Do you often get confused between similar-sounding English words like ‘there’ and ‘their’? Or ‘accept’ and ‘except’? Well, you are not wrong. After all, English has one of the most extensive vocabularies in the world, with over 1,50,000 words presently in use. And at times, these terms can be tough to decipher. One such confusion occurs in ‘sprain vs strain’.
In fact, these terms are used so interchangeably that you end up misusing them even after knowing their meanings! However, doing so may be harmful because these two define entirely different diagnoses.
Already strained about your sprain?! Or still, confused about your diagnosis? Don’t worry, we have got you covered! Here’s everything you need to know about Sprain vs Strain…
What are sprain and strain?
Ligament is the structure which connects bone to bone. The muscle attaches to the bone through a connective tissue called a tendon. Injury to the ligament is called SPRAIN, while an injury to the muscle or tendon is called STRAIN. Thus the structures getting affected in a sprain is different than in a strain.
However, the good news is that it is easy to manage sprain and strain with a success rate of complete recovery.
Sprain and strain are injuries of soft tissues in the body. But the function of the ligament varies from that of a muscle or tendon.
A sprain is an overstretched or tears to the ligament. It is commonly seen in the ankle, knee, elbow and wrist. A strain, on the other hand, occurs due to overstretching or tear to the muscle or tendon.
A tendon is a tough cord-like structure that connects muscle to the bone. The common sites of strain are back, shoulder and knee.
Both ligaments and tendons are viscoelastic in nature, but the main function of a ligament is stability and avoiding excessive movement. On the other hand, tendons are for force transmission and movement of the bone. These primary differences in their functions are the main reason why treatment of a sprain differs from that of strain.
Both these soft tissues have one similar function – to detect the joint position or joint movement. It is also known as Proprioception.
This joint position sense or proprioception is conducted by the signals, which are then sent to the spinal cord and brain regarding the position and movement of a particular joint with respect to the body, space and surroundings.
This is critical in all individuals in maintaining body functioning, balance and coordination even when the vision is obstructed or external cues are minimal.
The feedback coming from these structures to the nervous system is very critical especially in demanding postures in athletes with rapid change in their direction of movements. To name a few sports like football, basketball, volleyball, tennis, and badminton.
Causes of strain and sprain
- Excessive loading
- Sudden stretch
- Muscular imbalance
- Overuse repetitive trauma
- Wrong biomechanics: faulty landing, plant and cut manoeuvre, change of direction,
- twisting/pivoting, throwing, hitting,
- Inadequate warm-up, cool-down or recovery
- History of an old injury (re-injury/ recurrence to same structure or different structure/area)
- Improper sports gears (wrong footwear, shoe size, racquet size and grip)
- Intrinsic factors: postural deviations, anatomical defects or abnormalities, hypermobility
- Extrinsic factors: surface: uneven, slippery
- In contact sports, like football, rugby, boxing athletes have a higher incidence of having strains as they are exposed to aggressive impactful activities
Nevertheless, in non-contact sports like tennis, athletics, golf, strains are commonly seen due to constant repetitive movements.
Also Read | All about ACL Injuries and how to avoid them
Symptoms of sprain and strain
Strains and sprains occur in a lot of common presentations and hence have to be carefully assessed/diagnosed by your physiotherapist. Symptoms common to both include-
Pain: Sudden onset of pain following an injury/fall or even a wrong jerky movement. Pain can be mild to severe, depending on the severity and the grade of injury.
Swelling: The appearance of swelling depends upon the severity. Tenderness and bruising will also be present.
Difficulty in performing movements: This arises due to the above symptoms. A person with a strain might feel weakness while acting as the injured muscle. Muscle action may be further hampered by inhibition due to pain, which can be seen in both strain and sprain.
Location of pain or swelling or skin changes varies depending on the structure injured. Thus it can help the medical professional differentiate between the strain and sprain.
Signs and Symptoms of sprain
Joint instability: As mentioned earlier, the ligaments play a critical role in joint stabilisation and also joint position sense. In case of a torn ligament, the joint can become unstable, and a person may complain of repeated twisting or buckling or giving way.
Excessive mobility: when the ligament is torn, the passive blocking structure is damaged, and thus, the joint can become hypermobile compared to the other side.
Expert medical professionals while assessing, may find excessive mobility or instability or opening or laxity at the affected joint compared to another uninjured side. Sometimes in the acute phase, these signs may not be positive due to swelling or muscle guarding.
