What is a sprain?
When you sprain something, it means you’ve damaged a ligament. This can be by twisting it, stretching it too much or tearing it, which is often caused by a sudden or unnatural movement.
There are countless ligaments in your body – they’re a bit like rubber bands that attach bones to one another and allow your joints to move freely. But when you injure a ligament (otherwise known as spraining something), it’s harder to move the affected joint normally and you may notice some pain, bruising and swelling.
You’re very likely to experience a sprain at some point in your lifetime, especially if you play a lot of sport. They’re usually nothing to worry about and often get better on their own. But in some cases, you may need to see a doctor.
Where do most people get a sprain?
Sprains are very common, but certain areas of the body are more prone than others. Areas most commonly affected by sprains are:
- the ankle – a sprained ankle is one of the most common sports injuries there is. Often, it happens when you roll, twist or turn it awkwardly
- the knee – this joint has 4 main ligaments: the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL) and the lateral collateral ligament (LCL). Spraining these ligaments is common if you play a lot of sport
- the wrist – the wrist is made up of many joints that link 15 separate bones. You can sprain it after falling badly on your hand, or if you’ve twisted or stretched it too far
- the thumb – similar to a sprained wrist, a sprained thumb often happens when the ligaments in the thumb are overextended when you land on your hand awkwardly
- the foot – a foot sprain is the rarest ligament injury, but it can happen if you take part in sports that demand lots of twisting or bending of the feet, like gymnastics
What’s the difference between a sprain and a strain?
Strains and sprains are easily mixed up. Both describe soft-tissue injuries that happen around a joint and they share some of the same symptoms.
But while a sprain describes a damaged ligament, a strain is when muscles or tendons become injured, often due to overstretching or a tear.
Tendons are another form of tough connective tissue that hold your muscles and your bones together, whereas your muscles help move your body – you use them to jump, walk and chew, for example.
Strains are especially common in the legs, knees, feet and back, whereas sprains happen mostly in the ankles, wrists, thumbs and knees.
Another slight difference between the two injuries is that a sprain is usually brought on suddenly after an awkward movement or direct impact to the joint, while a strain often (but not always) develops over time.
How bad is my strain or sprain?
This comes down to how badly the ligament, muscle or tendon has been damaged. For this reason, sprains and strains are often divided into 3 groups:
- grade I – this is when the sprain or strain isn’t very serious, usually there’s been a mild stretching of soft tissue, possibly some small tears, and the structure of the joint isn’t affected. You should be able to put some weight on the joint
- grade II – the next level up is if you’ve partially torn (or ruptured) a ligament, muscle or tendon, which may or may not have affected the joints structure. Walking, putting weight on the joint or moving it will likely cause pain
- grade III – when you’ve seriously sprained something, you’ve completely torn the ligament, muscle or tendon and damaged the stability of the joint. You can’t put weight on the joint or move it
What are the symptoms of a sprain or strain?
Sprains are usually mild injuries and most people find they get better on their own without medical help.
The common symptoms of a sprain include:
- bruising and swelling around the injured area
- less joint movement around the affected area
- some sharp pain, especially when moving it
- not being able to use the joint as normal or put your weight on it, making some everyday activities like walking or lifting difficult
Strains share many of the same symptoms as a sprain, which can sometimes make it tricky to work out which injury you have. But as well as those listed above, the symptoms of a strain can also include:
- muscle weakness
- muscle cramps or spasms
When to see a doctor
Most sprains and strains can be dealt with at home with self-care measures. But in some cases, you might need to speak to a doctor. This includes if:
- you notice the pain or swelling around the joint is getting worse
- you’ve been treating the injury for some time and it isn’t getting better
- you’re struggling to walk normally or complete everyday tasks
- you have a high temperature or fever-like symptoms as well – this could be a sign of an infection
In very rare circumstances, you might need emergency medical attention. Call an ambulance or go to the emergency department as soon as possible if:
- the joint or body part around the injury is sitting at an awkward angle or has changed shape – this could be a sign of a broken bone or that the joint has been dislocated
- you noticed a cracking noise when you got injured
- you feel numbness around the injury, it’s changed colour or is cold when you touch it – this could be a sign that you’ve lost circulation to that body part
- the pain is very bad
- you cannot walk on or move that part of your body
Common causes of sprains and strains
Playing contact sports can increase your risk of spraining or straining something. This is because the soft tissue that supports your joints – including muscles, ligaments and tendons – are more likely to be damaged after direct impact from another player. Non-contact sports or everyday exercises that require fast acceleration, like sprinting, can also cause a strain or a sprain.
Sports most likely to bring on a strain or a sprain include basketball, rugby, skiing, gymnastics, football, wrestling, tennis, golf and volleyball.
