What Are Sprains and Strains?

Common ligament and muscle injuries

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Sprains and strains are common soft-tissue injuries. Both are often caused by tissue being stretched too far. This can lead to tissue damage and even tearing. Though their names sound similar, sprains and strains are uniquely defined by the tissues they involve.

Sprains are injuries to ligaments, bands of tissue that connect bones to each other and prevent abnormal movements. Strains involve muscles and/or tendons, tissue that attach muscles to bones and other structures.

This article will walk you through the symptoms of sprains and strains, what causes them, when you should get medical help, and how they're diagnosed and treated.

Young man with an injury
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Symptoms of Sprains and Strains

Sprains and strains have some symptoms in common and others that are unique to each injury.

The symptoms they share include:

  • Pain
  • Swelling/inflammation
  • Difficulty moving the injured part
  • Limited range of motion

Symptoms vary with the intensity of the injury.

Sprain Symptoms

Regardless of severity, sprains generally cause bruising. You may feel a tear or pop in the joint when it first happens.

Joint function varies with the severity of the sprain.

Level of Injury Damage Impact on Joint
Mild sprain  Ligament stretched  Joint is stable
Moderate sprain Ligament partially torn Joint is unstable
Severe sprain Ligament completely torn or separated from bone Joint is loosened and function is impaired

Some of the most commonly injured ligaments are in the ankle, knee, and wrist.

Strain Symptoms

Strains do not cause bruising. Instead, you may experience:

  • Muscle spasm
  • Muscle weakness
  • Cramping

A mild strain involves slight stretching or pulling. A moderate strain includes slight tears. Severe strains involve tears to the muscle, tendon, or both. More serious injuries mean a greater loss of muscle function.

Common strain locations are the neck, shoulder, lower back, and hamstring.

When to Get Help

Knowing when to get help is important. Many sprains and strains can be managed with simple steps on your own. But you should get checked to make sure it's not something more serious.

You should get medical attention if:

  • You have severe pain and can't put any weight on the injured extremity
  • The injured area looks deformed when compared to the opposite side
  • You can't move the injured area
  • You can't walk or use the part because of pain
  • Your limb buckles or gives way when you try to move
  • You've injured this part before
  • You have severe swelling, or swelling doesn't improve with rest and elevation

A complete muscle tear is a medical emergency. You may hear a popping sound when it happens, followed by extreme pain and being unable to use it. If this happens, get immediate medical help.

Causes

Many sports put you at risk for sprains and strains, including:

  • Football
  • Basketball
  • Gymnastics
  • Volleyball

These injuries can also occur with everyday activities, such as:

You can end up with a sprain or strain from any activity that goes beyond your personal physical limits. If your connective tissues are tight or your muscles are weak, a simple activity like picking up something heavy or rolling your ankle may cause an injury.

Causes of Tears

Tendon and ligament tears are often caused by abnormal movement when there's a heavy load on the tissue, such as an awkward landing after a jump. They're also possible due to:

  • Falls
  • Sudden impact, especially while fully stretched
  • Abrupt movement
  • Quickly stopping or starting
  • Sudden twisting motion

Some illnesses can cause tendons to become weak, which makes them more likely to tear. These conditions include:

  • Kidney disease
  • Hyperparathyroidism
  • Gout
  • Leukemia
  • Rheumatoid arthritis
  • Diabetes

Long periods of inactivity can also make muscles and tendons weaken and stiffen, which makes tears more likely.

Diagnosis

A healthcare provider may be able to diagnose a sprain or strain with just a physical examination.

They look for swelling and tender spots, check your range of motion, and press on the affected area. This can be extremely painful, but it's necessary for a diagnosis.

They may send you for X-rays to rule out a broken bone. An ultrasound or magnetic resonance imaging (MRI) can show how badly soft tissues are damaged.

Typically, healthcare providers classify the severity of ligament injuries as follows:

  • Grade 1 is stretching or slight tearing; pain is minimal and the body part is usable
  • Grade 2 is a partial tear; using the body part causes pain
  • Grade 3 is a complete tear; it's likely impossible to use the body part

Treatment

Treating sprains and strains often involves the RICE method. That stands for rest, ice, compression, and elevation. You may also want to take a pain reliever.

More severe injuries may require additional treatments, however.

Rest

The first 24 to 48 hours after the injury is a critical treatment period. Rest as much as possible.

For milder injuries, you may be able to gradually start using an injured extremity within a couple of days. Still, avoid any activities that cause pain.

For a more serious injury, your healthcare provider may tell you not to use the injured body part for longer. Be sure to follow the instructions you're given.

You may need to use a splint, sling, brace, or crutches to adequately rest the affected area.

Ice

For the first 48 hours post-injury, ice the sprain or strain 20 minutes at a time every three to four hours. 

If you don't have an ice pack available, you can use a bag of frozen vegetables or freeze water in a zipper bag. Place a soft cloth between the cold pack and your skin for protection.

Do not ice a sprain or strain for more than 20 minutes at a time. You won't help it heal any faster and could cause tissue damage.

Compression

You can use an elastic bandage for compression when elevating a sprain or strain in early treatment.  Wrap the area, overlapping the elastic wrap by one-half of the width of the bandage with each pass.

It should be snug without cutting off circulation. If your fingers or toes become cold, blue, or tingle, take the bandage off and re-wrap it.

This is good for something like a sprained ankle but may not be feasible or helpful for something like a back strain.

Elevation

Elevating the injury can help keep swelling down, which reduces pain. Try to get the injured part higher than your heart, if possible.

At night, you can elevate an arm or leg by placing pillows under your limb.

Anti-Inflammatories

Non-steroidal anti-inflammatory drugs (NSAIDs) can ease swelling and pain in an injury. Over-the-counter NSAIDs include:

Follow the dosing guidelines on the label. Don't take more than that unless instructed to by a healthcare provider.

Options for Severe Sprains and Strains

For more serious injuries, you'll probably need to immobilize the area for a while. This may be done with a brace, splint, or cast.

The time required varies depending on the location and severity of your injury. For Grade 2 and 3 ankle sprains, for example, the recommendation is strict immobilization for between seven and 10 days.

Once you're allowed to move the injured part, it may still be weeks or even several months before you're back to unrestricted activity.

In some cases, surgery may be needed to repair the damage. This is more common in people who are young and athletic. That's at least in part because kids may be too active too soon after an injury.

Summary

Sprains are ligament injuries and strains are muscle or tendon injuries. Symptoms include pain, inflammation, and difficulty using the injured part.

Both injuries can be caused by over-stretching the soft tissues. They can involve partial or complete tears.

Healthcare providers diagnose sprains and strains with a physical exam. Imaging may be done to rule out a fracture or assess the damage. Sprains are often given a grade of 1 through 3 based on their severity.

Rest, ice, compression, elevation, and NSAIDs are the standard treatment for sprains and strains that aren't severe. In more severe cases, you may need to immobilize the body part. Surgery may be performed for severe tears in young, athletic people.

A Word From Verywell

Sprains and strains should be taken seriously. The better you follow the treatment regimen that's right for your injury, the sooner it'll heal.

Remember to have it checked by a healthcare provider to make sure nothing more serious is going on. Then, plan to take it easy for a few days (at least) to give your body time to recover.

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12 Sources
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