Sprain vs. strain: Labeling your pain correctly

Sprain vs. strain: How important is it to label your pain correctly? While these terms are sometimes used interchangeably, they are actually two different injuries.

"A sprain is a ligament injury, and strain refers to a muscle (or sometimes tendon) injury," explains Jeff North, a physiatrist and section chief of Physical Medicine & Rehabilitation at Einstein Montgomery Hospital.

"Ligaments are found at the joints, and serve to stabilize motion at the joint," said Dr. North. "Tendons are also at and near the joint, but are more elastic and their tensions are dependent on not only joint position but muscle contraction activity as well."

"Acute injuries away from the joint are more likely to be muscular (strain) or also could be bone, nerve, bursa, skin or other soft tissue," he adds. Think: Hamstring strain.

Initial diagnosis and treatment of both a sprain and a strain are also very similar. The injuries are classified on a grading scale for severity from I to III. A Grade I tear involves a few fibers of ligament or muscles and little to no effect on the joint motion or function, while Grade III means there is usually a complete or very significant tear with instability in the joint.

As for treatment, Dr. North says, "typical recommendations for both include RICE (rest, ice, compression, elevation), but rest really should be limited to probably 24-48 hours for Grade I and most Grade II injuries and early motion and mobilization is advocated to decrease stiffness and to bring more appropriate blood flow for healing."

He suggests gentle stretches or active range of motion exercises at first, nothing aggressive. As the pain subsides though, the exercises can slowly progress to more weight-bearing or resistance exercises.

So does it matter if you call your injury a sprain or a strain? Yes. If significant pain or difficulty weight-bearing persists longer than a few days, seek medical attention. The more significant the injury, the more important a precise diagnosis becomes. You risk more repercussions in the future if your injury is not properly diagnosed and treated. Sometime immobilization and/or reconstruction surgery will be needed for more severe injuries.

According to Dr. North, expected healing of ligament injuries has been known to take from six weeks to three months. However, return to activities and sports can be sooner if appropriate steps are taken in the rehabilitation process and joint and muscles are strong and stable, and pain free with motion and activities.

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