By Janice Harvey, RPh, CDE
If you’ve ever twisted your ankle when stepping on uneven ground or hurt your back lifting something heavy, then you know what it’s like to experience the pain of a sprain or strain. But do you know the difference between sprains and strains, how to treat them, and what can be done to prevent them? Let’s look a little closer.
What’s the difference between a sprain and a strain?
A sprain occurs when ligaments (bands of tissue that connect bones together) are stretched too far, putting significant stress on a joint. Ankles, knees, wrists and thumbs are commonly sprained joints. A sprain can happen during an everyday activity or during sports activities. For example, a wrist sprain might occur when landing on an outstretched hand during a fall, or a knee sprain could occur when pivoting while playing basketball.
When we say we’ve “pulled a muscle,” we’re really talking about a strain. They are similar to sprains, but it is the muscles and sometimes tendons (fibrous tissue that connect bones to muscles) that are affected. Strains may result from a single event, such as when lifting something heavy, or they can be caused by a chronic, repetitive injury to the muscle, as happens in some work situations. Commonly strained areas are the hamstrings (back of the thighs) and the lower back.
Whether a sprain or a strain, symptoms can include pain, swelling, and limited range of motion of the affected area. You may not be able to put weight on the injured area or use it normally. Where they differ is that sprains cause bruising, while strains affect muscle and instead cause muscle spasms or cramping.
Do certain activities increase the risk?
While sprains and strains can occur suddenly and sometimes seemingly without any real cause, some activities and situations increase the risk, such as:
- Sitting, standing or moving in an awkward way, without thinking about how you are moving your body – This is especially the case when lifting heavy objects. Do your best to stay in shape. The better shape you are in, the better your body moves to support you.
- Environmental conditions – Be more careful on slippery or uneven surfaces.
- Overexerting yourself or carrying out repetitive movements – Tired or weak muscles don’t do a good job of supporting joints and are more prone to injury. Stretch and warm up your muscles before exercise and do a cool-down when switching to more sedentary activities.
- Participating in activities that put stress on joints or muscles – Contact sports, such as football and wrestling, can increase the risk of muscle strains. Sports that involve jumping and sudden movements can be hard on the Achilles tendon of the ankle, while racquet sports often lead to elbow strains.
- Equipment choice – Choose footwear, bracing and sports equipment that fits well and provides the right amount of support.
Treating the symptoms
Mild sprains and strains can often be self-treated. However, more severe situations, such as a torn ligament or tendon, may require surgery. Visit your doctor if you can’t move or bear any weight on the affected joint, if the pain is unbearable, or if you experience any numbness in the injured area.
For the first few days after a sprain or strain, follow these steps to reduce swelling and support healing:
- Protection – Your doctor or physiotherapist may suggest that you immobilize the area with a brace or splint to protect the injury now and prevent future injury of the same area.
- Rest – Stop activities that utilize the injured area and try not to put any weight on the injury.
- Ice – To reduce swelling, apply an ice pack for 15 to 20 minutes every 2 to 3 hours. Avoid heat for the first couple days. As well, talk to our pharmacists about use of topical and oral medications to reduce swelling and ease pain.
- Compression – Wrap a tension bandage around the area until the swelling stops. Don’t wrap it too tightly. Loosen the wrap if the pain increases, if the area becomes numb, or if there is swelling below the wrapped area.
- Elevate – Keep the injured area elevated above the level of your heart, especially at night.
After a couple days, if you can move the injured area without pain, begin with gentle use so the joint or muscle does not become stiff. Regular stretching and strengthening exercises can help to minimize your risk of future injuries.
Most sprains and strains will feel better after 2 weeks, though it can take up to a couple months in more severe cases. It’s a good idea to avoid strenuously exercising the area for up to 8 weeks to reduce likelihood of further injury. If you have a sprain or strain that’s taking longer than usual to get better, your family doctor may suggest that you see a physiotherapist to maximize stability and strength of the injured joint.
Pharmacist assessment and prescribing
Our pharmacists can meet with you to provide a minor ailment assessment for sprains and strains. This may result in recommendations for over-the-counter pain medications or, if appropriate, a prescription for a higher-strength anti-inflammatory medication. During your appointment, our pharmacists will check your current medications list and lab results to ensure that we are prescribing a safe and effective treatment for you. If it is not safe to prescribe, or if the injury is not actually a “minor” ailment, we can refer you for appropriate care.
Your health. Our priority.