Do I Have a Sprain or a Strain?

Sprains and strains are common soft-tissue injuries among athletes and active people, and while they may sound alike, they are not interchangeable terms. There are some key differences between the two.

The soft tissue includes the muscles, tendons that connect muscles to bones, and ligaments that connect bones to bones. However, determining if you have a sprain or a strain will depend on what area of the soft tissue is affected.

The team at UPMC Sports Medicine provides expert care, from diagnosis to treatment, to help people heal from strains and sprains.

Sprain Vs. Strain: What’s the Difference?

If you’re wondering how sprains and strains are different, telling them apart is rather simple.

Sprains occur when you overstretch or tear a ligament. Ligaments are the bands of tissue that connect two bones together in a joint. The joints, such as ankles and wrists, are especially prone to sprains.

A strain results from overstretching or tearing muscles or tendons. They can commonly occur in one’s hamstrings (the muscle along the back of your upper leg) or lower back. “Tearing a muscle” is another way of saying muscle strain.

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Symptoms of Muscle Strains and Ligament Sprains

Sprains and strains are both likely to cause:

  • Pain.
  • Swelling around the joint or soft-tissue area.
  • Bruising.
  • Trouble moving the joint (including bending or putting weight on it).

You’re more likely to have muscle spasms or muscle weakness with muscle strains. For example, if you strain your low back, you might feel extreme tightness in your back.

If the pain or swelling lasts several days or gets worse, or you begin to have numbness and tingling, see a doctor. Also, seek care if your mobility doesn’t get any better with rest, ice, compression, and elevation.

Other reasons to seek medical attention immediately include:

  • The limb looks deformed or like something isn’t right.
  • You have fever, chills, or dizziness.
  • The pain seems to be moving around, shooting down arms or legs.

What Causes Sprains and Strains?

While these types of injuries are common in athletes and active people, they can occur when anyone overuses or overstresses their joints and muscles.

Causes and risk factors of sprains and strains may include:

  • Beginning a rigorous exercise program too quickly.
  • Continuing to perform physically demanding work when very tired, or continuing activities through existing injuries or soreness.
  • Wearing high-heeled shoes or ill-fitting footwear.
  • Picking up heavy objects.
  • Not using proper lifting techniques.

Sprains usually happen because of trauma to the joint. This can include a hit, fall, or accident, or a movement that jars your body (like a sudden twist). The trauma stretches the ligament too far, damaging it.

Twisting your ankle is a top cause of ankle sprains. Falling onto an outstretched hand is one of the most common ways people sprain a wrist.

Strains can also happen because of trauma, such as falling, landing wrong when jumping, or getting hit. Lifting something too heavy is another good way to strain your back.

Contact sports like soccer, football, hockey, and wrestling can lead to hamstring strains. Power sports that require sprinting or jumping off a block also put hamstrings at risk for strain.

But strains can also happen over time from repetitive motion. Repetitive motion strains are chronic (as opposed to acute strains, which occur during a trauma). For example, playing tennis or rowing — very repetitive movements— can cause elbow strains over time.

Diagnosing Sprains and Strains

Sprains and strains can often present with similar symptoms, so it’s important to see a health care provider to determine which injury you sustained.

The health care provider will take a medical history and ask about what you did when you first felt the pain. By asking questions and touching and moving the affected area, they may be able to diagnose a sprain or strain.

When mobility is very limited — bending, moving, or putting any weight on it causes extreme pain — the provider may order imaging scans. An X-ray or a MRI can help providers better understand the extent of the injury. Knowing the severity impacts the treatment.

An X-ray can see bony structures and rule out fractures (a broken bone), but it won’t offer much insight about the soft tissue. An MRI (magnetic resonance imaging scan), though not always required to diagnose a sprain or strain, can see your muscles, tendons, and ligaments. An MRI can show if you have a partial or complete tear of the ligament (sprain) or tendon/muscle (strain).

Sprain Vs. Strain Treatment

Treatment for sprains and strains will vary depending on the severity of the injury. For mild sprains and strains, a doctor may recommend you take a nonsteroidal anti-inflammatory medication (NSAID) such as ibuprofen.

Providers may also advise you to use the RICE method to help facilitate healing. RICE stands for:

  • Rest, meaning you should rest the joint, stay off it, and don’t use it.
  • Ice to reduce swelling. Ice the injury for 20 minutes on, 20 minutes off, as much as you can for the first 24 to 48 hours.
  • Compression, such as tape or an ACE bandage, to help with swelling.
  • Elevation means keeping the injury above your heart (if possible) or off the ground.

With RICE, mild and mild-to-moderate sprains and strains may heal at home. Your doctor may have you wear a boot or a sling to help immobilize the joint while it heals. If you’ve injured your knee or ankle, crutches may be necessary to help keep weight off of the injury.

Severe strains and sprains may need surgery. Severe means that the injury tore the muscle, tendon, or ligament. For example, ACL tears often require surgery to repair.

Your doctor may also suggest physical therapy to help you rehabilitate a sprain or strain.

For ankle sprains, it’s crucial to strengthen the area around the sprain. Ankle sprains have a high recurrence rate. After you sprain it once, you are likely to do it again. People can wind up with chronic ankle instability if a sprain doesn’t heal properly.

Visit UPMC Sports Medicine to learn more, or call 1-855-937-7678 to make an appointment for a suspected sprain or strain.

Sprains, Strains, and Other Soft Tissue Injuries. OrthoInfo. Link.

What is the Difference Between a Sprain and a Strain? Medical News Today. Link.

About Sports Medicine

An athletic lifestyle carries the potential for injury. Whether you’re an elite athlete or a weekend warrior, UPMC Sports Medicine can help. If you are looking to prevent, treat, or rehabilitate a sports injury, our multidisciplinary team of experts can help you get back into the game. If you are seeking to improve your athletic performance, we can work with you to meet your goals. We serve athletes and active people of all ages and experience levels. Our goal is to help you keep doing what you love. Visit our website to find a specialist near you.