Millions of people see their doctors each year for muscle and tendon strains and ligament sprains. These common injuries often lead to pain, weakness, and muscle spasms, and significantly affect daily activities.
The most common types of sprains and strains include ankle sprains, wrist sprains, back strains, and ACL tears.
If you think you may have a sprain or strain, you should see your provider to prevent further harm to your muscles, tendons, and ligaments. Rest, ice, compression, and elevation can help you recover from your injury, but some cases may require surgery or physical therapy.
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What Is a Sprain or Strain?
Doctors define a sprain as a condition where one or more of the ligaments in your joint are damaged or torn. Ligaments connect the bones to your joints. When damaged, your joint may become unstable, and you also may experience pain and inflammation.
Sprains often happen when you twist, turn, or stretch a joint beyond its normal range of motion. This can occur during activities like running, jumping, or playing sports, where you might land awkwardly or change direction suddenly.
A strain is a condition where you stretch or tear a muscle or tendon that connects to the bones in your joint. These muscles and tendons play a crucial role in allowing you to move your body and control movement. When damaged, you may have limitations in mobility and rotation and experience pain.
Strains often happen when a muscle or tendon gets stretched too far or contracts too strongly. This can occur during activities that require repetitive movements, lifting heavy objects, or sudden movements.
How common are sprains and strains?
Sprains and strains are frequent injuries, affecting millions of people each year. Symptoms may vary, with some people having persistent pain, while others may have sudden pain and inflammation due to an injury.
The most common types of sprains are ankle sprains, knee sprains, and wrist sprains. You can sprain other areas, but these joints are the most prone to sprains.
What are the types of sprains?
Doctors grade sprains based on how bad the injury is. There are three grades:
- Grade 1 sprain. This is a mild sprain with some damage to the ligament. With rest and ice, it may heal on its own.
- Grade 2 sprain. This is a moderate sprain, which means there could be a partial tear of the ligament. The joint is somewhat unstable and might need immobilization, such as with a walking boot or wrist splint.
- Grade 3 sprain. This is a complete tear of the ligament, which can make the joint very unstable. Some grade 3 sprains require surgery to repair the torn ligament.
What are the types of strains?
Strains, like sprains, range from mild to severe. You can overstretch a muscle or tendon and heal with ice and rest, or you can partially or completely tear a tendon and may need surgery.
Strains are either:
- Acute strains. These occur suddenly, often due to a sudden movement, forceful contraction, or overworking the muscle or tendon.
- Chronic strains. These develop over time due to repetitive movements or overuse of a muscle or tendon.
Both acute and chronic strains can vary in severity, ranging from mild discomfort to severe pain and limited mobility.
What causes sprains and strains?
A sprain or a strain may happen from:
- Starting an intense exercise program too quickly.
- Continuing to do physical work when you're very tired.
- Wearing high-heeled shoes or footwear that doesn't fit well.
- Picking up something heavy.
- Not using proper lifting techniques.
Although sprains and strains are common in athletes, they can happen to anyone who overuses or puts too much stress on their joints and muscles.
What are sprain and strain risk factors and complications?
Sprain and strain risk factors
Many factors may put you at risk for a sprain or strain, including:
- Previous injury. If you previously had a sprain or strain, you're more susceptible to future injuries in the same area.
- Fatigue. Tired muscles are more prone to injury.
- Improper warm-up. Failing to properly warm up before physical activities can increase your risk of injury.
- Poor flexibility. Limited joint flexibility can make certain movements more difficult, increasing the likelihood of sprains and strains.
- Overuse. Repeating the same motion or activity excessively, without allowing time for rest and recovery, can strain muscles and ligaments.
- Age. Older people may have decreased muscle strength, balance, and flexibility, making them more susceptible to sprains and strains.
- Environmental factors. Slippery or uneven surfaces, inadequate lighting, or other hazardous conditions can increase the risk of injury.
- Sports and activities. Certain sports or activities, such as contact sports or those involving sudden stops or changes in direction, have a higher risk of sprains and strains.
- Improper equipment. Wearing ill-fitting or worn-out footwear or using faulty sports equipment can contribute to the risk of injury.
Sprain and strain complications
Sprains and strains can lead to complications if not treated or if they're severe.
Some common complications include:
- Chronic pain. If a sprain or strain doesn't heal properly or if there's underlying damage, it can lead to long-term or chronic pain in the affected area.
- Joint instability. Severe sprains can cause instability in the affected joint, making it more prone to future injuries or dislocations.
- Limited mobility. Injuries to muscles, tendons, or ligaments can result in decreased flexibility and range of motion, making it difficult to perform daily activities or play sports.
- Recurring injuries. Without proper rehabilitation and strengthening exercises, the risk of recurring sprains or strains in the same area increases.
- Muscle weakness. Prolonged immobilization or lack of appropriate rehabilitation exercises can lead to muscle weakness in the affected area.
