About muscle sprains and strains

What is muscle sprains and strains?

Muscle sprains and strains facts

  • A sprain is abnormal stretching or tearing of a ligament that supports a joint.
  • A strain is abnormal stretching or tearing of a muscle or tendon.
  • Sprains and strains may be caused by repetitive activities or by a single event.
  • The diagnosis of a sprain or strain usually can be made after the healthcare professional takes a history of the injury and performs a physical examination. Depending upon the situation, X-rays, CAT scan, or MRI scan may be needed to help make or confirm the diagnosis.
  • RICE (rest, ice, compression, and elevation) are the keys to treatment.
  • Most sprains and strains resolve with time, but occasionally other treatment, including physical therapy and surgery, may be required.
  • Anti-inflammatory medications may be helpful in decreasing the pain and inflammation of the injury.

What is the difference between a sprain and a strain?

A sprain is an injury to ligaments, while a strain is an injury to muscle or tendon tissue.

How muscles work

The purpose of muscles is to allow the body to move. A muscle attaches to bone, either directly or by way of a tendon, on each side of a joint. When the muscle contracts, the joint moves through its range of motion. The muscle that you feel underneath your skin is really made up of many smaller bundles of muscle fibers called fascicles. These, in turn, are made up of individual muscle fibers that are crosslinked to allow them to slide back and forth within the fascicle. Sliding together causes the muscle fibers to shorten and the muscle to contract and move the joint. The fibers return to their resting position when the fibers elongate and allow the joint to relax.

The transition of muscle to tendon happens gradually as muscle fibers give way to tendon fibers before the bony attachment occurs. The anatomy of each tendon is different and depending upon their location in the body, the tendon portion may be very short or very long. A strain is damage caused by an overstretched muscle or tendon, causing their fibers to be pulled apart and lose the ability to contract. The severity of injury depends upon the amount of tissue that is damaged. The muscle fiber may be just stretched, partially torn, or completely torn apart. The most common cause of the injury is overuse, which weakens the muscle. Muscles and joints are forced to perform movements for which they are not prepared or designed. An injury can occur from a single stressful incident, or it may gradually arise after many repetitions of a motion. The damage can occur in three areas: the muscle itself, the muscle tendon intersection where the muscle fibers transition to tendon fibers, or the tendon itself. Strains are described by the severity of damage in three grades:

  • Grade 1 strains usually cause stretching of a few of the muscle fibers.
  • Grade 2 injury is more significant damage and some muscle fibers are damaged and torn.
  • Grade 3 injury is a complete rupture of the muscle.

How joints work

Joints are stabilized by thick bands of tissue called ligaments that allow the joint to move only in specific directions. Some joints move in multiple planes. Therefore, they need more than one group of ligaments to hold the joint in proper alignment. The ligaments are anchored to bone on each side of the joint. If a ligament is stretched or torn, the injury is called a sprain.

The grading system for sprain injury is similar to that of strains.

  • Grade 1 sprains describe fibers of the ligament that are stretched.
  • Grade 2 sprains are injuries where part of the ligament is torn.
  • Grade 3 sprains are when the ligament is completely torn or ruptured.

Where do sprains and strains usually occur?

The ankle is one of the most common joints that is sprained. Usually, the mechanism of injury is a rapid "rolling" or "twisting" of the ankle and turning it inward so that the sole of the foot starts to point upward (supination). This causes stretching and damage to the ligaments on the outside or lateral part of the ankle that hold the joint stable.

Knee sprains are common football injuries and often make headlines because of their potential for ending professional athletes' playing careers. There are four ligaments of the knee that allow it to act as a hinge joint, flexing (bending) or extending (straightening). The medial and lateral collateral ligaments and the anterior and posterior cruciate ligaments keep the knee in alignment and are assisted by the quadriceps and hamstring muscles. As an example of characterization of an injury, when a player completely tears the anterior cruciate ligament (ACL) in the knee, it is described as a grade 3 injury of that cruciate ligament.

Neck injuries are common, for example, after a car accident. While whiplash is a nonmedical term, it accurately describes the head and neck movement when violently flexed forward and backward as the car abruptly stops. While the rest of the body is held in place with a seat belt and/or air bag, the head is like a bobble head and can continue moving. Both muscles and ligaments hold the neck bones (cervical vertebrae) in place and the stresses placed on those structures can cause pain and damage. Sometimes, the vertebrae are not damaged but the ligaments that support and stabilize the bones are torn, causing significant pain and swelling. On occasion, these injuries can cause the neck to become unstable and put the spinal cord at risk for injury.

