Distinguishing a sprain from a strain can be difficult. They share many similarities, including common symptoms, severity grading, and treatment approaches. However, the primary distinction between the two lies in the specific soft tissues they impact.
A sprain is an injury to the ligaments around a joint, which are responsible for connecting bones to one another. Typically, a sprain is caused by overstretching the ligaments in the wrong direction, resulting in the tearing of some or all of the ligament fibers.
Common sprains include lateral ankle sprains, which occur when the ankle is rolled; knee sprains, such as those involving the ACL or MCL; and wrist sprains, often experienced when landing on an outstretched arm.
In all cases, the sprained ligaments are affected, necessitating proper care and rehabilitation to ensure a complete recovery.
The common symptoms associated with sprains include:
A sprain can range from mild to severe. There are three grades of sprains based on the amount of damage to the affected ligament.
Grade I: Minor overstretching of the ligament that can result in slight tearing. Grade I sprains typically heal within one 1-2 weeks.
Grade II: Moderate overstretching of the ligament that leads to partial tearing. The healing time for grade II sprains is increased to approximately 4-8 weeks.
Grade III: Complete tear or rupture of the ligament. May require surgical reconstruction as ligaments do not typically heal on their own. The healing time for grade III sprains varies but is often longer than 8 weeks.
The first step in treating a sprain is often offloading, which involves a period of relative rest and/or immobilization depending on the severity of the injury. Additionally, range of motion exercises and soft tissue mobilization through manual therapy are incorporated to improve flexibility and mobility.
Strengthening exercises are important for the muscles in the affected region as they help to provide stability and support during the healing process. Balance/proprioception exercises are also commonly included to enhance coordination and prevent future injuries. Lastly, if the goal is to return to sports, sports-specific training and progressions are integrated to ensure a safe and effective transition back to the desired level of physical activity.
A strain is an injury to tendons and/or muscles. Tendons are the tissue that connects muscles to bones whereas a muscle is the tissue that contracts allowing us to move. There are two main types of strains: acute strains and chronic strains. Acute strains result from a sudden or awkward motion, a fall, or an abrupt stretch or pull. Whereas chronic strains stem from repetitive overuse of the muscle or tendon, particularly when the muscle is fatigued, weak, under-trained, or over-trained.
Common examples of strains include hamstring strains, rotator cuff strains, and calf strains. In all these cases, the tendons or muscles experiencing the strain are impacted. It is crucial to provide proper care and engage in rehabilitation measures to promote a complete recovery.
The common symptoms associated with strains include:
A strain can range from mild to severe. There are three grades of strains based on the amount of damage to the affected muscle or tendon fibers.
Grade I: Mild strain that only affects a small portion of fibers. The symptoms of a grade I strain include mild soreness. However, the range of motion and strength are generally unaffected.
Grade II: Moderate strain that results in the tearing of about 50% of the fibers. With a grade II strain, acute pain and loss of range of motion are likely.
Grade III: A severe strain can lead to a complete rupture of the muscle and/or tendon, causing the tendon to detach from its attachment site on the bone. In such cases, the pain is intense, accompanied by a total loss of function. Surgical intervention is typically necessary to reattach the tendon.
The rehabilitation for a strain comprises several key elements. Firstly, offloading is implemented, which involves a period of relative rest and/or immobilization based on the severity of the strain. Secondly, range of motion exercises are incorporated, including soft tissue mobilization through manual therapy, as well as passive and active range of motion exercises with an initial emphasis on avoiding stretching. Lastly, strength training plays a crucial role in the rehabilitation process, gradually reintroducing load to the muscle tissue through progressive resistance training.
Obtaining an accurate diagnosis for sprains and strains is important for effective rehabilitation. At MAVEN, our highly skilled physical therapists specialize in developing rehabilitation programs tailored to these types of injuries. Contact us today to book a consultation.
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