Is it a Sprain or a Strain? (part 1)

Find out the specifics of sprains and strains in this 2-part article

Part 1: Sprains

There is a plethora of information surrounding sprains and strains. As a result, the information presented here has been split into 2 articles. This is part 1 – be sure to check out Part 2: Strains.

The Basics

Sprains and strains are often discussed together and thought of as being essentially the same. This most likely is due to the fact that initial treatment for mild strains and sprains are so similar. However, there are differences between the two injuries, and the full course of treatment and rehabilitation after a severe strain is not the same as it would be for a severe sprain.

Although it won’t be discussed here, it’s important to note that the forces and mechanisms that cause sprains and strains are also able to cause injuries known as avulsion fractures. In these cases, instead of the ligament or muscle/tendon being injured, it pulls away from its attachment site on the bone, breaking off a fragment of bone with it. These injuries can be hard to diagnose initially because the symptoms often mimic those of a sprain or strain.

Before we go into the differences between strains and sprains, let’s clear up some often-used non-medical terminology. As far as medical diagnoses go, there is no such thing as a “tweak” or a “pull”. These terms are often used in reference to minor injuries of body parts such as hamstrings or ankles. When people use these terms, they’re often referring to a mild (Grade 1) strain or sprain.

What is a Sprain?

A sprain is a stretching or tearing injury to a ligament (the connective tissue near joints that runs from one bone to another). Rather than being the stand-alone structures that many people think of when learning about them, oftentimes ligaments are actually thickened areas of the joint capsule (the connective tissue that surrounds the joints of the body). Sprains happen when a joint is forced to move outside of its normal range or direction of movement which results in a structural failure of the tissue. The strongest part of a ligament is in its middle, so most sprains occur in the ends of the ligament, where the tissue is weaker.

Sprains are classified into 3 categories, or degrees, that are delineated by the amount of movement (compared to the other side) that is produced during certain special tests. These special tests check how well a ligament is working, so if the injured side has more movement than the uninjured side, this indicates that at least some of the pain from the injured side is coming from a sprained ligament. The amount of movement produced during this test (indicating the amount of laxity present in the joint) is one of the things that determines how severe the injury is.

Classification of Sprains

A grade 1 sprain (or 1st Degree Sprain) is a mild injury in which the ligament is stretched with little or no tearing of the tissue fibers. This type of injury produces the least amount of laxity in the special tests mentioned above. These sprains have little to no swelling, some pain, very little dysfunction, some slight tenderness right over the injury site, and practically no loss of (or change in) range of motion of the injured joint.

A grade 2 sprain (or 2nd Degree Sprain) is a moderate injury with more laxity, pain, swelling, and dysfunction than is seen in 1st degree sprains. This is because some of the ligament’s fibers have torn. In grade 2 sprains, the joint may be unstable in weight-bearing positions.

A grade 3 sprain (3rd Degree Sprain) is a severe injury to the ligament. In these sprains, the ligament is torn all the way across (also referred to as a rupture). These injuries are very painful at first and leave the injured person with significant loss of function of the injured joint. There is a great deal of laxity (because the ligament is not doing its job anymore), instability, swelling, tenderness, and bruising.

Compression and Tension on the Ligament

Intermittent compression and tension on the ligamentous structures in the body will help increase their strength, especially near where they attach to bones. This intermittent compression and tension can come from things like daily activities, properly designed rehearsals, and safe exercising. However, constant compression or tension leads to irritation and degeneration of the tissue. When ligaments and joint capsules are chronically irritated and inflamed, their collagen fibers shrink and they become vulnerable to major injuries. This is why dance medicine professionals urge dancers NEVER to try to enhance their splits by placing their feet on something a few inches off the ground and “sitting” into the split with their body weight being used to extend the split “flexibility”. This technique is only going to destroy your hips and knees, putting you at risk of developing instability or suffering a major acute injury like a joint dislocation.




What makes sprains different from strains? Find out by reading Part 2: Strains.