Sprains, Strains And Tears

Sprains, strains, and tears: these common injuries can sideline anyone, from weekend warriors to those simply navigating daily life. While often used interchangeably, these terms represent distinct injuries with varying levels of severity. Whether it's a tweaked ankle or a pulled hamstring, knowing how to treat sprains, strains, and tears is crucial for a swift recovery. But do you know the difference between them, and when you need to get medical care?

What Are Sprains, Strains And Tears?

While the terms sprain and strain are sometimes used interchangeably in everyday language, they have different medical definitions.

• A sprain typically involves an injury to a ligament, the stretchy tissue that connects two bones in a joint. Common example: sprained ankle
• A strain generally involves an injury to a muscle or tendons, the tissue that connects muscles to bones. Common example: strained hamstring
• A tear refers to a more severe sprain or strain that involves the complete separation of ligaments, muscles, and/or tendons. Common example: ACL tear

The degree of sprain is measured based on the level of tears or stretching to the ligaments.

“We generally define the severity of sprains and strains in three levels,” said Sean P. Calloway, MD, an independent orthopedic sports medicine surgeon who chooses to practice at Franciscan Health Indianapolis. “A grade I strain or sprain is an injury related to stretching of a ligament/muscle with no tears to tissues. A grade II sprain or strain can involve a partial tear to ligaments/muscles. A complete tear, called a ‘grade III’ sprain or strain, is an injury in which the ligament, muscle, or tendon completely pulls off the bone.”

How Do Sprains, Strains And Tears Happen?

Sprains, strains and tears can happen during exercise or develop over time, said Thomas Schmittdiel, MD, a Michigan City sports medicine physician with Franciscan Physician Network.

"People are living life. It's pretty hard to go through, life without having any type of injury," he said. "The two kinds of categories I classify them are, 'Did this just happen like within the last few days?' We call that an acute injury, and those are usually from traumas, falls or twists. And then the other category is what I consider chronic injuries, which are basically overuse. Some of the tissues have deteriorated and that just comes with living a full life."

How Do I Tell If I Have A Sprain, Strain Or Tear?

"If you are not able to put weight on your ankle or through your foot and you can't walk on it, that's a great sign to go to the ER to get checked out," Dr. Schmittdiel said. "If you're having difficulty putting weight through it, and then especially if you give yourself a few hours of rest, and you're still not able to put their weight, it's probably a good idea to go get checked out." 

Physicians generally can determine the degree of a sprain, strain or tear through a detailed history of the injury and a detailed physical examination. If needed, an MRI can confirm the diagnosis and help guide the best treatment plan.

Treating Sprains and Strains

Minor sprains and strains can usually be treated successfully at home without medical attention. Common signs of these injuries include swelling, pain, mild redness or bruising, and reduced mobility.

Home treatment for sprains and strains

To speed the healing of a sprain or strain, remember to use RICE: rest, ice, compression, and elevation. “Most minor sprains or strains will get better in about a week or so,” Dr. Calloway said. “The main thing is to take it easy and stay off the injury for as much as possible for a few days.”

Anti-inflammatory medicine such as naproxen (Aleve) or ibuprofen (Advil) can help reduce pain and inflammation while a grade I, or mild, sprain or strain heals. Make sure you talk to your physician if you experience any side effects with these medications. Also, avoid taking these medications if you have any drug allergies with non-steroidal anti-inflammatories (NSAIDs).

When to seek medical care

If your sprain or strain symptoms are not improving after one to two weeks, consider getting your injury checked by an orthopedic specialist who can evaluate the injury and determine the appropriate treatment plan.

Treating A Tear

If you experience a ligament or muscle tear, you’ll likely experience an immediate inability to move or put weight on the affected joint or muscle. You should seek medical attention as soon as possible, either at an emergency room or through a same-day appointment with Franciscan Health’s orthopedic care team.

While some tears may require surgical repair, not all do. Treatment for tears is determined individually based on the specific injury and each patient’s long-term physical activity goals. A grade II sprain, marked by pain and swelling, as well as the inability to bear full weight, may find rest, ice and non-inflammatory medications to be beneficial.  A more severe Grade III sprain marked by severe pain, swelling and bruising, may require a walking boot or ankle brace to stabilize the area during healing and physical therapy to aid the healing process.

Prioritize Healing

A sprained joint can become susceptible to repeated sprains if steps aren’t taken to treat the initial injury fully. As a result, it’s essential to take a few days to rest and stay off the injury before carrying on with an everyday routine.

“There are some relatively easy things that we can do in a clinical setting to reduce the likelihood that a sprain or strain would reoccur. These include simple physical therapy maneuvers or immobilization with a sling or compression wrap,” Dr. Calloway said.

Dr. Schmittdiel emphasizes the benefits of physical therapy after a strain, sprain or tear.

"The stronger we get all the muscles around it, the more stable that joint's going to be," he said. "It helps heal those nerves and it hopefully will help you from misstepping or reinjuring yourself in the future."

If you have a sprain or strain that doesn’t seem to be healing on its own, or if you’ve suffered a severe joint or muscle tear, please reach out to Franciscan Health’s team of orthopedic specialists. We can help determine a course of care that will get you back to enjoying the activities you love.