- Arthritis. In some cases, severe or repeated injuries to joints can increase the risk of developing arthritis later in life.
- Nerve damage. Injuries to muscles, tendons, or ligaments may also affect nearby nerves, leading to symptoms such as numbness, tingling, or weakness in the affected area.
It's essential to seek medical attention for sprains and strains, especially if they're severe or if symptoms persist. Proper treatment, rehabilitation, and preventive measures can help reduce the risk of complications and promote full recovery.
How can I prevent a sprain or strain?
To help prevent sprains and strains, you can:
- Gradually increase intensity. When starting a new exercise or activity, gradually increase the intensity, duration, and frequency over time. Sudden increases in intensity can strain muscles.
- Listen to your body. Pay attention to any pain, discomfort, or signs of fatigue during physical activity. Stop or modify your activity to prevent pushing yourself beyond your limits.
- Maintain a healthy weight. Excess weight can put additional stress on your muscles and joints. Maintain a healthy weight through a balanced diet and regular exercise.
- Maintain physical fitness. Engage in regular exercise to improve strength, flexibility, and overall physical fitness. This can help support and protect your muscles and joints.
- Pay attention to surfaces. Be cautious when walking, running, or exercising on uneven or slippery surfaces. Use appropriate footwear with good traction and avoid hazardous conditions.
- Take breaks and rest. Allow sufficient time for rest and recovery between exercise sessions or intense activities to avoid overuse injuries.
- Use proper technique. Learn and use proper technique and form for activities such as lifting, jumping, or sports-specific movements.
- Use protective equipment. For high-risk activities or contact sports, wear appropriate protective gear, such as helmets, knee pads, or wrist guards.
- Warm up before participating in any physical activity or exercise. Spend a few minutes doing dynamic stretching and low-intensity movements to prepare your muscles, tendons, and ligaments for more intense activity.
- Wear proper footwear. Ensure you wear appropriate footwear that provides support and cushioning for your activity or sport. Replace worn-out shoes regularly.
Remember, while these preventive measures can reduce the risk of sprains and strains, it is still possible to experience injuries. If you do get injured, it's important to rest, apply appropriate first aid measures, and see your doctor if needed.
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What Are the Signs and Symptoms of Sprains and Strains?
The signs and symptoms of sprains and strains can vary depending on the severity of the injury, but there are some common symptoms.
Sprain symptoms
- Bruising. In some cases, bruising may appear around the sprained area due to damage to small blood vessels during the injury.
- Limited range of motion of the affected joint. Moving the joint may become painful or difficult.
- Pain at the site of the injury. The intensity of pain can range from mild to severe, depending on the severity of the sprain.
- Swelling around the affected joint or area. The swelling may occur immediately or develop over time.
- Tenderness. The area around the sprain may be tender to touch.
Strain symptoms
- Limited range of motion in the affected muscle or joint.
- Muscle cramping. There may be a painful tightening or knotting sensation in the muscle.
- Muscle spasms. Strains can cause sudden, involuntary contractions of the affected muscle.
- Muscle weakness in the affected area. It may be difficult to perform certain movements or activities.
- Pain in the affected muscle or tendon. The pain can range from mild to severe, depending on the extent of the strain.
- Swelling in the area of the strained muscle. This is generally less pronounced compared to sprains.
These symptoms can overlap, and your doctor should evaluate your condition for an accurate diagnosis and appropriate treatment.
When should I see a doctor about my sprain or strain symptoms?
You should consider seeing a doctor for your strain or sprain if you experience any of the following:
- Inability to bear weight or move. If you're unable to put weight on the injured limb or if you have significant difficulty moving the affected area, it may be a sign of a severe sprain or strain.
- Joint instability. If the joint feels loose or "gives way" during normal movement, you may have a more severe injury, such as a ligament tear.
- Limited range of motion. If you have persistent difficulty moving the injured area or notice a significant loss of range of motion, see your doctor for an evaluation to determine the extent of the injury and guide appropriate treatment.
- Numbness or tingling. This could be a sign of nerve involvement.
- Recurring injuries. If you have a history of recurring sprains or strains in the same area, your doctor can assess the underlying cause and provide guidance on how to prevent future injuries.
- Severe pain. Intense and persistent pain that doesn't improve with rest, over-the-counter pain medication, or self-care measures could indicate a more serious injury.
- Significant swelling or bruising. If the swelling and bruising are extensive, or if they don't improve within a few days, it can indicate a more severe injury or the possibility of other underlying issues.
- Any concerns or uncertainty. If you have any concerns or are unsure about the severity of your injury, have your doctor evaluate your condition, provide an accurate diagnosis, and recommend appropriate treatment options.
Remember, it's best to see your doctor for a diagnosis and treatment recommendations based on your specific injury.
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How Do You Diagnose a Sprain or Strain?
To diagnose a sprain or strain, your doctor will:
- Take your complete medical history, focusing on any previous injuries you may have had.