How to prevent sprains and strains
Certain activities or lifestyle factors can increase your chances of spraining or straining something too. It might not always be possible to prevent this, but being aware of the risk factors can help.
Sprain or strain injuries are more likely if:
- you’ve had a strain or a sprain before – making sure you warm up and cool down properly can reduce the chances of you getting injured again
- you’re overweight – injuries are more likely to happen if you’re putting more pressure on your joints. Losing weight can help reduce this risk
- your muscles are tired and you continue to push yourself while playing or exercising – if your muscles feel overworked, stopping what you’re doing can reduce your risk of injury
- you’re older – the risk of muscle injuries is thought to increase with age. Warming up, cooling down and taking part in slower paced physical activity can reduce your chances of a sprain or strain
- you’ve been drinking lots of alcohol – this can make you sleepy and more prone to injuries and falls. If possible, try to reduce how much alcohol you drink or substitute it with alcohol-free alternatives
Treatment for sprains and strains
A sprain or strain is usually nothing serious and it should get better on its own. Self-care measures can help speed up your recovery, though.
Looking after your sprain or strain at home
In the first 48 to 72 hours after your sprain or strain, follow the acronym ‘PRICE’. This means:
- protect – use a support or strapping, such as an ankle support, for your injury
- rest – avoid using the injured body part as much as possible and don’t put any weight on it. Crutches might be helpful if you’ve sprained or strained something lower down the body
- ice – apply an ice pack to the problem area as soon as you can and hold it there for 15 to 20 minutes at a time, every 2 or 3 hours, for up to 3 days. This can help reduce inflammation and bruising. Avoid putting the ice directly on the skin by wrapping it in a towel to prevent ice burn
- compression – using bandages or braces for the first 48 hours can reduce swelling and allow the injured joint to start healing. Don’t make the bandage too tight, which can restrict blood flow. Aim for a mild pressure
- elevation – keeping your injured joint up on a chair or box can also limit swelling. If you’ve sprained or strained an area of your arm, a sling might be useful
You may also want to use painkillers like ibuprofen or paracetamol, but avoid heat and alcohol, as these can make bruising and inflammation worse.
If you can start to move the joint without too much pain after a few days, keep doing so gently to stop the muscles from becoming stiff.
Getting medical help for your sprain or strain
Sometimes, your sprain or strain might be more severe and take longer to heal. In this case, a doctor may be able to refer you for an X-ray, a scan, or to see a physiotherapist.
Once the swelling and pain has gone down and you’ve rested your injury enough, a physiotherapist can help you focus on the next stage of recovery by improving the flexibility and range of motion of your injured joint, as well as strengthening the muscles around it. This is usually done by setting specific exercises over a number of weeks, which depend on the type of injury you have.
If you have an ankle sprain, for example, you might be asked to move your ankle in circles, both clockwise and anti-clockwise, or to try to spell out the letters of the alphabet with your ankle, by ‘writing’ the letters in the air.
Getting a scan or X-ray
If your injury has been painful for more than 6 weeks, or a fracture is suspected, a doctor might recommend additional imaging scans, including a magnetic resonance imaging (MRI), a computerised tomography (CT) scan, or an X-ray. These can sometimes detect small fractures, breaks, dislocations or ligament and tendon injuries, which are much clearer to see once the initial swelling has gone down.
If your scan detects a serious sprain or strain – where the muscle, tendon or ligament has been torn badly or come away from the bone – you might need surgery, but this is quite rare.
If it looks like you might have a fracture as well as a dislocated joint, you’ll probably need more scans to check the area over in more detail. If a fracture is detected, you might need surgery. If there’s no fracture, trained medical staff will gently move your dislocated joint back into its socket, which is known as reduction.
In all cases, your doctor will be able to discuss the best treatment option for you.
Your health questions answered
How long does it take for a strain or sprain to heal?
It depends on how seriously you’ve injured yourself, but generally speaking, a moderate sprain or strain should start to feel better after 2 weeks.
If your injury is minor, avoid intense exercise, including running and cycling, for at least 4 weeks. If your sprain or strain is more serious, you may need to avoid exercise for as long as 8 weeks or even several months to allow your injury to heal. In this case, see a doctor as soon as you can.
- sprains and strains both involve damage to soft tissue, but they aren’t the same. A sprain is when you injure a ligament and a strain is an injured muscle or tendon
- sprains are very common and are more likely to affect the ankle, knee, wrist, thumb or foot
- sprains and strains can vary in terms of how serious they are and are graded in 3 different categories
- playing sport or exercising a lot increases the likelihood of spraining or straining something, especially sports like football, rugby and gymnastics
- strains are more likely to develop over time, although this isn’t always the case, and they often happen in the back, knees, feet and legs
- if you think you’ve seriously sprained or strained something, or you notice other symptoms at the same time as one of these injuries, see a doctor as soon as possible