Signs and Symptoms of strain
Muscle spasm: after muscle injury, the affected muscle plus the nearby muscles go into spasm. The muscle shortens as a protective mechanism to guard the injured area, to avoid further damage and to start the healing process immediately. The extent of muscle spasm depends on the severity of the injury.
Defect in muscle belly: Abnormality in muscle contour (bulge or dent) can appear after a muscle tear, thus, reducing the strength to perform the movement.
Reduced mobility: when a muscle tear occurs, there is pain and reduction in muscle strength. This, as a result, leads to restricted movement.
Clinical signs and symptoms unique to a ligament sprain are best assessed after 4-5 days post-injury. The person may present with the instability of the related joint. It is essential to diagnose this instability clinically, and so consultation with your doctor/physiotherapist is critical. Similarly, strains give rise to specific muscle-specific symptoms like muscle spasms & weakness.
When to see the doctor?
It is relatively simple to manage sprains and strains of mild to moderate grade at home with proper protection, rest and icing. However, if the symptoms such as–
- Pain, swelling
- Pain on injured joint movements or
- Inability to stand/ hold objects.
If these complaints persist or do not subside within 48 to 72 hours post-injury even with rest and ice, then you need to seek medical (physiotherapist or orthopaedic doctor) help immediately.
There is considerable overlap in the initial symptomatic presentations of strain & sprain. But the treatment for both is different. Hence, the main reason to visit your doctor is to get a proper differential diagnosis and a specific treatment later for early and healthy recovery.
How are sprains and strains treated?
As discussed above, the initial treatment of sprains and strains are usually the same. That includes PRICE protocol (refer to the infographics below) in the first phase. It is necessary to understand the importance of PRICE protocol in the tissue healing process. The first step is to stop performing activities which are causing pain.
Protection and Rest of injured muscle or joint will help to prevent further damage or re-injury. Usage of appropriate braces, binders or taping will help to protect it.
Icing for 20 minutes – 2-3 times/day is advised as it will aid in reducing the swelling. Small gel ice packs or Cryotherapy packs work best to serve the purpose.
Compression is given with bandage tied gently or Kinesio-taping. Make sure that it is not too tight.
Lastly, Elevate the injured area to reduce swelling. This will help to accelerate the healing process.
However, the main chunk of the treatment starts after pain and swelling reduction. That includes strengthening and stretching of particular muscle groups, training for balance – proprioception, return to sport (RTS) or return to work.
How to prevent ligament sprains and muscle strains?
It is very much possible to reduce the chances of muscle sprains and strains. To prevent such injuries, you can consider the following precautions:
1. Maintaining a good posture: Make sure you do not assume a static posture for a long time e.g sitting on a desk or standing. Take frequent breaks (not the coffee break) for simple joint movements, stretching and walking.
2. Use of proper technique: Either it is lifting a box from the ground or a jumping and landing activity in athletes. The technique, using the right group of muscles plays a crucial role in preventing these injuries.
3. Warm-up and cool down: In many of us, there’s a misbelief that heavyweight workouts or high-intensity aerobic exercises can cause muscle strains. However, it cannot be denied if you don’t invest a good amount of time in warming up your muscles and cooling them down post workouts. Warm-up and cool down have a good impact on reducing the rate of muscle strains.
4. Take precautions while walking on a wet, slippery surface. Take the support of the hand railing, wear footwear with a good sole.
- Appropriate size footwear: Wear footwear according to your foot size and shape. Avoid wearing oversize or undersize as it will have maximum chances for an ankle sprain.
Want to recover from a sprain or strain in the right way? Look no further!
Although not serious in nature, sprains or strains can turn into serious injuries if not taken care of. Home remedies work for in the short runs, but they may not be as effective or safe in the long term. It, thus, becomes important to seek the advice of a physiotherapist.
REHAB STATION is among the most renowned sport and musculoskeletal centric physiotherapy labs situated in the heart of Pune city. The Sports Physiotherapists at REHAB STATION strive to ensure to live up to the statement that defines an ideal sports physiotherapist.
“Prevention is better” than cure is the least applied phrase in the modern world. REHAB STATION aims at spreading awareness regarding Preventive Rehabilitation. As sports physiotherapists, they can help you prevent muscle and ligament injury and overcome the plateau in your performance!