Sprains v. Strains and How to Treat Them

The terms sprain and strain are often used interchangeably when referring to pain around joints. While their symptoms and treatments look similar, the source of the pain is quite different, and, as a result, how they heal and how long it takes to heal can vary dramatically.

Here’s a quick look at what differentiates sprains and strains:

Sprains involve ligaments, a tough band of fibrous tissue that connects bones to other bones or to cartilage. When a ligament is overstretched, torn, or twisted, it’s considered sprained. Commonly sprained areas include the ankle, wrist, knee, and thumbs.

Sprains tend to occur suddenly—think rolling your ankle. The severity of the injury depends on how much of and how severely the ligament is damaged. Common symptoms include:

• pain
• swelling
• bruising
• limited movement around the joint
• inability to put weight on the joint or use it normally
• a “popping” sensation at the time of the injury

Strains involve an injury to a muscle or to the tendon that attaches a muscle to a bone (hint: think T as in tendon for strains). Strains occur when a muscle or tendon is overstretched, torn, or twisted and are common in the legs, back, knee, and feet. While strains can be the result of one bad movement (e.g., improperly lifting a heavy item), they can also develop over time due to overstretching, repetitive motion, or holding an awkward position for long periods of time. Common symptoms include:

• pain or tenderness
• swelling
• limited range of motion in the affected area
• muscle weakness
• muscle spasms or cramping

Apart from the bruising that occurs with sprains but not strains, it can be hard to tell the types of injuries apart. For some unfortunate individuals, things get even a little more challenging as you can experience a sprain and a strain at the same time.

If you’re experiencing pain from what you suspect is a sprain or strain, it’s recommended that you, first, protect the involved area by minimizing stiffness/loss of motion and weakness, while allowing the area to heal. This should be followed by practicing what’s known as the RICE method (below), for at least the first 24-48 hours and as needed after that.

• Rest: Stop any exercise or physical activities and avoid putting any weight on or exerting the affected area. 
• Ice: Apply ice to the injury for up to 20 minutes every 2 to 3 hours.
• Compression: Wrap the affected area with a bandage or trainer’s tape to help reduce swelling. If the pain increases or the area feels numb, loosen the wrap.
• Elevation: If possible, keep the injured area raised above chest level.

In addition, over-the-counter pain relievers and anti-inflammatory drugs can provide some relief as needed.

Even though strains heal faster as tendons tend to heal faster than ligaments, both types of injuries will take at least two weeks to heal. In both cases, you will need to refrain from strenuous exercise and activity for up to eight weeks to keep healing on track and to prevent further injury.

That said, if you experience any of the following, you should schedule an appointment with a doctor:

• if there was a “popping” sound with the injury
• difficulty walking or standing without pain
• pain and swelling that does not improve or gets worse over time
• limited movement and flexibility around the affected area
• numbness or tingling in the affected area
• instability of the joint or affected area
• chills or fever

Severe injuries may require physical therapy or even a walking cast or brace to ensure a safe and full recovery.

Regardless of the severity of your injury, you should never try to ignore or power through it.

Doing so can lead to a more severe damage that takes longer to heal. A minor problem that should take just a few weeks to heal can sideline you from life and the activities you love for months or even longer.

Matt Nofziger, MD, is an orthopedic surgeon at Southwestern Vermont Medical Center Orthopedics.