Strains and Sprains: Symptoms and Treatment Options

physical therapyWarm weather brings a return to the outdoors and more vigorous activities, such as softball, running and yard work. This sudden increase in activity can cause a higher risk of injury, including two of the most common injuries, sprains and strains. Identifying the symptoms of a strain or sprain and knowing when to seek treatment can help prevent long-term pain and disability.

Sprain vs. Strain

A sprain results from the overstretching of a ligament, one of the strong bands of connective tissue that connects bones to other bones. Common areas of ligament sprains include the knee and ankle. Symptoms of a sprain include swelling, pain, joint instability and tenderness over the injured ligament. Based on the symptoms, a sprain can be categorized from first degree (mild) to third degree (severe).

In comparison, a strain is an overstretching or damage to a tendon, the tissue that connects a muscle to  bone. Commonly injured areas include the Achilles tendon and lower back. Symptoms are similar to those of a sprain, and strains are categorized according to what structure is injured and the severity.

X-rays or MRIs can be performed to rule out a fracture and determine the extent of a sprain or strain.


Treatments following a sprain or strain injury are similar. The severity of the pain, the amount of swelling, whether or not there are structural deformities, whether weight can be placed through the limb and changes in skin color need to be considered to determine the proper course of treatment. You should seek medical attention when your symptoms are severe. Mild symptoms generally do not require medical intervention and usually resolve on their own in 48 to 72 hours.

If your doctor determines that you need physical therapy, your treatment will involve three stages. The initial stage of rehabilitation (generally the first 2 to 3 visits) normally follows the PRICE principle:

P – Protect from further injury by applying bracing or assistive devices as needed

R – Restrict activity levels, including sports and other injury irritating activities

I – Apply ice to decrease swelling

C – Compress injured area to decrease swelling

E – Elevate injured area to alleviate swelling and inflammation

The second stage of rehabilitation includes a progression to therapeutic exercise. During this stage, gentle range of motion exercises are started. As the patient progresses, strengthening exercises are added to the plan of care.

The final stage of rehabilitation involves a return to sports, work or activities of daily living (cooking, grocery shopping, gardening, etc.). This phase includes exercises or activities that mimic movements and requirements of tasks required to perform normal activities. This period may also include treatments to correct other strength, flexibility, alignment or range of motion impairments that may have caused the initial injury. This phase is important to prevent re-injury to the area.  

If you have suffered a strain, sprain or other injury, consult your physician and contact us to schedule therapy to help you recover as quickly and as safely as possible.

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