Sprains And Strains

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Woman holding her back and experiencing back pain at home, possibly due to a sprain or strain

Sprains and strains are among the most commonly experienced soft tissue injuries among adults. Statistics Canada reports that these injuries exhibited the highest incidence rates among Canadians aged 12 and over during the 2009-10 period. 51% of the individuals under study reported experiencing an injury of this type during the period. This compares with 17% who reported the next most common type of injury (bone fractures).

Sprains and strains are closely related injuries and sometimes even occur together. In addition, their symptoms are very similar and patients frequently confuse one for another.

In what follows below, we first discuss the causes of these two injury groups and how they compare with each other. We then perform a brief comparison of the symptoms and treatments of the two injury types.

Sprains And Strains – Causes & Risk Factors

Tissue Damage Involved

A key difference between sprains and strains lies in the nature of the tissue damage  involved.

Sprains are caused by damage (stretching or tearing) to the ligaments of a joint. Ligaments are tough pieces of tissue connecting bones of a joint together.

Strains are caused by similar damage (stretching or tearing) to muscles or tendons. The tendons are bands of tissue that connect muscles to adjacent bones.

Both sprains and strains tend to be classified as one of grades I, II or III depending on the severity of the damage. A grade I, or mild sprain or strain usually involves stretching, but no tearing, of the affected ligaments, muscles or tendons.

Grade II sprains or strains involve a partial tear of the affected ligament, muscle or tendon. However, a grade III injury (sprain or strain) involves a complete tear of the affected muscle, ligament or tendon.

What Causes Sprains & Strains?

Another key difference between these injuries lies in how the damage is caused. Most sprains are the result of a sudden traumatic event that exerts a significant force on the ligament.

On the other hand, strains can either be the result of a similar force or they can be the result of the muscle or tendon being overworked over a prolonged period.

This can occur, for example, with an athlete who overtrains over a period of time and does not allow enough time for rest and recovery between training sessions.

Where Do Sprains & Strains Occur?

Another important difference between sprains and strains relates to the areas of the body that they tend to affect.

Most sprains tend to appear in the form of an ankle sprain. However, strains tend to mainly occur either to the hamstring muscle (at the back of the thigh) or to the lower back.

In general, sprains tend to occur at or near a joint. This is because ligaments, the tissues that suffer damage in sprains, are mainly located in joints (they bind the bones of a joint together).

On the other hand, muscle strains can sometimes occur away from a joint. If the tendon is the injured structure, however, a strain can result in pain or swelling at or near a joint.

Risk Factors

Sprains and strains share many risk factors in common. They are both sports medicine injuries that tend to happen to athletes or physically active individuals. Athletes in contact sports are particularly affected.

For both injuries, the risk of occurrence increases for individuals with weak, undeveloped or imbalanced joint muscles. The risk of injury occurrence is also higher if you have previously experienced the same injury.

Finally, those who fail to stretch and/or warm up properly before commencing activity are more at risk of either a sprain or strain injury. This is because the muscles, ligaments or tendons are colder and less supple. This makes them more vulnerable to damage (tearing or overstretching) if they experience a sudden tug or other force.

Symptoms & Treatment

Symptoms

Both sprains and strains result in several common symptoms. Among these are pain and swelling.

There will also be joint or muscle weakness.

Both injuries also can result in contusions or skin discoloration at or near the site of the injuryt.

Additionally, for both injuries, there is sometimes a popping noise or sensation at the time the injury is incurred.

However, there is one key difference between the two injuries in relation to symptoms. In some cases, muscle or tendon strains can result in muscle spasms. However, ligament sprains tend not to produce these spasms.

In addition, as mentioned above, sprains tend to occur at or near joints. The symptoms of a sprain will usually include reduced range of motion of the injured joint.

Treatment

For both sprains and strains, treatment of a grade I (and most grade II) injuries will usually be home based and will depend on the P.R.I.C.E. strategy:

  • Protect the injured joint or muscle and allow it time to heal. Do this by refraining from activities that may place stress on the injured area. An orthopedic brace or athletic tape may be used to prevent injuries during the recovery period;
  • Allow the injured joint or muscle to Rest and recover naturally;
  • To reduce pain and swelling, apply Ice or a cold compress to the injured area for 20 minutes at a time;
  • Apply Compression to the area to improve blood flow and reduce swelling;
  • Elevate the injured area above heart level whenever possible to facilitate the flow of blood back to the heart. This will in turn promote its replacement with fresh and nutrient rich blood, thus accelerating healing.

For both sprains and strains, physical therapy is usually an important part of the overall treatment strategy. It will help to stretch and strengthen affected joints and muscles and reduce the risk of re-injury after normal activity has resumed.

Treatment of grade III sprains or strains will usually require surgery, especially if there is accompanying bone damage.

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