Sprain vs. Strain

A sprain/strain is a very common injury, but these two terms are sometimes confused and often used interchangeably.

What’s the Difference?

A sprain is damage to a ligament. This is what happens when you sprain your ankle, you stretch one or more of the ligaments surrounding your ankle. A strain is damage to a muscle. This also sometimes called a “pulled muscle” and involves a stretched muscle that is now painful. When either of these sprains/strains stretch out to the point of a tear, they are then known as “tears”.

How Do You Differentiate Between the Two?

One method a therapist utilizes to help differentiate a sprain from a strain is a test known as “O’Donoghue’s”. With this test, the therapist will passively put the painful area through a range-of-motion (ROM). This takes the muscles out of the equation. Then the patient will actively go through the same ROM by themselves, now engaging the muscles. If the area hurts during passive, but not active ROM, it points to a sprain. If the area hurts during active, but not passive ROM, it points to a strain, since the muscles are now doing the work. Remember that this is just one test, and not fool proof. There are plenty of cases where either injury results in a painful ROM regardless of whether its passive or active.

How Do You Treat Them?

Ligaments and Muscles are 2 totally different types of tissue.  Ligaments have avascular zones, are primarily made-up of collagen (>80%), and function in a stability manner. Muscles on the other hand, are vascular, are primarily composed of muscle fibers (only 2% collagen), and function in a direct movement-based fashion. This means treatments for a strain can be slightly different than that of a sprain.

Both will undergo the same conceptual rehabilitation path of: Decreasing Pain –> Increasing ROM –> Increasing Functionality & Strength. And both will also respond well to the acute therapies of Bracing / Resting / Icing / Compression / Elevation, and supplementation with Protein (since the body will utilize up to 35% more post-injury) and natural Anti-Inflammatories (such as Circumin Phytosome). BUT, they may differ on other techniques used along the path.

Sprains have a larger emphasis on Increasing Blood Flow (such as through Laser Therapy), Collagen Deposition (like with scraping or supplementing with Vitamin C and Collagen), and Stability (such as single-leg and balance exercises).

Strains on the other hand, may have a larger emphasis on Smooth Muscle Movement (with techniques that break up fascial adhesions, like Pin-and-Stretch/ART), Improving Contractility (such as with E-Stim), and Movement Mechanics & Progressions (Squat, Lunge, Hinge, Press, Pull, Carry).


Learn how tendons & ligaments heal, as well as what you can do to optimize them healing HERE!



Looking For More?

  • High-Quality Supplements: Check out our Online Supplement Dispensary HERE
    • We Partnered With “Thorne” To Offer The Highest-Quality Supplements On The Market:
      • Clinically-Studied (the Mayo Clinic, the Cleveland Clinic, the National Institutes of Health, and more)
      • NSF & NSF Sport Certified
      • Clean Ingredients
    • Our Entire Dispensary is currently 20% OFF!
  • Education / Special Offers: Subscribe to our Free Monthly Newsletter HERE
    • Educational Study Reviews
    • Supplement & Product Reviews / Recommendations
    • Special Offers On Numerous Health- & Wellness-Focused Brands
  • At-Home Products & Guides For Rehab / Pain-Relief / Bracing: Check out our Shop HERE
    • Effective Products For At-Home Injury Management, Rehabilitation, and Prevention
    • Guides Jointly Written By A Chiropractor, Yale Emergency Room Physician, and Personal Trainer




Written by Dr. Brandon Buchla, DC, CSCS

Check us out at www.atpplusct.com

Leave a Comment

Your email address will not be published. Required fields are marked *