Sprain versus Strain by Jason Patterson, MD
A sprain and a strain, they’re the same thing, right?
Although they sound very similar and are often treated similarly, they are in fact different injuries. Before understanding the difference between sprain and strain, it’s important to understand the difference between ligaments, tendons and muscles.
What are ligaments, tendons and muscles and how do they work together?
A ligament is connective tissue that connects one bone to another. They are found near moving bones (a joint) and primarily provide stability to the joint so that the motion is controlled and smooth. Examples are ankle ligaments between the leg and the foot that allow the ankle to move like a hinge forward and backward and provide stability when walking on uneven ground or cutting on the field or court. A tendon is also connective tissue that connects a muscle to a bone. Its main function is to move the bone in the desired direction. A secondary function is to provide stability as well around joints. An example is the Achilles tendon that connects the calf muscle to the heel and helps move the ankle and foot. Most are familiar with muscles and their function. When they contract, they pull on the tendons and move bones and joints.
What is a sprain?
A sprain is an injury to a ligament in the body. We commonly think of an ankle sprain, which injures the ligaments that support the ankle joint. There are different severities, or grades, of ankle sprains with grade 1 being a mild injury and a grade 3 being a complete rupture. The good news is that most ankle sprains, even grade 3, do not require surgery to heal. They do, however, require proper diagnosis and treatment. The key is to restore proper stability and function to the joint and ligament that was injured. This often requires timely immobilization, early rehabilitation, and other modalities as indicated. Also, sprains and fractures of the bone are often difficult to differentiate without a radiograph and exam. Certain ligaments are more unforgiving and when torn will often do better with surgical intervention. For these reasons, it is very important to see a specialist to get a proper diagnosis and treatment for a suspected sprain.
What is a strain?
A strain is an injury to a muscle. Sometimes a tendon injury is also classified as a strain. Like a ligament sprain, a muscle strain is a tear of the muscle. There are also different severities. Fortunately almost all muscle strains do not require surgery. Unfortunately, however, torn muscles do not heal very well and again need urgent diagnosis and treatment to prevent further injury and successful rehabilitation to treat the injury and prevent future problems. It is important to work with your specialist and physical therapist to rehab these injuries and know when it is safe to return to sport and activity.
What about a tendon injury?
For completeness, a tendon injury is typically thought about a little differently. Since a tendon is a rope-like structure, it can either have a longitudinal split tear or a complete rupture. Think of a braided rope and pulling the braided portion apart in the middle so there’s a gap or hole in the rope. That is typically what a longitudinal split tear would look like. The rope or tendon will still function, but often with pain and weakness. Sometimes it can be treated with therapy and bracing but often requires surgery. A rupture is essentially cutting the rope in half and separating the ends. Now the muscle is no longer connected to the bone and will not function. Typically urgent surgery is required to restore function and minimize long-term problems.
How are these diagnosed?
These injuries are often evaluated and treated by a specialist requiring a physical exam, radiographs, and sometimes an MRI or ultrasound. Typically the sooner these injuries are seen and treated, the better the outcomes.
Speak with a Foot & Ankle Specialist Today
Are you suffering from a recent sprain, strain, or possible tendon injury? Make an appointment with one of our Foot & Ankle Specialists today to start your healing journey. OrthoArizona has nearly two dozen offices throughout the Valley, each focused on quality care, compassion, and excellent customer service. Since 1994, OrthoArizona has been dedicated to compassionate care of the highest quality.
The advice and information contained in this article are for educational purposes only and are not intended to replace or counter a physician’s advice or judgment. Please always consult your physician before taking any advice learned here or in any other educational, medical material.
About The Author
Jason Patterson, MD is an Orthopedic Foot & Ankle Surgeon with OrthoArizona
Dr. Jason Patterson is a Board-Certified Orthopedic Surgeon specializing in Foot and Ankle. He treats all foot and ankle disorders from the most basic to the complex in both pediatric and adult conditions treating all acute and chronic issues.
Dr. Patterson believes in individualizing and tailoring each treatment plan based on the patient’s specific problem and needs. Fortunately, many foot and ankle disorders respond well to non-surgical treatment. He likes to exhaust all non-surgical treatment first before moving on to more invasive procedures and surgeries. As an orthopedic surgeon, he focuses on the impact the foot and ankle can have on the rest of the lower extremity, such as the knees, hips and back.
Dr. Patterson has treated patients for Sports injuries, Arthritis, Fractures, Sprains/Strains, Tendonitis, Bunions and Hammertoes, Achilles tendon problems, Overuse injuries, Flatfeet, and Congenital conditions. When safe and appropriate, he utilizes minimally invasive surgical techniques to minimize risk to wound healing. He has a large ankle replacement practice utilizing CT imaging technology and 3D printed custom blocks to promote accuracy and longevity of the ankle replacement implants.