Wrist injuries are common because we use our hands to perform many tasks. Usually, the wrist is damaged because of a fall, but repetitive tasks and a single aggressive move can cause pain. Some sports are more prone to wrist injuries because of the forces that are asked to be placed on the joint. These include throwing sports like baseball and football, bowling, skateboarding, snowboarding, and tennis.

The thumb and fingers can also be injured. Skier's or gamekeeper's thumb describes a sprain at the base of the thumb where a ligament attached to hold the thumb stable when grasping. It is most often injured in a fall where the thumb is forced away from the palm of the hand, like when a skier falls and the ski pole pushes the thumb in an awkward direction.

Muscles strains may involve any body area that is required to perform work. lower back pain and spasm is a common result of repetitive lifting injuries, but it only takes one twist or turn at the wrong time or in the wrong position to cause muscle fibers in the back to tear and go into spasm. Low back strain is the most common work-related injury.

Muscles of the legs can be damaged from overuse or imbalance. For example, the quadriceps muscle in the front of the thigh extends the knee and is balanced by the hamstring muscles of the back of the thigh, which flex the knee. Excess bending or straightening can cause the muscle fibers to tear. Muscles that move and stabilize the hip are prone to injury. Groin injuries or groin pulls are strains of the hip muscles that normally the thigh inward (medically termed adduction). When the leg is pulled away from the body like doing the splits, the adductors are stretched and potentially damaged.

We use our arms and hands for a variety of activities and the arm muscles (biceps and triceps muscles) and the forearm can be strained because of lifting, pushing, pulling grabbing, twisting, and any other activity that you can imagine the arm and hand trying to accomplish.

Chest wall muscles can be pulled because of activities as aggressive as lifting or as seemingly harmless as sneezing or coughing. Strains of the large muscles on the outside of the chest (pectoralis muscles) or the muscles between the ribs (intercostal muscles) can cause significant pain and can mimic the pain of a broken rib.

The core muscles of the torso of the body, including the abdominal wall muscles and those of the back, lend stability to the trunk and are often the source of power for the arms and legs to lift and push. These muscles can be strained from many different activities that require the torso to bend, stretch, or twist.

What are the symptoms for muscle sprains and strains?

Bruising symptom was found in the muscle sprains and strains condition

A joint sprain is the overstretching or tearing of ligaments. Ligaments are the bands of tissue that connect two bones together in a joint. The most common location for a sprain is the ankle joint.

A joint strain is the overstretching or tearing of muscles or tendons. Tendons are the dense fibrous cords of tissue that connect bones to muscles. The most common locations for a muscle strain are the hamstring muscle and the lower back.

The symptoms of a sprain and a strain are very similar. That’s because the injuries themselves are very similar. It’s no wonder the two conditions are frequently confused.

  • Pain or tenderness
  • Redness or bruising
  • Limited motion
  • Muscle spasms
  • Swelling
  • Muscle weakness

What are the causes for muscle sprains and strains?

Our bodies work hard day after day, so an occasional strain or sprain isn’t uncommon. Certain situations make you more likely to injure your joints. These include:

  • athletic activities or exercise, including running or jogging
  • accidents, such as falling or slipping
  • lifting heavy objects
  • overexerting yourself
  • sitting or standing in an awkward position
  • prolonged repetitive motion

What are the treatments for muscle sprains and strains?

When a muscle, tendon, or ligament fibers are damaged, the body will heal the area by producing scar tissue. The area that is injured needs to be kept relatively rested while healing.

first aid begins with rest, ice, compression, and elevation (RICE) and are keys elements in the treatment of both sprains and strains. More intense treatment can be required depending upon the injury and the patient's level of function. For example, an athlete who sprains the ACL of their knee may need to reconstruct the ligament, but an elderly patient who is less active may not need such an aggressive approach.

