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Ankle/Leg

Sprain vs. Strain

What Is the Difference Between a Sprain and a Strain?

A sprain is an injury to a ligament–a stretching or a tearing. One or more ligaments can be injured during a sprain. The severity of the injury will depend on the extent of injury to a single ligament (whether the tear is partial or complete) and the number of ligaments involved.

A strain is an injury to either a muscle or a tendon. Depending on the severity of the injury, a strain may be a simple overstretch of the muscle or tendon, or it can result in a partial or complete tear.

What Causes a Sprain?

A sprain can result from a fall, a sudden twist, or a blow to the body that forces a joint out of its normal position. This results in an overstretch or tear of the ligament supporting that joint. Typically, sprains occur when people fall and land on an outstretched arm, slide into base, land on the side of their foot, or twist a knee with the foot planted firmly on the ground.

Where Do Sprains Usually Occur?

Although sprains can occur in both the upper and lower parts of the body, the most common site is the ankle. Ankle sprains are the most common injury in the United States and often occur during sports or recreational activities.

Most ankle sprains happen when the foot turns inward as a person runs, turns, falls, or lands on the ankle after a jump. This type of sprain is called an inversion injury.

The knee is another common site for a sprain. A blow to the knee or a fall is often the cause. Sudden twisting can also result in a sprain.

Sprains frequently occur at the wrist, typically when people fall and land on an outstretched hand.

What Are the Signs and Symptoms of a Sprain?

The usual signs and symptoms include pain, swelling, bruising, and loss of the ability to move and use the joint. However, these signs and symptoms can vary in intensity, depending on the severity of the sprain. Sometimes people feel a pop or tear when the injury happens.

Doctors use many criteria to diagnose the severity of a sprain. A person with a mild sprain usually experiences minimal pain, swelling, and little or no loss of functional ability. Bruising is absent or slight, and the person is usually able to put weight on the affected joint. People with mild sprains may do not need an x ray, but one is sometimes performed if the diagnosis is unclear.

When To See a Doctor for a Sprain

  • You have severe pain and cannot put any weight on the injured joint.
  • The area over the injured joint or next to it is very tender when you touch it.
  • The injured area looks crooked or has lumps and bumps (other than swelling).
  • You cannot move the injured joint.
  • You cannot walk more than four steps without significant pain.
  • Your limb buckles or gives way when you try to use the joint.
  • You have numbness in any part of the injured area.
  • You see redness or red streaks spreading out from the injury.
  • You injure an area that has been injured several times before.
  • You have pain, swelling, or redness over a bony part of your foot.
  • You are in doubt about the seriousness of the injury or how to care for it.

An x ray may be needed to help the doctor determine if a fracture is causing the pain and swelling. Magnetic resonance imaging (MRI) is occasionally used to help differentiate between a significant partial injury and a complete tear in a ligament.

When diagnosing any sprain, the doctor will ask the patient to explain how the injury happened. The doctor will examine the affected joint and check its stability and its ability to move and bear weight.

What Causes a Strain?

Twisting or pulling a muscle or tendon causes a strain. Strains can be acute or chronic. An acute strain is caused by trauma or an injury; it can also be caused by improperly lifting heavy objects or over-stressing the muscles. Chronic strains are usually the result of overuse–prolonged, repetitive movement of the muscles and tendons.

Where Do Strains Usually Occur?

Two common sites for a strain are the back and the hamstring muscle (located in the back of the thigh). Contact sports such as soccer, football, hockey, boxing, and wrestling put people at risk for strains. Gymnastics, tennis, rowing, golf, and other sports that require extensive gripping can increase the risk of hand and forearm strains. Elbow strains sometimes occur in people who participate in racquet sports, throwing, and contact sports.

What Are the Signs and Symptoms of a Strain?

Typically, people with a strain experience pain, muscle spasm, and muscle weakness. They can also have localized swelling, cramping, or inflammation and, with a minor or moderate strain, usually some loss of muscle function. Patients typically have pain in the injured area and general weakness of the muscle when they attempt to move it. Severe strains that partially or completely tear the muscle or tendon are often very painful and disabling.

How Are Sprains and Strains Treated?

Reduce Swelling and Pain
Treatment for sprains and strains is similar and can be thought of as having two stages. The goal during the first stage is to reduce swelling and pain. At this stage, doctors usually advise patients to follow a formula of rest, ice, compression, and elevation (RICE) for the first 24 to 48 hours after the injury. The doctor may also recommend an over-the-counter or prescription nonsteroidal anti-inflammatory drug, such as aspirin or ibuprofen, to help decrease pain and inflammation if they are not allergic or have no contraindication.
For people with a moderate or severe sprain, particularly of the ankle, a hard cast may be applied. Severe sprains and strains may require surgery to repair the torn ligaments, muscle, or tendons. Surgery is usually performed by an Orthopedic surgeon.

It is important that moderate and severe sprains and strains be evaluated by a doctor to allow prompt, appropriate treatment to begin. The information above lists some signs that should alert people to consult their doctor. However, a person who has any concerns about the seriousness of a sprain or strain should always contact a doctor for advice.

Can Sprains and Strains Be Prevented?

There are many things people can do to help lower their risk of sprains and strains:

  • Maintain a healthy, well-balanced diet to keep muscles strong.
  • Maintain a healthy weight.
  • Practice safety measures to help prevent falls by keeping stairways, walkways, yards, and driveways free of clutter, and salt or sand icy patches in the winter).
  • Wear shoes that fit properly.
  • Replace athletic shoes as soon as the tread wears out or the heel wears down on one side.
  • Do stretching exercises daily.
  • Be in proper physical condition to play a sport.
  • Warm up and stretch before participating in any sports or exercise.
  • Wear protective equipment when playing.
  • Avoid exercising or playing sports when tired or in pain.
  • Run and walk on even surfaces.

 

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