Sprains Versus Strains

Regardless of the type of work performed, from clerical duties to heavy construction, any worker may suffer a sprain or strain. This handout provides basic information on the difference between sprains and strains.

Sprains – A sprain is an injury to ligaments, which are the thick bands of fibrous tissue that connects the bones and binds joints together. Ligaments hold the skeleton together in a normal alignment. Commonly injured ligaments are in the ankle, knee, and wrist. The ligaments can be injured by being stretched too far from their normal position or by over contraction. When too much force is applied to a ligament, they can be stretched or torn and result in a sprain. The most common type of sprain is the twisted ankle. More than 25,000 individuals sprain an ankle each day in the United States.

The usual signs and symptoms of sprains include pain, swelling, bruising, instability, and loss of the ability to move and use the joint. However, these signs and symptoms can vary in intensity, depending on the severity of the 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 and stretches or tears the ligament supporting that joint. Typically, sprains occur when people fall and land on an outstretched arm, land on the side of their foot, or twist a knee with the foot planted firmly on the ground. Sometimes people feel a pop or tear when the injury happens.

Strains – Strains are injuries that affect muscles and tendons, which are the fibrous bands of tissue that attach muscles to bones. Strains are a type of injury that results from trauma, such as a fall, or outside force that displaces the surrounding joint from its normal alignment. Bruising, swelling, instability, pain, weakness, and muscle spasms are common symptoms experienced after a strain occurs.

By pulling too far on a muscle (i.e., overstretching) or by pulling a muscle in one direction while it is contracting in the other direction (i.e., over contraction) can cause injuries within the muscle or tendon. Strains can also be caused by chronic activities that develop an overstretching of the muscle fibers.

Strains can be acute or chronic. An acute strain is associated with a recent trauma or injury, or it can occur after improperly lifting heavy objects or overstressing the muscles. Chronic strains are usually the result of overuse (i.e., prolonged, repetitive movement of the muscles and tendons).

Two common sites for strains are the back and the hamstring muscle. Typically, people with a strain may experience pain, limited motion, muscle spasms, and possibly 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

RICE Therapy – This is considered an emergency home treatment for most muscle/tendon strains, ligament sprains, suspected fractures, joint inflammation, and bruises.

(R) Rest – Reduce regular exercise or activities of daily living, as needed. Your healthcare provider may advise you to put no weight on an injured area for 48 hours. If you cannot put weight on an ankle or knee, crutches may help. If you use a cane or one crutch for an ankle injury, use it on the uninjured side to help you lean away and relieve weight on the injured ankle.

(I) Ice – Apply an ice pack to the injured area for 20 minutes at a time, 4 to 8 times a day. A cold pack, ice bag, or plastic bag filled with crushed ice and wrapped in a towel can be used. To avoid cold injury and frostbite, do not apply the ice for more than 20 minutes.

(C) Compression – Compression of an injured ankle, knee, or wrist may help reduce swelling. Examples of compression bandages are elastic wraps, special boots, air casts, and splints.

(E) Elevation – If possible, keep the injured ankle, knee, elbow, or wrist elevated on a pillow, above the level of the heart, to help decrease swelling.

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