Have I a Sprain or a Strain?

Sprains and strains are two types of soft tissue injury. 

A sprain is a joint injury that typically involves tearing of the ligaments and joint capsule. Common sites for sprains include the thumb, ankle and wrist.
A strain is an injury to muscle or tendons. Common sites for strains include the calf, groin and hamstring.
 
Initial first aid is important to limit the damage and encourage healing and should include rest, ice, compression with bandages and elevation (RICE) for the first 48 hours.
 
Soft tissue injuries may be sudden (acute) or get worse gradually (chronic). They can take between two and 12 weeks to heal, depending on the injury, initial and ongoing management, and the age and general health of the person.
 
Symptoms may include:
• Pain
• Swelling
• Stiffness
• Reduced function. i.e. unable to run/walk
 
Degrees of severity
Acute soft tissue injuries are graded between I and III:
 

Sprains and strains are two types of soft tissue injury. 

A sprain is a joint injury that typically involves tearing of the ligaments and joint capsule. Common sites for sprains include the thumb, ankle and wrist.
A strain is an injury to muscle or tendons. Common sites for strains include the calf, groin and
hamstring.
 
Initial first aid is important to limit the damage and encourage healing and should include rest, ice, compression with bandages and elevation (RICE) for the first 48 hours.
 
Soft tissue injuries may be sudden (acute) or get worse gradually (chronic). They can take
between two and 12 weeks to heal, depending on the injury, initial and ongoing management, and
the age and general health of the person.
 
Symptoms may include:
• Pain
• Swelling
• Stiffness
• Reduced function. i.e. unable to run/walk
 
Degrees of severity
Acute soft tissue injuries are graded between I and III:
Grade I – some fibres are torn and the site is moderately painful and swollen, but function and strength are mostly unaffected.
Grade II – many fibres are torn and the site is painful and swollen, with some loss of function and strength.
Grade III – the soft tissue is totally torn, with considerable loss of function and strength. Grade III injuries often need surgical repair.
 
Causes
Soft tissue is made from bundles of fibres. Muscle and tendons contain specialised cells that monitor the degree of contraction and stretch. With general use, muscles and tendons use soft contractions to resist overstretching. However, sudden twists or jolts can apply greater force than the tissue can structurally withstand. The fibres overstretch beyond their capacity and tear. Bleeding from ruptured blood vessels causes the swelling.
 
Treatment 
 
A Physio can provide you with an accurate diagnosis and can formulate a treatment plan.
 
Suggestions for immediate treatment of acute sprains or strains include:
• Stop your activity.
• Rest the injured area.
• Use icepacks every two hours, applied for 15 minutes and separated from the skin by wet towelling.
• Compress or bandage the injured site firmly, extending the wrapping from below to above.
• Elevate (raise) the injured area above heart height whenever practical.
• Avoid exercise, heat, alcohol and massage, which can exacerbate swelling.
 
Most soft tissue injuries take a few weeks to heal, depending on the severity of the sprain or strain and the general health of the individual. It is important to get the correct treatment as soon after the injury as possible to assist rapid recovery. See your Physiotherapist immediately if function is impaired or if the pain and swelling don’t subside after a couple of days.
 
Treatment options may include:
• Physiotherapy exercises to promote healing, strength and flexibility
• Manual techniques, such as mobilisation and massage
• Pain-killing medications
• Rehabilitation to return to normal levels
• Referral for scans / specialist if the injury is severe
 
Severe injuries where the tissue has completely ruptured may need surgery to reattach the torn pieces back together. Surgically repaired Grade III injuries will require significant Physiotherapy to regain strength and function. A short period of immobilisation can assist with the healing process for Grade II type injuries.
 
Completing the proper rehab for a sprain or strain is important to achieve a full recovery but more importantly it prevents re-injury. The biggest risk factor of a sprain or a strain is previous injury. Don’t make the mistake and end up in the same place a few months later!