs GM.What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?.J Athl Train. 2012;47(4):435-43. doi:10.4085/1062-6050-47.4.14
Stevens M, Tan CW.Effectiveness of the Alfredson protocol compared with a lower repetition-volume protocol for midportion Achilles tendinopathy: a randomized controlled trial.J Orthop Sports Phys Ther.2014;44(2):59-67. doi:10.2519/jospt.2014.4720
Schiftan, GS, etal.The Effectiveness of Proprioceptive Training in Preventing Ankle Sprains in Sporting Populations: A Systematic Review and Meta-Analysis. Journal of Science in Medicine and Sport. 18(3): May, 2015.
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