Sprains and Strains

A SPRAIN is a tear in a ligament and a STRAIN is a tear in a muscle. Sprains and strains are graded into categories depending on the severity of the tear. The three classifications are – mild (1st degree), moderate (2nd degree) and severe (3rd degree). A mild sprain or strain refers to a tear of up to 20% of the fibres (micro-tear); moderate refers to a tear of 20-75% of the fibres (partial tear); and severe refers to a tear of 75-100% of the fibres (complete or full tear).

Factors that contribute to ligament sprains include a sudden movement beyond the normal range of motion, muscle imbalances, prolonged alteration of posture, poor proprioception/balance and altered biomechanics. Contributing factors for muscle strains include overuse or repetitive micro-trauma, contraction of a muscle while it is in a stretched position, un-preparedness for activity, violent contraction, excessive forceful stretch or a sudden movement.

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Common areas to sprain include “rolling” the ankle (“inversion sprain”) and knee. These injuries are more frequent in runners, soccer players, tennis players, skiers and snowboarders. Common areas to strain include the adductors (inner thigh muscles, ‘pulled groin”) and the hamstrings. These injuries are more frequent in athletes who are involved in kicking, sprinting, skating, water skiing, or jumping (high jump or hurdles).

There is usually local tenderness in the area. There may be some swelling and/or bruising depending on the severity of the tear. Stretching the area tends to cause more pain and discomfort. The pain, swelling, bruising and tightness are correlated to the degree of the tear. A severe (3rd degree) sprain is often associated with a subluxation or dislocation of the joint. If the sprain is not treated properly, a chronic instability can form in the joint, leading to additional or continual sprains. Similarly, if a strain is not treated properly, scar tissue can form in the muscle and limit the range of motion, which can contribute to further damage.

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Once you have sustained a sprain or strain it is important that you receive the appropriate care as quickly as possible. Begin with RICE (rest, ice, compression, elevation) and then make an appointment at the clinic. Treatment at the early stages will focus on decreasing pain, minimize swelling and inflammation and promote healing with Targeted Soft Tissue Therapy and Acupuncture. As the tissues heal treatment will shift focus to re-establishing the appropriate strength and balance of the muscles and proprioception with Functional Rehabilitation. Long term goals are a safe return to activity and prevention of re-occurrences