If you have ever tried to distinguish between sprains and strains but cannot quite identify the difference between the two, you are not alone. These two terms are often used interchangeably to describe overstretching or tearing of soft tissues in and around your joints. There is a key difference, and knowing what that is can help you differentiate between joint sprains and strains.
Sprains are injuries to the ligaments, and strains affect the muscles and tendons. Their symptoms are nearly identical—but may offer clues as to the type of injury you have. Whether it is a strain or a sprain, at-home treatment will likely follow the same course, at least at first.
Cause
Soft-tissue injuries fall into two basic categories: acute injuries and overuse injuries.
- Acute injuries are caused by a sudden trauma, such as a fall, twist, or blow to the body. Examples include sprains, strains, and contusions.
- Overuse injuries occur gradually over time when an athletic or other activity is repeated so often that areas of the body do not have enough time to heal between occurrences. Tendinitis and bursitis are common soft-tissue overuse injuries.
Common Acute Soft-Tissue Injuries
If you have hurt your foot or ankle, it is best to err on the side of caution. The acronym RICE can help you remember what to do:
Rest—Rest the affected area. Stay off the injured foot or ankle until it can be fully evaluated. Walking, running, or playing sports on an injured foot or ankle may make the injury worse.
Ice—Apply ice to the affected area as soon as possible, and reapply it for 15–20 minutes every three or four hours for the first 48 hours after injury. Ice can decrease inflammation.
Compression—Wrap an elastic bandage (such as an Ace wrap) around the affected foot or ankle. The wrapping should be snug, but not so tight as to cut off circulation.
Elevation—Elevate the affected extremity on a couple of pillows; ideally, your foot or ankle should be higher than your heart. Keeping your foot or ankle elevated also decreases swelling.
-
Strains
A strain is a twisting, stretching or pulling of a muscle or its attachment. It can be acute, caused by over stretching or pulling of the muscle/tendon or chronic, the result of overuse through prolonged, repetitive movement. Pain, swelling and muscle spasms are all usual symptoms of a strain.
A strain affects the muscles, tendons and ligaments but has less to do with joint function. Common strains are in the lower back and hamstrings, especially in athletes. Strains can also occur in the wrist, ankle and other parts of the body where major muscles and tendons are present. A strain can cause extreme pain, no matter where it is.
Treatment is mostly DIY and exclusively aimed at offering comfort. Think massage, heat, stretching, and rest. For a runner with a muscle strain, running, jumping and sprinting should wait until you can stretch and walk comfortably. Meanwhile, proper stretching and warm-ups can help prevent future injury.
Symptoms include:
- Pain
- Muscle weakness/stiffness
- Swelling/bruising
- Cramping
- Decreased motion or difficulty with activities of daily living
-
Sprains
Similar to a strain, a sprain is a stretching or tearing of the ligament, the soft tissue structures that hold joints together and restrict or constrain movements within the joints. It can range from very mild to significant. Like a strain, sprains result in discomfort, swelling, and limited mobility in the affected area, and can occur in a variety of settings, including activities that involve lots of pivots and direction changes, like skiing and football.
Rest and protection of the joint are the initial recommendations for a sprain. If the issue persists, medical attention is recommended. Treatment depends on which ligament is injured and could include bracing to protect the injured area and allow it to heal. Once swelling is reduced, range of motion, strength and flexibility will be reintroduced through various exercises dictated by a physician.
Sprain symptoms include
- Pain
- Bruising
- Limited movement
- Muscle spasm
- Muscle weakness
- Swelling
- Cramping
- Feelings of instability or “giving out”
- Difficulty with walking, moving or using an injured area
-
Fractures
Unlike strains and sprains, a fracture is when a bone is cracked or broken. Symptoms of a fracture include sudden, severe and immediate pain, swelling, and bruising, and the inability to bear weight or move the injured part of your body. The symptoms of a fractured bone may not always be obvious.
A diagnosis is typically made after a physical exam and imaging, such as an x-ray, MRI, or ultrasound. The majority of fractures are treated with rest and immobilization and, in some cases, surgery. But each fracture and part of the body has different rules and orthopedic plans and algorithms based on the type and degree of the fracture. Some require surgery, and some just need two or three weeks of immobilization.
Signs and symptoms of fractures include:
- Pain
- Swelling
- Bruising
- Limited or painful motion
- Deformity
-
Contusions (Bruises)
Contusions occur when a direct blow (or repeated blows) by a blunt object strikes part of the body, crushing underlying muscle fibers and connective tissue without breaking the skin. A contusion can result from falling or jamming the body against a hard surface. Discoloration of the skin is caused by blood pooling around the injury.
Most contusions are mild and respond well to the RICE protocol. If symptoms persist, medical care should be sought to prevent permanent damage to the soft tissues.
When to See a Doctor
Mild sprains and strains can usually be treated at home. However, it’s time to seek professional medical care if you are concerned that your child has fractured a bone.
Visit the doctor if your child:
- Cannot move the joint
- Cannot bear to put weight on the limb
- Experiences numbness in the injured area
- Has swelling or bruising directly over a bone
Prevention
Injuries often occur when people suddenly increase the duration, intensity, or frequency of their activities. Many soft-tissue injuries can be prevented through proper conditioning and training. Other prevention tips include:
- Use Proper Equipment
Replace your athletic shoes as they wear out. Wear comfortable, loose-fitting clothes that let you move freely and are light enough to release body heat.
- Aim for Balanced Fitness
When developing a fitness program, make sure it is one that is balanced and incorporates cardiovascular exercise, strength training, and flexibility. Add activities and new exercises cautiously.
- Warm Up
Warm up to prepare for exercise, even before stretching. Run in place for a few minutes, breathe slowly and deeply, or gently rehearse the motions of the exercise to follow. Warming up increases your heart and blood flow rates and loosens up muscles, tendons, ligaments, and joints.
- Stay Hydrated
Drink enough water to prevent dehydration, heat exhaustion, and heat stroke. Drink 1 pint of water 15 minutes before you start exercising and another pint after you cool down. Have a drink of water every 20 minutes or so while you exercise.
- Cool down
Make cooling down the final phase of your exercise routine. It should take twice as long as your warm-up. Slow your motions and lessen the intensity of your movements for at least 10 minutes before you stop completely. This phase of a safe exercise program should conclude when your skin is dry and you have cooled down.
- Stretch
Begin stretches slowly and carefully until reaching a point of muscle tension. Hold each stretch for 10 to 20 seconds, then slowly and carefully release it. Inhale before each stretch and exhale as you release. Do each stretch only once. Never stretch to the point of pain, always maintain control, and never bounce on a muscle that is fully stretched.
- Rest
Schedule regular days off from vigorous exercise and rest when tired. Fatigue and pain are good reasons not to exercise.
Ask Your Doctor
A high ankle sprain can be painful and can lead to significant functional loss and disability. Working to gain mobility and strength after a sprain should be your main goal. Tightrope surgery and physical therapy can help you return to optimum functional mobility as quickly as possible.
To learn more about this procedure or to schedule an appointment with one of our specialists, call us at 800-698-1280.
