Sprain and strain injuries are some of the most common types of injuries we see in our practice. They can be niggly and annoying at best, and at worst they can put you out of action for months.
What is the difference between a sprain and a strain?
We’ll forgive you for not knowing the answer to this question! It’s a tricky thing for people to get their heads around.
A sprain is this stretching – sometimes including tearing – of ligament tissue. Ligaments connect the two or more bones that make up a joint.
A strain is this stretching – sometimes including tearing – of a muscle or a tendon. Tendons are very strong, fibrous attachments that connect muscle to bone. Tendons are, in fact, a continuation of muscle tissue.
Ankles are the most common joints to be sprained. Hamstrings and the tiny (very strong) muscles that support your lower back are the most common muscles that we treat for strain.
What are the causes of strains and sprains?
Strains and sprains usually occur due to
- traumatic injury
- exercising with faulty movement patterns
- improper lifting or carrying
- repetitive motion
Why is treatment important for a sprain or strain injury?
One of the most challenging things about sprain and strain injuries is that once you have injured the tissues in a particular area, it predisposes you to re-injuring them again (and maybe again and again). It is not unusual to see people with worsening cases of sprains or strains to the same area of the body.
When muscles, tendons or ligaments are stretched or torn, the body works hard to repair the damage and strengthen the tissue. In just a few weeks, new fibres of soft tissue are produced to take the place of old ones that are damaged. This tissue is known as scar tissue. This proliferation of scar tissue helps strengthen the area, but without prompt treatment and rehabilitation, the tissue itself generally ends up being quite disorganised and can affect how well the joint or muscle functions post-injury.
When should I seek treatment for sprain or strain injury?
It is important to follow the PRICE protocol for up to at least 48 hours and up to one week following a sprain or strain injury.
Once swelling and pain have subsided, it is important to start to work gently with the area to expect optimal recovery. At between 2 to 6 weeks of healing, we have an opportunity to influence the organisation of the newly-forming tissue. Doing so can make an enormous difference to the function of the injured area as it heals and into the future.
How does treatment help a sprain or strain injury?
As new fibres grow, it is typical for them to be quite coarse. Scar tissue is comprised of more collagen and less elastin (yep, the stretchy stuff). It is also generated in a way that gives maximum strength to the area as quickly as possible and what this looks like is a messy configuration of fibres not aligned along the length of the muscle, tendon or ligament. The fibres grow in a disorganised way.
Proper treatment at this time will focus on massaging the newly-forming tissue to help it align with the original structure. This protocol aims to give maximum motion to the muscle, tendon or ligament as it is healing and into the future.
Doing proper rehabilitation work on a sprain or strain injury can help improve range of motion, increase flexibility and decrease scar tissue. These outcomes are important in the short-term and can also make a significant difference to the overall function of the injured part into the future.
What happens if I don’t rehabilitate an injured joint or muscle?
When muscles and joints repair after injury, it is likely that their range of motion and flexibility will decrease. Over time, reduced motion in one area of the body can start to impact the alignment and weight bearing in other areas. For example, a person who has an old knee injury may start to feel hip or lower back pain years later. Sooner or later, the extra weight-bearing these joints have had to do to compensate catches up.
For the benefit of your future self, it is important to seek treatment for joint and muscle injuries when they occur. Often, just one or two sessions can be of enormous benefit. Your therapist may be able to offer you some tips for things you can do at home to speed and improve your recovery.
When you don’t make the investment in your healing, problems may show up in the future and these can be much more difficult to treat.
Blog by Dr Tracy Kopp, Chiropractor