Understanding Sprains and Strains (original) (raw)

Sprain vs. Strain: What’s the Difference?

People use the words “sprain” and “strain” almost interchangeably, to describe everything from a twisted ankle to a pulled hamstring. But they’re not the same.

A sprain is a stretch or tear in a ligament. Ligaments are bands of fibrous tissue that connect bones to bones at joints.

A strain is also a stretch or tear, but it happens in a muscle or a tendon. Tendons link muscles to the bones.

Sprains usually happen when a person falls, twists, or is hit in a way that forces the body out of its normal position.

The most common type of sprain is a sprained ankle. About 25,000 people sprain an ankle every day. Think of a runner who goes over a curb and catches their foot, twisting the ankle; or a baseball player who slides into a base and twists their knee.

Wrist and thumb sprains are also common, particularly in sports like skiing, where it’s not unusual to fall and land on an outstretched palm.

Athletes in contact sports, like football, hockey, and boxing, have the biggest chance of strains. Even in noncontact sports like tennis, golf, or rowing, doing the same motions over and over can lead to strains of the hand and forearm.

These injuries can happen when you work out at the gym, or they can happen at home or the workplace, especially if you do a lot of heavy lifting.

The signs of most sprains or strains are very similar: pain and inflammation, and often bruising and swelling, at the injured area. Depending on how bad the sprain or strain is, the pain may be mild, moderate, or severe.

With a sprain, you may feel a tear or pop in the joint as it happens. The joint may then feel either stiff or unstable.

With a strain, you may have spasms or cramping in the affected muscle.

The worse the sprain or strain, the harder it is to use the affected area. Someone with a mild ankle sprain may just favor that ankle slightly. A more severe ankle sprain may cause much more pain and make it tough or impossible to walk.

If you have a sprain, your doctor may mention its “grade”:

Most people with mild sprains and strains can treat these injuries at home by following “RICE” therapy (see below). For more severe cases, see a doctor, who may do X-rays to check that you don’t have a fracture. You may also get an MRI to check on your ligaments.

Even if you don’t have a fracture, you may need other treatment, such as an ankle cast and/or crutches for a severe ankle sprain. In some cases, you may need surgery to repair the torn ligament or tendon. Physical therapy and rehabilitation exercises often help, too.

Although the degree of pain and swelling are usually the best indicators of how severe a sprain or strain is, this is not always the case. Some injuries, like Achilles tendon tears, may cause only mild pain at first but are actually more severe.

See a doctor right away if any of these things happen:

The gold standard of care for sprains and strains is known as “RICE” therapy. It stands for:

RICE therapy is particularly important during the first 24 to 72 hours after a sprain or strain happens. During this time, you can also take medication to curb pain. Check with your doctor to see what medicine is OK for you, and follow the instructions on the label exactly. Ibuprofen or another NSAID (non-steroidal anti-inflammatory drug) can help because it can reduce inflammation. If you have questions, ask your doctor or pharmacist.

As your pain and swelling gets better, you can cut down on RICE therapy and start to use the affected area again. You’ll need ice and compression less often, such as at the end of the day, as swelling and pain tend to flare up after use.

You probably can’t wait to get active again, but you shouldn’t rush it. You could reinjure the area and make it worse.

On the other hand, you shouldn’t rest the injured area too long, or scar tissue could limit what you can do.

It’s best to rehab your injury gradually. Your doctor or a physical therapist can recommend certain exercises that can help you get back to your normal routine bit by bit, at a safe pace.

For example, if you’ve sprained your ankle, you may begin by walking slowly on a flat treadmill, then move to an incline, then begin to jog. Someone with a sprained wrist may begin with range-of-motion exercises, and then move on to lifting very light weights.

You can expect some discomfort during rehabilitation. But a sudden flare-up of severe pain is a signal to take a step back and move more cautiously. Talk to your doctor if this happens.

The time frame for recovery depends on the severity of the injury and can vary from person to person. It may take just a few days for a slight sprain of an ankle to heal, or it may take months for a knee that needs surgery to reconstruct it.

For most mild to moderate sprains and strains, you can expect to regain full mobility within 3 to 8 weeks. More severe injuries can take months for a full recovery.

You should have an understanding before you leave your doctor’s office or hospital about what you need to do to recover. Make sure you have answers to these questions:

Let your doctor know if you get a lot of sprains or strains. You may have chronic weakness that can be helped by strengthening exercises that can prevent constant injuries. Other tips to prevent sprains and strains include: