How it Works: Strain vs Sprain

By Jarrod Beachum, PA-C

With the good summer weather comes an increase in outdoor sports, hiking, exercise, and other fun activities. With the bad summer weather comes the frequent rains, with wet stairs and sidewalks, slippery floors, and more. Either way, we tend to see an increase in ankle and wrist injuries during this time of the year. When we are describing your injury to you, we may use words that sound the same but are actually different problems. I wanted to write this blog to explain the difference so you have a better understanding of the situation if the time comes.

A sprain is an injury to the ligaments. That injury can be overstretching it (Grade 1), partial tearing (Grade 2), or complete tear (Grade 3). Ligaments are what connect our bones together. They are made of mostly collagen and don’t have a good blood supply, so they are slower to heal. If you took all of the muscles off of us, we couldn’t move, but the bones would still be held together thanks to the ligaments. Some famous ligaments most people are familiar are the knee ligaments, such as the ACL (anterior cruciate ligament) or PCL (posterior cruciate ligament). However, the most common ligament sprains are those to the ankle, and there are a bunch of them! When you twist your ankle and we are in the office moving it around and causing pain (sorry!), we are checking to see if the various major ligaments are still intact or not. We are also looking for other signs of sprains, including swelling, localized pain, bruising, popping, or restricted movement. For Grade 1 and Grade 2 sprains, we would most likely recommend rest, ice, compression, and elevation, along with anti-inflammatories. Suspected Grade 3 sprains would most likely be referred for further evaluation and could be treated with casting, rehab, and surgery in severe cases (rare).

A strain on the other hand is an injury to either the muscles or the tendons that connect the muscles to bones. As with sprains, the extent of injury ranges from overstretching to complete tearing of the tissue, which can be quite painful and results in the inability to complete the normal range of motion for the muscle group affected. Strains can be both acute and chronic. A common chronic strain can be seen in tennis elbow (lateral epicondylitis), where the tendons in the outside of the elbow are overworked and strained, causing inflammation and pain at the point where they attach to the humerus. A common muscle strain is seen with heavy lifters, usually in the biceps or pectorals. The symptoms of muscle or tendon strains are generally the same as those for sprains, but the location of the pain and how it started hurting gives us a clue as to the nature of the injury. Of course, you can absolutely have a strain and sprain at the same time, and generally the treatment is the same anyways. What is important is to follow the recommendations for treatment so you can safely recover without causing more damage. With correct and prompt treatment, most sprains and strains will recover well with conservative care.

If you would like to know more about this topic or any other, please stop by 45 Urgent Care and I will be glad to talk to you. Keep us in mind in the unfortunate event this happens to you. We are open 8a-8p Monday through Saturday, so no need to wait long hours in the ER if you don’t have to!

Jarrod Beachum, PA-C