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Sprain and Strain

Sprain Vs. Strain

A sprain is an injury to a ligament - a stretching or a tearing. One or more ligaments can be injured during a sprain. The severity of the injury will depend on the extent of injury to a single ligament (whether the tear is partial or complete) and the number of ligaments involved. A strain is an injury to either a muscle or a tendon. Depending on the severity of the injury, a strain may be a simple overstretch of the muscle or tendon, or it can result in a partial or complete tear.

What Causes a Sprain?

A sprain can result from a fall, a sudden twist, or a blow to the body that forces a joint out of its normal position. This results in an overstretch or tear of the ligament supporting that joint. Typically, sprains occur when people fall and land on an outstretched arm, slide into base, land on the side of their foot, or twist a knee with the foot planted firmly on the ground.

The talus bone and the ends of two of the lower leg bones (tibia and fibula) form the ankle joint This joint is supported by several lateral (outside) ligaments and medial (inside) ligaments. Most ankle sprains happen when the foot turns inward as a person runs, turns, falls, or lands on the ankle after a jump. This type of sprain is called an inversion injury. One or more of the lateral ligaments are injured, usually the anterior talofibular ligament. The calcaneofibular ligament is the second most frequently torn ligament.

What are Symtoms of a Sprain?

The usual signs and symptoms include pain, swelling, bruising, and loss of the ability to move and use the joint (called functional ability). However, these signs and symptoms can vary in intensity, depending on the severity of the sprain. Sometimes people feel a pop or tear when the injury happens. You should see a doctor if you have severe pain and cannot put any weight on the injured joint, if the injured area has lumps & bumps (other than general swelling), if you cannot move the joint, and/or if you experience numbness or redness spreading out from the injury.

A person with a moderate sprain usually has some difficulty putting weight on the affected joint and experiences some loss of function. An x ray may be needed to help the doctor determine if a fracture is causing the pain and swelling. Magnetic resonance imaging is occasionally used to help differentiate between a significant partial injury and a complete tear in a ligament.

What Causes a Strain?

A strain is caused by twisting or pulling a muscle or tendon. Strains can be acute or chronic. An acute strain is caused by trauma or an injury such as a blow to the body; it can also be caused by improperly lifting heavy objects or overstressing the muscles. Chronic strains are usually the result of overuse - prolonged, repetitive movement of the muscles and tendons.

Two common sites for a strain are the back and the hamstring muscle (located in the back of the thigh). Contact sports such as soccer, football, hockey, boxing, and wrestling put people at risk for strains. Gymnastics, tennis, rowing, golf, and other sports that require extensive gripping can increase the risk of hand and forearm strains. Elbow strains sometimes occur in people who participate in racquet sports, throwing, and contact sports.

What are Symptoms of a Strain?

Typically, people with a strain experience pain, muscle spasm, and muscle weakness. They can also have localized swelling, cramping, or inflammation and, with a minor or moderate strain, usually some loss of muscle function. Patients typically have pain in the injured area and general weakness of the muscle when they attempt to move it. Severe strains that partially or completely tear the muscle or tendon are often very painful and disabling.

Treating Sprains & Strains

Treatment for sprains and strains is similar and can be thought of as having two stages. The goal during the first stage is to reduce swelling and pain. At this stage, doctors usually advise patients to follow a formula of rest, ice, compression, and elevation (RICE) for the first 24 to 48 hours after the injury (see the box below). The doctor may also recommend an over-the-counter or prescription nonsteroidal anti-inflammatory drug, such as aspirin or ibuprofen, to help decrease pain and inflammation.

For people with a moderate or severe sprain, particularly of the ankle, a hard cast may be applied. Severe sprains and strains may require surgery to repair the torn ligaments, muscle, or tendons. Surgery is usually performed by an orthopedic surgeon. Rest, ice, compression, and elevation are important.

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