Strains and sprains are injuries which affect different types of soft tissue in the body, although they often have similar symptoms. This article explains exactly what strains and sprains are, how and where they occur, and how best to treat them.
Strains and sprains affect the muscles, tendons and ligaments. Both injuries can bring on pain, swelling, and limited movement at the injury site. The pain can be mild, moderate or intense, depending on the severity of the injury.
Strains
A strain occurs when a muscle or tendon is overstretched or torn. It may also be described as a being ‘pulled’. Strains happen when a muscle/tendon has been used beyond its normal limits. Repetitive movements over a long period of time which put stress on the muscle/tendon can cause a ‘chronic’ strain. Whereas, a sudden, single high-force incident (such as a sharp twist or explosive running), can lead to an ‘acute’ strain. Further aggravating factors include muscle fatigue, working or exercising in cold conditions, poor lifting technique, and a lack of warm up before activity. Poor flexibility, muscle weakness and/or imbalance can also make muscles/tendons more prone to damage.
Any muscle or tendon can be strained, but most commonly, strains occur in the back, neck, shoulders, and in the legs (often in the calves and hamstrings).
The symptoms of a strain are:
PAIN: typically a sharp, sudden pain at the time of injury. It may feel tender and be painful to touch and move the area. In the case of chronic strains, the onset of pain may be more gradual.
APPEARANCE: swelling is often present with bruising to follow.
FUNCTIONAL LOSS: lack of or limited movement and an inability to bear weight in the affected limb.
SPASMS: you may experience involuntary muscle spasms.
Sprains
A sprain occurs when a ligament – the tissue which connects the joints – is a torn, twisted or stretched. Falling or twisting the wrong way typically causes a sprain, because the movement forces a joint into an awkward position and ends up stretching, twisting or tearing the ligament. Twisting an ankle, falling down the stairs, landing awkwardly, and slipping or twisting suddenly, are all ways to end up with a sprain. Overusing a joint when playing sport or at work can also weaken ligaments over time and make them more suseptible to injury.
Sprains can occur in any ligament but are most common in the ankle, knee, wrist and fingers.
The symptoms of a sprain are:
PAIN: intense and immediate pain at the time of injury. In chronic cases, pain may be more gradual in onset.
APPEARANCE: rapid swelling of the affected area, with bruising to follow.
FUNCTIONAL LOSS: difficulty using the joint and a feeling of joint instability (a perception of ‘giving way’ or being unable to support any weight).
MOVEMENT: a feeling of stiffness and reduced range of motion.
POP: in severe cases, a ‘pop’ may be heard or felt at the time of injury.
HOW BAD IS IT?
Strains and sprains are graded I – III according to their severity.
Grade I (Mild): Slight stretching or some micro tears of tissue fibres. Pain is generally mild, with some swelling and loss of movement.
Grade II (Moderate): Partial tear of muscle or ligament leading to pain, bruising and swelling. Limited functionality and range of motion, with some instability.
Grade III (Severe): Complete rupture or tear of the muscle or ligament. Signficant pain, swelling and bruising, with loss of function, range of motion and a marked decrease in stability.
TREATMENT
Treatment for strains and sprains will vary according to the severity of the injury.
Grade 1 strains and sprains usually take approximately 2-4 weeks to recover, Grade 2 approximately 6-12 weeks, and Grade 3 potentially months, especially if the injury requires surgical treatment.
In more severe cases of strains and sprains, further investigation (e.g. X-ray, MRI, CT Scan or Ultrasound) may be used to clarify the diagnosis and extent of injury.
For the first 2 to 3 days after a sprain or strain, the NHS recommends following the 5 steps known as PRICE therapy to help bring down swelling and support the injury:
- Protection – protect the injury, for example by using a support, or shoes that support your foot or ankle.
- Rest – stop any exercise or activities and try not to put any weight on the injury.
- Ice – apply an ice pack (or a bag of frozen vegetables) to the injury for up to 20 minutes every 2 to 3 hours. Be sure to wrap the ice pack so it’s not applied directly onto the skin.
- Compression – wrap a bandage around the injury to support it during the day.
- Elevate – keep it raised on a pillow as much as possible.
To help prevent swelling, try to avoid heat (such as hot baths and heat packs), alcohol and massages for the first couple of days.
When you can move the injured area without pain stopping you, try to keep moving so the joint, muscle or tendon does not become stiff.
WHERE DOES CHIROPRACTIC COME IN?
Chiropractors are experts in diagnosing, treating and managing conditions caused by problems in the musculoskeletal system. This means they are well placed to make a detailed assessment of your injury and develop an individualised treatment plan to aid your recovery and get you back on your feet. Treatment for strains and sprains will often involve soft tissue massage, mobilisation, gentle adjustments, rehabilitation exercise advice and kinesio taping. If appropriate, we can refer you to other healthcare professionals for imaging such as ultrasound, X-ray, CT or MRI scan.
So if you’re suffering with a strain or sprain that isn’t getting better after following NHS self-care advice, our experts are here to help.