- Perform a physical, paying special attention to the joint's stability, range of motion, and any inflammation while asking about pain.
Depending on the results of the exam, your doctor may order additional tests.
Additional tests to confirm a sprain or strain
- Imaging tests to provide a more detailed view of the injury. X-rays can help rule out bone fractures, while MRI or ultrasound scans can assess soft tissues, such as ligaments, tendons, and muscles, for sprains or strains.
- Additional tests. Depending on the severity and location of your injury, additional tests, such as CT scans or electromyography (EMG), can evaluate the extent of the damage or assess nerve involvement.
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How Do You Treat a Sprain?
Treating a sprain involves a combination of first aid, followed by rest, ice, compression, and elevation (R.I.C.E).
Here are the steps your doctor may recommend:
- Rest. Avoid putting weight or strain on the injured area. If necessary, use crutches or a cane to assist with mobility.
- Ice. Apply ice to the affected area for 15 to 20 minutes every two to three hours during the first 24 to 48 hours to help reduce swelling and pain. Use a cold pack or wrap ice in a thin towel to avoid direct contact with the skin.
- Compression. Use a compression bandage or an elastic wrap to gently wrap the injured area. This helps reduce swelling and provides support to the sprained joint. Be careful not to wrap it too tightly, as it may interfere with circulation.
- Elevation. Raise the injured area above the level of the heart, if possible. This helps reduce swelling by allowing fluid to drain away from the injured site.
- Pain management. Over-the-counter pain relievers like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can help alleviate pain and reduce inflammation.
- Supportive devices. Consider using a brace, splint, or crutches to provide stability, protect the injured joint as it heals, and help prevent further injury.
- Physical therapy. Once the pain and swelling reduce, it's important to start gentle exercises and stretches to regain strength and range of motion. Consult your doctor or physical therapist for guidance on appropriate exercises.
- Surgery. Severe sprains may require surgery if the ligament is too damaged to heal properly on its own.
Remember, if the pain and swelling worsen or don't improve after a few days, it is important to see your doctor for an exam and treatment.
How Do You Treat a Strain?
The treatment for a strain may vary depending on the severity of the injury. Your doctor may recommend:
- Rest. Avoid activities that cause pain or further aggravate the strained muscle. Give yourself time to rest and allow the muscle to heal. In more severe cases, you may need to immobilize the area with a splint or brace.
- Ice therapy. Applying ice to the strained area can help reduce swelling, inflammation, and pain. Use an ice pack wrapped in a thin cloth or a bag of frozen vegetables and apply it to the area for about 15 to 20 minutes every two to three hours, especially in the first 48 to 72 hours after the injury.
- Compression. Applying compression to the strained muscle can help reduce swelling and provide support. Use an elastic bandage or compression wrap to gently wrap the affected area. Don't wrap it too tightly, or you can hinder circulation.
- Elevation. Elevating the strained muscle above the heart level can assist in reducing swelling. Prop up the affected limb on pillows or cushions to promote fluid drainage.
- Pain relief. Over-the-counter pain medications like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can help alleviate pain and reduce inflammation. Follow the recommended dosage and guidelines.
- Gentle stretching and strengthening. Once the acute phase has passed, gentle stretching exercises and gradual strengthening exercises prescribed by your doctor or physical therapist can help restore flexibility and strength to the strained muscle.
- Physical therapy. In more severe cases or when the strain is not improving with self-care, your doctor may recommend physical therapy. A physical therapist can provide specialized exercises, manual therapy, and other treatments to promote healing, restore function, and prevent re-injury.
- Avoiding certain activities. While recovering, avoid activities or movements that can strain the injured muscle further. Gradually reintroduce activities as your muscle strength and flexibility improve.
- Surgery. Severe strains may require surgery if the muscle is too damaged to heal properly on its own.
It's important to note that the severity of the strain and individual circumstances can influence the treatment plan. It's best to consult with your doctor for an accurate diagnosis and specific treatment recommendations for your strain.
What are the goals of treatment?
The goals of treating sprains and strains are to:
- Relieve pain. The primary goal is to reduce the pain of the sprain or strain. Pain management techniques, such as rest, ice, and over-the-counter pain relievers, help alleviate discomfort.
- Reduce swelling. Swelling is a common symptom of sprains and strains. The R.I.C.E method (rest, ice, compression, and elevation) can minimize swelling, allowing the injured area to heal more effectively.
- Promote healing. Treatment aims to facilitate the body's natural healing process. By providing support to the injured area through immobilization, compression, and appropriate rest, your body can repair damaged tissues and restore function.
- Restore function and range of motion. As healing progresses, introducing rehabilitation exercises will restore strength, flexibility, and range of motion in the injured area. These exercises help prevent stiffness and improve functional abilities.
- Prevent further injury. By providing proper support and protection to the injured area, treatment aims to minimize the risk of recurrent injuries or complications. Supportive devices such as braces, splints, or taping techniques can help stabilize the joint and prevent further strain.
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