Sprain vs Strain: What Beginners Should Know and Do

A sprain is an injury to a ligament, the tissue that joins bone to bone at a joint. A strain is an injury to a muscle or a tendon. The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), part of the National Institutes of Health, covers both under "sports injuries," a term that applies to anyone who is active, not only athletes. NIAMS says many such injuries can be treated at home, but some signs call for a health care provider.

1. The one-word difference: ligament vs muscle

NIAMS defines the two like this:

A simple memory aid: sprain = joint, strain = muscle or tendon. NIAMS's own examples make the split clear: rolling or twisting your ankle on an uneven surface or an awkward landing causes an ankle sprain, while running, jumping, and sudden starts and stops put you at risk of a hamstring strain in the back of the thigh.

2. Acute or chronic?

NIAMS also sorts injuries by how they start:

• Acute injuries happen suddenly: a fall, a blow, a twisted joint. Sprains are a typical example.
• Chronic injuries come from overuse and build gradually. NIAMS warns that overuse can wear down tissue and set the stage for an acute injury later.

For beginners, NIAMS's list of risk factors reads like a checklist of early training mistakes: using incorrect technique, overtraining, increasing intensity too quickly, poor footwear, and a previous injury.

3. Signs you need a health care provider

NIAMS says to see a provider if you have signs of a serious injury:

• Severe pain, swelling, or bruising
• Pain and swelling that don't go away after a few days
• Being unable to put any weight on the area
• An obvious deformity

Its list of acute-injury symptoms also includes not being able to move a joint normally, extreme weakness in the injured limb, and a bone or joint that is visibly out of place. Any of these is a reason to stop and get checked rather than wait.

4. First aid for minor injuries: R-I-C-E

If there are no signs of a serious injury, NIAMS says it is probably safe to treat the injury at home, at least at first, using R-I-C-E:

• Rest. Limit activities that use the injured area for at least a day or two, and avoid putting weight on it.
• Ice. Apply an ice pack for 20 minutes at a time, four to eight times a day, using a cold pack or crushed ice wrapped in a towel. To avoid cold injury and frostbite, don't go over 20 minutes.
• Compression. An elastic bandage can help reduce swelling, but don't wrap so tightly that it cuts off circulation.
• Elevation. If possible, keep the injured ankle, knee, elbow, or wrist raised on a pillow above the level of the heart.

NIAMS adds a timing note on heat: don't use heat right after an injury, because it tends to increase inflammation and swelling. Heat can help later, but not before 72 hours after the injury.

If pain or other symptoms persist or get worse, check with a provider.

5. Don't train through it

NIAMS is direct: you should not try to "work through" the pain of an injury, whether it is sudden or from overuse. If a movement hurts, stop right away; continuing can cause further harm.

NIAMS lists pain when you play or exercise, plus swelling and a dull ache at rest, as symptoms of a chronic overuse injury, and sudden severe pain or extreme swelling or bruising as symptoms of an acute one. In both cases the instruction is the same: stop the movement that hurts.

6. Coming back

After the injury heals, NIAMS says a rehabilitation program may be needed before returning to the activity that caused it, often with a physical therapist rebuilding strength and range of motion. Most sports injuries, it notes, respond well to treatment and rehabilitation.

NIAMS also stresses continuing some type of regular exercise once you have healed, while lowering your risk of a repeat:

• Choose activities suited to your fitness level.
• Increase intensity gradually.
• Use proper equipment and technique.
• Learn to spot injuries early and treat minor ones at home.

7. Key takeaways

• A sprain injures a ligament at a joint; a strain injures a muscle or tendon.
• See a provider for severe pain, swelling, or bruising, inability to bear weight, or a visible deformity.
• For minor injuries, NIAMS recommends R-I-C-E: rest a day or two, ice 20 minutes at a time, compress, and elevate.
• Avoid heat for the first 72 hours, and never ice longer than 20 minutes.
• Don't train through pain; stop the movement that hurts.

This article is general information, not medical advice. Talk with a doctor or physical therapist before starting a new exercise routine, especially if you have a health condition or injury.