Sprains and Strains
The terms sprains and strains are often used synonomously with each
other, however, there is a definite difference between the two. The
underlying difference lies in the type of tissues that are injured.
the differences between these two injuries, the tissues
involved, and the severity of the injury can be very beneficial when
assessing treatment options, and recovery times.
is a Sprain?
Sprains are injuries to ligaments. Ligaments are the primary connective
tissue that attaches bones to other bones. All moveable joints within
the body are created by ligaments and joint capsules. They attach two
bones together, and provide static stability to the joint, as well as
important proprioceptive feedback regarding joint position and joint
Many joints have several ligaments, and thus,
for several different structures that can be injured. For instance, at
the knee, there are four primary ligaments, the Anterior and Posterior
Cruciate Ligaments (ACL
) and the Medial and Lateral Collateral
, LCL). In addition to the
ligaments, the knee joint is
also enclosed by a joint capsule. All of these structures work together
to provide stability to the joint.
What is a Strain
Strains are injuries to muscles and tendons. Muscles are contractile
tissues that help to produce movement in the body. Tendons are
connective tissues that attach muscles to bones. Tendons are considered
non-contractile, meaning that they do not actively change length during
movement. Strains of muscles are a very common sports injury, in all
types of sports. Many different factors can lead to muscle strains,
including improper warm up, poor flexibility
, overuse of the
poor biomechanics, and many others.
Severity of Sprains
The severity is generally classified by a number, from 1-3.
The severity is determined by the amount of laxity, or looseness,
present within the ligament or joint capsule. This is determined by
your physician or certified athletic trainer
through special ligament stress tests.
When a ligament is injured, fibers within the tissue are torn. This
results in a decrease in strength of the structure, as well as possibly
stretching out the ligament. When this occurs, more movement within the
joint is possible. Stress tests to determine the severity of the damage
to the ligament are measured by the amount of motion at the joint, as
well as how the ligament feels at its end range (end feel).
Grade I involves tearing of a small amount of ligament fibers,
with very little extra motion at the joint. There is also a solid end
feel with the stress tests, showing that the ligament is intact.
Grade II sprains involve tearing of about half of
the ligament fibers, give or take. There may be a "mushy" or soft end
feel when the ligament is stress tested, and there is more available
motion at the joint during testing.
Grade III sprains involve tearing of more than half
of the ligament fibers, or a complete tear of the ligament. There is an
"empty" end feel, and a significant amount of increased motion during
The severity of strains is also often measured on a 1-3 scale. While
not as easy to determine, several factors help to measure the damage to
the muscle or tendon. This includes pain, loss of strength, loss of
function, and possible deformity of the muscle or tendon.
Grade I strains involves very small tears to the
muscle fibers, and is associated with pain during contraction of the
Grade II strains involve tearing of many more muscle fibers, and pain
levels are significant with muscle contraction. There may also be a
small area of the muscle that feels abnormal when palpated or touched.
Grade III strains involve a complete rupture of a muscle or tendon,
with significant pain and swelling, and possibly a visible defect in
Sprains and Strains
The best treatment for sprains and strains is to follow the R.I.C.E.
principles of injury treatment. Depending on your pain levels, amount
of swelling, or feelings of instability, you should seek medical
evaluation from your physician or certified athletic trainer.
Please remember that the information on these pages
is meant to help educate you regarding common sports injuries, and
should not take the place of sound medical advice from a licensed
physician or certified athletic trainer. If you are in pain, then the
best course of action is generally to seek medical advice. Use the
information on these pages to answer your questions, but go see your
family physician or certified athletic trainer.
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