What is the Difference Between a Sprain and a Strain? – Sarah Fischer

What is the Difference Between a Sprain and a Strain? – Sarah Fischer

Sprain and strain, the two sound pretty similar but they actually are two different injuries. Some people aren’t sure which is which, or what the difference is, as there are similarities between the two, but over the next few paragraphs I will go over what actually occurs with each injury and the various grade levels of the two.

So let’s start with sprain, this occurs when there is an “over stretch” to a ligament. Your ligaments are fibrous bands of connective tissue that surround each joint and attach from bone to bone. They do not have much stretch/elasticity to them  and due to this, when injured they often take more than normal to heal, and once stretched often will become and stay slightly overstretched leaving a bit more instability to the joint and a higher risk of spraining that specific area again in the future. Common area for sprain is the ankle, specifically to the lateral side due to an increase in the movement of inversion (“rolling” the ankle) making the anterior talofibular ligament the most commonly sprained ligament in the ankle. Other common area for a sprain to occur is the knee and wrist, often when hyperextension occurs with the joints.  There are three grades of classifying the severity of a sprain.

Grade 1, mild – this involves a minor stretch or slight tear to the ligament, the person is still able to continue with activity and there is no real pain with movement

Grade 2, moderate- this is when there is actual tearing to the ligament, during the time of injury the person may hear a snap or pop noise. With a grade 2 sprain there is enough pain that continuing with activity may be difficult and not advised as the joint is now less stable.

Grade 3, severe –  being classified as the most severe level, this is when there is a complete tear of the ligament and may also be an avulsion fracture, meaning that a small piece of bone has detached along with the ligament, but leaves the ligament still intact. The joint is now very unstable and activity can not continued. There will be quite a bit of pain, and may lead to chronic pain and instability of the joint that is affected.

Now, let’s go over a strain. This involves a tearing/overstretch to the musculotendinous junction, where the muscle and tendon connect, may also occur where the tendon attaches to bone. A strain may be caused due to over stretching the area, contracting the muscle more quickly and greater than normal against resistance, poor biomechanics due to fatigue and/or overuse, or also muscle imbalances. The musculotendinous junction may become weaker or at a higher risk to injury due to overuse to the specific area. A strain may occur and involve any muscle and tendon but some are a bit more common than most, specifically hamstring, rotator cuff muscles, biceps and iliopsoas just to name a few. Just like a sprain there are 3 grades to strain.

Grade 1, mild – causing a slight stretch or tear to the unit/junction resulting in very little to no loss in strength and the person will be able to continue with activity.

Grade 2, moderate – there may be a snapping or popping noise heard and felt at the time of injury. This will result in various numbers of fibers tearing and a dip/gap may be felt at the site of injury. The person will feel pain and have difficulty with activity due to muscle weakness and pain.

Grad 3, severe- just like previously mentioned with a sprain, this is a complete rupture of the musculotendinous unit/junction, and may even result in an avulsion fracture. The muscle will have shortened due to a complete tear and will have weakness and pain to the area.

With a sprain or strain depending on severity of the injury swelling and bruising to the area may occur in the initial acute phase. Healing time can take longer than other tissues when the ligament and/or tendon is directly affected as both tissues are hyopvasular. In any case of a sprain or strain one should consult with a physician especially if weakness, intense pain and a gap is felt at the site of injury. Depending on the grade of the injury, more so with a grade 3 strain or sprain surgeries may be required. Once an area is injured scar tissue may occur and the site may be more susceptible to injury depending on activity and overuse. When recovering from an injury, we also tend to compensate more with the unaffected side, and other muscles will engage and take up the slack for the injured muscle. We need to be cautious and aware of our posture and body mechanics to not over use and cause injury to other areas when trying to protect the healing injury.

Massage therapy can be a great way to assist with the recovery process. Your therapist can assess the situation and create a treatment plan that best suits you and your specific needs and areas of concern. They can work with the affected and unaffected side to decrease muscles imbalances that may occur. During the recovery and rehabilitative phase of an injury, along with a treatment plan, home care exercises can be demonstrated and given to the client to assist with regaining strength and use of the affected area. Massage can help with increasing flexibility, decreasing muscle tone and adhesions/scar tissue and increase blood flow and circulation to specific areas as well. Massage is also a great for preventative care to decrease the risk of injury or re-injury.

At Adica Massage Clinic, we are here to assess your needs and treat them accordingly!