Depending upon the extent and location of the injury, it may take many weeks to return to normal function. That does not mean that all activity must stop; instead, there needs to be a gradual return to function that is guided by the body's response to activity. Most often, the patient can "listen" to their body's response to activity and increase or decrease the amount and intensity of activity. There is a balance between resting a part of the body enough to help with healing and resting it too much so that strength and range of motion are lost. For example, when the rotator cuff is strained, it may take a significant amount of time for the shoulder to return to full function. Resting the arm for a prolonged period of time in a sling to rest the muscle group may lead to stiffness in the shoulder joint and loss of range of motion. The health care professional and patient must appreciate that balance and minimize the loss of function while maximizing the rate of healing.

Muscle, tendon, and ligament heal themselves naturally by repairing the fibers or filling in the damaged area with scar tissue. Full muscle and joint mobility may take time to return and gradual stretching may be required to return the injured area to normal. Additionally, depending upon the area of the body that is injured, the damage sustained, and the amount of loss of function, physical therapy may be suggested. A variety of treatment modalities may be considered, including ultrasound and massage, to encourage healing and preserve range of motion and function.

If the muscle or tendon is ruptured or severely torn (grade 3 strain), surgery may be required to repair the damage. Some common sites of this injury include the

  • quadriceps (front of the thigh) muscle or its tendon, either the quadriceps or patellar, that allows the knee to extend or straighten tendon;
  • hamstring muscle located in the back of the thigh and flexes the knee;
  • Achilles tendon which attached the calf muscle to the calcaneus (heel) and allows the ankle to flex;
  • biceps muscle or tendon, which flexes the elbow.

Surgery is a consideration for certain sprains. The decision to offer surgical operations to repair muscle, tendons, or ligaments depends upon the patient's underlying function before the injury and their expectations for activity after recovery. Not all ligaments need repair, even if completely torn. For example, a professional athlete may continue to perform at a high level even with a torn posterior cruciate ligament in the knee but cannot with a torn anterior cruciate ligament.

Anti-inflammatory medications like ibuprofen (Advil) and naproxen (Aleve) are often suggested to help decrease inflammation and relieve pain. Before taking any over-the-counter medication, it is important to appreciate that side effects and medication interactions exist and it is wise to ask your health care professional or pharmacist for advice and direction.

For more significant pain, prescription pain medications may be prescribed for a short period of time.

What are the risk factors for muscle sprains and strains?

Participating in contact sports — such as soccer, football, hockey, boxing and wrestling — can increase your risk of muscle strains.

Certain parts of the body are more susceptible to strains during participation in certain sports. Examples include:

  • Legs and ankles. Sports that feature quick starts and jumping, such as hurdling and basketball, can be particularly tough on the Achilles tendon in your ankle.
  • Hands. Gripping sports, such as gymnastics or golf, can increase your risk of muscle strains in your hands.
  • Elbows. Elbow strains are often caused by throwing sports and racquet sports.

Is there a cure/medications for muscle sprains and strains?

Damage to a muscle or its attached tendons is termed muscular sprains and strains, muscle pull, or even a muscle tear. When engaging in routine everyday activities, abrupt heavy lifting, participating in sports, or working, you can put too much pressure on your muscles.

  • Tearing of the muscle fibres and tendons that are linked to the muscle can cause injury to the muscle.
  • Small blood vessels that are damaged by the muscle ripping may also result in localised bleeding or bruising as well as discomfort from stimulation of the nearby nerve terminals.
  • Sprains are caused by stretching a ligament that is connected to a joint.
  • Strains (or torn muscles) develop when a muscle is overextended or is subjected to excessive pressure, such as the calf muscle.
  • Cure or Medication for Muscle Sprains and Strains
  • Use NSAIDs to treat inflammation: NSAIDS, such as naproxen or ibuprofen, may lessen discomfort and enhance mobility. Without first seeing your doctor, never take NSAIDS if you have renal illness, a history of gastrointestinal bleeding, or if you also take a blood thinner like Coumadin. Acetaminophen, which helps to reduce pain but does not reduce inflammation, is a safer option in that situation.
  • Price Formula: The PRICE formula, which stands for protection, rest, ice, compression, and elevation, might be used to assist the injured muscle.

Swelling, bruising, or redness due to the injury
Cannot bear weight on or move the afflicted joint,Experiencing pain just where the bones of a damaged joint are,Any section of the wounded area is numb
ibuprofen (Advil, Motrin IB, others),Naproxen sodium (Aleve),Ocetaminophen (Tylenol, others)

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