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Sprains v Strains – how to know which is which – and what to do about it [article]

This article will shed light on the difference between muscle sprains and strains. We will also look at the causes and symptoms; how to treat muscle sprains and strains, and finally tips and tricks to prevent these types of injuries in the future.

 

What are sprains and strains?

At some stage over the years we have all damaged what’s known as our soft tissues; (muscles, tendons or ligaments). We’ve probably all been told someone it’s a sprain or a strain – but how do we know which is which?

 

Sprain

 

A sprain is an overstretching or tearing of a ligament (the tough white tissue which attaches bone to bone and generally found around joints)

 

Strain

 

A strain is an overstretching or tearing of muscle or tendon (the connective tissue which connects muscle to bone). Other common names for a strain are such things as a torn or pulled muscle or a ruptured tendon.


What causes sprains and strains?

 

Sprains occur many ways. The most common causes are falls (like rolling your ankle on rough ground), excessive twisting or being hit by an object (such as tackle in soccer). These incidents will cause a joint to move out of its normal range of motion resulting in the overstretching or tearing of a ligament.

Strains can occur over time or suddenly. Strains that occur over time are also referred to overuse injuries. They occur due to the continual stressing of a muscle fibres and its tendon (like overusing the tendons in the wrist with too much typing).

 

Strains that occur suddenly (acute) are due to a stretching, twisting or overloading of a muscle and its tendon.  A strain occurring suddenly is generally caused by over stressing/overloading a muscle (such as lifting heavy objects with poor technique and straining a muscle in your back) or stressing a previously injured area (such as sprinting and straining a hamstring that was not fully recovered).

 

How do you know whether it’s a sprain of strain?   

 

A sprain occurs suddenly around a joint and leads to symptoms such as:

  • Direct pain
  • Swelling
  • Bruising
  • Inability to use or move the joint.

 

A sprain can be categorized according to the severity:

            1st Degree (mild)             – Very few fibres are torn

            2nd Degree (moderate)     – A large number of fibres are torn

            3rd Degree (severe)         – A complete rupture of the muscle or tendon

             

A strain can occur over time or suddenly and shows the following symptoms:

  • Localised pain/ tenderness
  • Muscle weakness
  • Swelling
  • Muscle spasms / cramping
  • Limited movement

 

Similar to sprains, strains are categorized according to the severity:

            1st Degree (mild)             – Very few fibres are torn

            2nd Degree (moderate)     – A large number of fibres are torn

            3rd Degree (severe)         – A complete rupture of the muscle or tendon

 

Acute Treatment

 

Acute (immediate) treatment of sprains and strains is the same initially. Firstly you need to decide whether further medical advice is needed or not. If there are any deformities (something looks out of shape), changes in skin colour or large amounts of swelling about the injury site then it’s recommended that the injured site be immobilised and that further help be sought.

 

If medical assistance is not required immediately then the following should take place:

            P = Protect from further injury (splints, pads or crutches)

            R = Restrict activity, rest (first 48-72 hours)

            I  = Apply Ice (every 20mins per hour)

            C = Apply Compression (elastic bandage)

            E = Elevate injured area (elevate injured area above heart, if possible)

            D = Send person for diagnosis (if pain has not subsided after 24 hours)

 

During this phase stay away from HARMS which increase damage to the injury:

            H = Heat (Sauna, spa, hot showers etc all increase bleeding)

            A = Alcohol (Increases swelling)

            R = Running (Exercising too soon increases bleeding and swelling)

            M = Massage (Massage or heat rubs increase swelling and bleeding)

            S = Stretching (Stretching further tears damaged muscle fibres, ligaments or tendons)

 

Rehabilitation

 

Although acute injury treatment is similar for sprains and strains, their time to heal is different. Sprains take longer to heal as they are the result of damage to ligaments. Ligaments are made up of bundles of dense fibrous connective tissue, and are avascular (without blood vessels) which is why they appear white and take such a long time to heal (e.g.: Achilles tendon rupture).

 

This is different to a strain, which is muscle and tendon based injury. As muscles have rich supply of blood and nutrients from capillaries, they can heal much faster. Tendons also have blood supplied (although in small amounts) via the musculotendinous (between muscle and tendon) and osseotendinous (between bone and tendon) junctions, so tendons also heal quicker than ligaments.

 

The timeline for rehabilitation also varies depending on the severity of the injury, but as a general guideline the following three stages should be completed as soon as possible, injury permitting. If you or your clients are unsure at any stage, seek medical advice.

 

1st stage =         First 48-72 hours post injury

                        PRICE and No HARMS

 

2nd stage =        Post first 48-72 hours

                        Gentle muscle / joint movement

                        Muscle / joint stability exercises

                        Mild resistance exercises followed by icing

 

3rd stage =        Once movement is pain free

                        Gradually return to more strenuous strengthening activities

Pain should remain low; if it increases, stress is too much on injured area

 

How to avoid future sprains and strains

 

To decrease the likelihood of future injuries the following are recommended

 

  • Always perform a gradual warm-up before exercise and a gradual cool down after exercise
  • Stop any exercise if you feel pain!
  • Improve general strength and fitness to protect muscles and joints
  • Improve specific sports skills and techniques, preparing muscles and joints for the stresses they will be placed under during activity
  • Correct any muscle strength imbalances

 

 

Understanding the differences between strains and sprains allows us to better understand how these injuries occur as well as how to treat and rehabilitate from them. It also allows us to write better programs, whether for recovery and rehabilitation from a sprain or strain, or manipulating current training around these injuries.

 

 

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