Sprains and Strains: What’s the Difference and What Do I Do?

Do you have a joint that’s feeling loose or unstable or has become really inflamed? Do you get pain whenever a certain muscle activates? Sprains and strains are among the most common injuries that people sustain and can vary in severity from minor to surgical. While it will take a healthcare professional, like a physical therapist, to determine whether you have a sprain or a strain (or both) and the severity, it’s good to have an understanding of the difference between the two.


Sprains: ligament injuries

This word doesn’t indicate the severity of the injury and can be used for both completely ruptured and intact ligaments. Maximally stretching a ligament can still be very painful and trigger a whole inflammatory response despite minimal microdamage occurring. Sprains are named for the joint the ligaments serve (i.e. elbow sprain, sprained wrist, etc.) A good example is a sprained ankle which could involve a varying number of ligaments and varying degrees of tearing with pain levels not necessarily indicative of the level of injury.

A potential indicator of a partial or complete ligament rupture is joint instability. If a number of ligaments or an essential ligament ruptures, then surgery might be indicated. However, even with ACL ruptures (fully tearing the anterior cruciate ligament of the knee), surgery is not always necessary. It’s entirely possible to achieve the same activity levels and functional outcomes with conservative treatment/rehab following an ACL rupture as you can with surgery, minus the risks and side effects 1,2.


Strains: muscle/tendon injuries

Like sprains, a muscle strain could mean anything from maximally stretching to various degrees of tearing. However, unlike a fully torn ligament, a completely ruptured muscle usually requires surgical reattachment. This is because muscles often recoil on themselves when they’re fully torn and won’t reach to their attachment site for natural healing to occur. Anything less than a full rupture though can be easily treatable without surgery.

The term repetitive strain injury is usually what starts to confuse people. This term is simply referring to the mechanism of injury rather than the injured tissue. Repetitive movements can cause straining forces when tissues become vulnerable from muscles fatiguing or if movement mechanics were inefficient, to begin with. Identifying the specific tissues which were injured is only half the battle. The other half is to eliminate, modify, or optimize the repetitive movement to prevent chronic symptoms and re-injury.


I’m hurt, what do I do?!

A Doctor of Physical Therapy is a preferred healthcare provider to go to first to get an assessment, care plan, and treatment started all in the same visit (no prescription necessary in Illinois).

If you’re on the fence about going to see someone because it’s “not that bad,” then read this blog to find out how long you should wait to determine if it’ll get better on its own.

While you’re waiting for your appointment, here are answers to two common questions people have related to sprains and strains:

Should I use a brace?

These might be helpful in the short-term to help you get through your day with less pain but you don’t want your muscles to start weakening and forgetting how to work together to provide stability without a smelly brace. If it’s a ligament sprain, you want to start activating the muscles as soon as possible. If it’s a muscle strain, then you still want to allow the other muscles nearby the chance to provide strength and stability. If you were injured by repetitive strain, then you’ll want to look at your posture and movement mechanics to make sure you don’t end up wearing braces on multiple joints!

CARPAL TUNNEL TIP: braces for this condition are designed to keep your hand in line with your forearm. You can still achieve this pain-relieving posture without a brace while typing at a computer by adjusting your chair height so that your elbows are slightly higher than your wrists. Then, flatten your keyboard and either add a keyboard-rest or move your keyboard to the edge of the desk and allow your wrists to float to prevent any angulation at your wrists. The time when you might benefit most from a brace is during sleep when you don’t necessarily have control over what postures your wrist ends up in.

Should I use ice or heat?

The general rule of thumb is that ice reduces inflammation but can stiffen muscles while heat relaxes muscles but can increase inflammation. Based on this, if there is inflammation present (red/hot/swollen), try to avoid using heat and remember ice could make a muscle strain more painful – so, what do you do for a deep muscle/tendon strain that might be inflamed??

It’s a rabbit hole of a debate about whether certain tissues actually become inflamed when damaged. For example, tendons (continuous with muscle and serving as the reinforced attachment to bone) may or may not become inflamed to a significant or non-significant degree.

PRO TIP: if you’re unsure what to use, then don’t use either OR you can try them both for 15 minutes each one hour apart and see which one makes you feel better once you start moving – they both might feel nice in the moment, but it’s how they make you feel afterward that will tell you which (if any) is worth using.

If you think you’ve got a strain, sprain, or repetitive strain injury then take advantage of our Free Screen. One of our physical therapists will explain to you what’s going on and how to fix it with no commitment necessary because therapy might not necessarily be what you need most. We’ll either fix you up in-house, send you to your doctor for scans, or refer you to the health professional most equipped to treat your condition.


Don’t just hope to get better!

Get your healing story started with us!

Written by: Dr. Julia Melanson, PT, DPT

Edited by: April Oury, PT, MSPT, IOC, CFMT, FAAOMPT, Founder


  1. Dawson, A. G., J. D. Hutchison, and A. G. Sutherland. “Is anterior cruciate reconstruction superior to conservative treatment?.” The journal of knee surgery 29.01 (2016): 074-079.
  2. Kumar, Satish, Kaushalendra Singh, and Gaggan Chadha. “Comparative study of anterior cruciate ligament reconstruction versus conservative treatment among non-athletes: A 10-years follow-up.” Journal of Orthopaedics Trauma Surgery and Related Research 13.1 (2018).

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