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Strains and Sprains

  • Chris Woolston
  • Posted March 11, 2013

What's the difference between a strain and a sprain?

Both strains and sprains are injuries caused by over-stretching. The muscles, tendons, and ligaments in your body are all elastic tissues, made for stretching to a point. Past that point, the tissue breaks. Both types of injuries can cause sharp and immediate pain.

A strain is damage to a muscle or the tendon that links muscle to bone. The most common places for this sort of injury to happen is in the neck, back, thigh, or calf. A strain hurts, and you may see a bruise or experience tenderness deep in the muscle.

A sprain is an injury to a ligament, the elastic tissue in your joints like the ankle, knee, wrist, or elbow. You may actually hear a snap or pop when a sprain happens. The joint will swell or bruise. Very rapid swelling can be one sign that the injury is severe. If that happens or if you are unable to put any weight on the joint without intense pain, you should see a doctor.

How do these injuries occur?

Strains occur most frequently when a muscle gets stretched in an awkward or unexpected way. Bending at the waist to lift a heavy object is a prime cause of back strain. Another cause of strain is sudden effort, like breaking into a sprint or jumping right into a weight-lifting exercise without warming up first.

Sprains are more likely to happen when you stumble or fall. When your foot rolls sideways on a rocky trail or the edge of a curb, you can sprain your ankle. Similar pressures can happen while you move and brake quickly while playing sports like basketball or tennis. Another cause of sprains is a bad landing after a jump. You might stretch or tear ligaments in your wrist or elbow if you try to break a fall with an outstretched arm, forcing those joints to absorb your full weight.

How can I avoid strains and sprains?

To avoid strains, take the time to learn how to lift properly, using your leg muscles instead of your back. If you exercise more regularly, you may be able to prevent some strains simply because the muscles will be both stronger and more flexible.

You can lower your risk of sprains by choosing the right shoes and protective gear sports. Running shoes are designed to cushion and absorb the shocks that happen during long, regular strides. That cushioning can actually cause problems if you use those shoes for tennis or a back-country hike, because those activities require more ankle support. You can't be prepared for accidental falls, but tumbles are bound to happen while you learn a new sport like in-line skating or snowboarding, so plan accordingly. Wear protective wrist, elbow, and knee pads to keep those joints in working order.

And warming up before exercise really is worth it. A few minutes of light aerobic activity heats up your muscles and ligaments, making them more pliable and less prone to tearing. Stretching is also a good idea, especially if you make it a regular practice, since it can increase flexibility.

It's worth repeating that exercise is your first defense. The payoff is stronger muscles that are less likely to strain. And exercise improves your balance and coordination, reducing the chance you will experience an accidental fall. Just make sure you respect your body and ease into any new stretches or activities.

How should I treat a strain or sprain?

Both a strain and a minor sprain can benefit from the RICE treatment:

Rest: Give the injury 24 to 48 hours of quiet to heal. Use crutches or a sling to take the pressure off damaged joints.

Ice: Get ice on the injury as soon as you can. Cold can ease pain and reduce inflammation. If you don't have an ice pack, grab a bag of frozen peas. Protect your skin with a layer of damp towel, though, and don't leave the pack on for more than 20 minutes at a time. Apply the ice pack at least three times a day for the first couple of days.

Compression: Fluid can accumulate in the damaged tissue. An elastic bandage can provide the compression you need, but be careful not to wrap it too tightly since that can restrict blood flow. Tingling, cold, or a bluish tint are all signs that the bandage is too tight.

Elevation: Position the injured area so it is higher than your heart. This means sitting or stretching out with a pillow under your leg or arm. This will help reduce swelling.

In addition to the RICE remedy, you should take an anti-inflammatory pain reliever such as aspirin or ibuprofen. You'll hurt less, and the swelling should go down.

It may take a week or more for the healing to take place. Take it easy when you resume normal activity. If it hurts to move the joint, don't push it. Once you can move it without pain, start strengthening the muscles around it. A physical therapist can give you advice about exercises.

When should I see a doctor?

Moderate and severe sprains and strains will benefit from prompt treatment.

Don't ignore these symptoms:

  • Severe pain or extreme sensitivity to touch.
  • Inability to bear weight.
  • Swelling is normal, but lumps or crookedness along the injured joint or muscle are not.
  • Numbness in the injured area.
  • Redness or red streaks spreading out from the injury.

References

American Academy of Orthopaedic Surgeons. Sprains and strains: Whats the difference? 2007. http://orthoinfo.aaos.org/topic.cfm?topic=A00111

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Sprains and strains. 2009. http://www.niams.nih.gov/Health_Info/Sprains_Strains/default.asp

Mayo Clinic. Sprains and strains. 2009. http://www.mayoclinic.com/health/sprains-and-strains/DS00343

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