Sprains And Strains

Sprains and strains are widely experienced soft tissue injuries by both athletes and other physically active individuals. According to Statistics Canada, sprains and strains were, by a considerable margin, the most commonly experienced injury among Canadians aged 12 years or older during the period 2009-10. 51% of those aged 12 years or older reported experiencing either a strain or sprain compared to the next most prevalent injury, bone fractures, at 17%.

We will see below that the two types of injuries have many more shared features than differences. As a result, they are frequently confused with each other. It should also be noted that the two types of injuries sometimes occur together.

However, there are subtle differences between the two and it is useful to understand what these are.

In this text, we will examine the differences and similarities between the pathologies or causes of these two types of injuries. We will then compare the symptoms and the treatment strategies commonly used for each type of injury.

Sprains vs. Strains – The Differences

Causes

• A sprain is an injury to a ligament that results in the ligament being stretched or torn (either partially or completely). On the other hand, a strain is an injury that results in stretching or tearing (partially or completely) of either a muscle or the tendon that connects the muscle to an adjacent bone.
• Most sprains are the result of a traumatic event like a sudden significant force that stresses the ligament and damages it. This may include, for example, joint hyperextension or hyperflexion.

On the other hand, strains are caused either by a traumatic event or by overuse of a muscle or the corresponding tendon over time. Overuse can occur, for example, with an athlete who overtrains and does not get enough rest between periods of activity.This in turn results in weakening of the muscle or tendon and then to it being overstretched or torn.

• Ligaments are bands of tissue connecting bones that are part of the same joint. On the other hand, tendons connect a muscle to adjacent bones.

Body Parts Affected

• Most sprains are ankle sprains. On the other hand, the body parts most commonly affected by a strain are the hamstring muscles (at the back of the thigh) and the lower back.
• Because ligaments bind the bones of a joint together, sprains tend to result in pain and swelling at or near a joint. Strains, on the other hand, may take place near a joint (if they involve damage to a tendon close to that joint). However, they can also take place away from joints (e.g. hamstring muscle strains).

Symptoms

• Another subtle difference between the two types of injuries that it is useful to be aware of lies in their symptoms. Strains in many cases produce muscle spasms as one of their symptoms. Sprains, on the other hand, tend to more frequently result in bruising or contusions around the joint. Muscle spasms usually do not appear as a result of a ligament sprain.

Sprains vs. Strains – The Similarities

Risk Factors

• Both sprains and strains tend to happen to physically active individuals. Those experiencing these injuries may be active either as a result of a sport or because of their occupation. As a result, they may both be classified as sports medicine injuries.
• For both sprains and strains, frequent participation in sports requiring frequent changes of direction is an important risk factor. Many of these tend to be contact sports like basketball or football.
• Another risk factor that is common to both sprains and strains is having weak or underdeveloped joints or muscles.
• Failure to use proper equipment (for example, using old or worn out athletic shoes with poor arch support) is another common risk factor.
• A fourth risk factor common to both injuries is failure to warm up properly before your activity. This results in less supple tissues that are more easily stretched or torn.
• A fifth risk factor common to both injuries is having experienced the same injury at some point in the past. For both sprains and strains, this will increase your chances of experiencing another similar injury.

Symptoms

• Both sprains and strains result in pain and swelling. Another symptom that they share in common is a reduced range of motion and weakness of an injured joint or muscle.

Grades Of Severity

• Both sprains and strains are classified as one of grades I, II or III depending on the severity of the injury.

Grade I sprains or strains involve overstretching of the ligament or tendon, but no tearing.

Grade II sprains or strains involve a partial tear of the soft tissue involved (ligament for a sprain, muscle/tendon for a strain).

Grade III sprains or strains involve a complete severing of the ligament, muscle or tendon.

Treatment

• The typical treatment for either sprains or strains that are grade I in terms of severity is rest. The patient will be advised to avoid activities that may stress the injured soft tissues in order to allow them a chance to recover naturally.
• The patient may also be advised to wear an orthopedic brace or athletic tape to support the injured soft tissues and protect them from further injury.
• For grade I injuries (mild sprains or strains), doctors will also usually suggest home based treatments. These will generally include icing to reduce swelling, compression and elevation of the injured joint.
• Grade II sprains or strains will generally also be treated using home based measures. In most case, the P.R.I.C.E (Protection, Rest, Icing, Compression and Elevation) approach described above for grade I injuries will also be used for grade II.
• For grade III sprains or strains, treatment using home based conservative methods is unlikely to be adequate. Instead, surgery will be necessary to reattach the torn ligaments, muscles or tendons.

With some grade III injuries, there may also be damage to connected bone structures. These too will require surgical correction.

• For both sprains and strains, physical therapy will be an important component of the treatment. The physical therapist can devise an exercise program to strengthen and stretch the injured soft tissues. This will help to reduce the chance that the injury may re-occur.