A strain and sprain both describe a tear or rupture injury to soft tissue. However, the main difference is the type of soft tissue. The term 'strain' is used to describe a tear or rupture in a muscle or tendon. In comparison, 'sprain' relates to a tear or rupture of ligaments.
Sprain and strain are medical terms used to describe injuries to specific soft tissue injuries. Typically, sprains occur when there has been a tear injury to ligaments. Ligaments are found between joints to provide support and stability. While strains describe any muscle or tendon tear. To clarify, tendons are structures found between muscle and bone. The severity of these injuries can be described using grade classifications (please see: "Grade 1 vs Grade 2 vs Grade 3. What's the difference?"). Although they both describe an injury to soft tissue, the recovery timeline and management approach can vary.
Sprain and strain injuries can occur in any area where there are ligaments or muscles, respectively. However, there are common sites where these types of injuries occur more frequently than others. Examples are listed in the table below:
| Common Strain Injuries | Common Sprain injuries |
|---|---|
| Hamstring strain | Low ankle sprain (especially anterior talofibular ligament tears) |
| Quadricep strain | High ankle sprain or syndesmosis injury (e.g. tibiofibular ligament tears or ruptures, etc.) |
| Achilles rupture or tear | Knee ACL ruptures or tears |
| Calf strain | Knee MCL tears or ruptures |
| Biceps tendon rupture | Knee LCL tears or ruptures |
| Pectoralis tear or rupture | Lower back sprain |
| Lower back strain | Upper back sprain |
| Upper back strain | Neck sprain |
| Neck strain or whiplash injuries | Pitcher’s elbow (ulnar collateral ligament tear or rupture) |
| Gluteus medius tear | Jarred fingers |
| Rotator cuff tear or rupture | Wrist sprain |
| Adductor/groin strain |
A period of rest and reduced activity is recommended to help with recovery. Pain, swelling and inflammation are generally present during sprains and injuries, especially in the first 48-72 hours. Activities that aggravate the pain, such as stretching, pushing or pulling, should be minimised temporarily until symptoms ease.
Seeking advice from a qualified medical professional (e.g. physiotherapist, sports doctors, GPs, etc.) should occur immediately after a sprain or strain injury. Receiving a diagnosis is crucial to ensure the appropriate treatment is being delivered. Undiagnosed ruptures or complete tears can lead to long-term health and performance issues, such as osteoarthritis and re-injuries.
Using compression bands or tubes can help reduce swelling and bruising of the injured area(s). Settling swelling earlier on allows for the increased flexibility of muscles and joints. Achieving full range of motion earlier can lead to a quicker recovery and return to pre-injury activities.
Especially during the first few days or weeks, pain from strain and sprain injuries can be bothersome. Applying ice over the affected area for 15-20 minute sessions multiple times a day can help ease discomfort. Alternatively, pain-relief medication can be considered with the advice of a GP or pharmacist. Moderate to severe injuries may require bracing or crutches for extra support to aid in less painful movements.
While rest is crucial in the early period to help settle swelling and inflammation, rehabilitation needs to commence as early as day two or three after injury. A prolonged lack of movement can lead to both short and long-term problems. Most sprain or strain injuries will recover over time. However, hidden imbalances and weaknesses can occur, such as:
Deconditioning and lower fitness levels
Reduced musculature
Build of scar tissue around the affected structures
Increased chance of re-injury
Delayed return to pre-injury fitness levels
Longer periods of swelling
Seeking a rehabilitation expert such as a physiotherapist is recommended to help kick-start your recovery. Starting with simple activities and a tailored exercise program addressing your individual needs will be required until the end of your rehabilitation.
While there are differences between strain versus sprain injuries, the management of these conditions are very similar. An early physical assessment, diagnosis and treatment should be a priority for the desired outcome. Most people with these injuries will make a recovery back to their pre-injury fitness levels.
