Strains and Sprains

Strains and sprains are injuries to the body's soft tissues. Strains are injuries to muscles and/or tendons, which are the cords that connect muscles and bones. Sprains are injuries to ligaments, which are bands of strong connective tissue that support the joints (areas in the body where two bones meet) and connect the bones to each other. Strains and sprains may result from sudden injury or from long-term overuse.

What Are Strains and Sprains?

Strains and sprains are injuries to the body's soft tissues—its muscles, tendons, and ligaments. They are everyday occurrences for athletes but can happen to anyone as the result of a fall, a twist, or any other sudden blow to the body.

Strains are injuries to muscles or tendons, which support the bones and connect them to the muscles. Sprains are injuries to ligaments, which are bands of connective tissue that support the joints and connect the bones to each other.

Strains occur most often in the muscles and tendons of the legs and back. Hamstring pulls, groin pulls, and sore back muscles are common forms of strain. Sprains most often affect the joints, such as the ankles, knees, and wrists. Both strains and sprains cause pain, swelling, and inflammation * . The injured area may also be discolored if it has been bruised and blood forms pools underneath the skin.

Most people recover from strains and sprains if they see their doctor promptly and follow the doctor's instructions, which often involve what is known as a R.I.C.E. protocol: rest, ice, compression, and elevation.

Strains and sprains are injuries to the muscles, tendons, and ligaments.

Strains and sprains are injuries to the muscles, tendons, and ligaments.
Illustration by Frank Forney. © 2016 Cengage Learning®.
Sports Medicine

Athletes and those who exercise for physical fitness are at risk of strains and sprains. The branch of medicine that specializes in treating these injuries is called sports medicine.

Doctors who specialize in sports medicine can help athletes improve performance without injuring the body. They can also test athletes for drug use, treat injuries that result from exercise or sports, advise about proper clothing and protective gear, and supervise diet and fluid intake during training and travel, especially travel abroad.

What Are the Different Types of Strains and Sprains?

Doctors usually classify strains and sprains by the degree of damage done to the muscles or ligaments.

First degree

A first-degree strain or sprain is the least serious of the three degrees and causes the least amount of damage or stretching of ligaments or muscle fibers. No tears occur in the tissue fibers, pain and swelling are minimal, and range of motion (movement up and down, or sideways) is usually not affected to any significant degree. People who have a first-degree strain or sprain may experience some slight disability in using the affected joint, but on the whole, they can resume normal activities after a short recovery period.

Second degree

In a second-degree strain or sprain, up to 80 percent of the tissue fibers are ruptured. The individual experiences more pain, edema * , and reduced range of motion. Unlike first-degree injuries, two to three weeks may pass before the pain and swelling begin to show real improvement. Athletes who resume their sports activity too soon risk the real possibility that the second-degree injury will turn into a third-degree injury, which requires a longer recovery time.

Third degree

In third-degree injury, a complete rupture occurs in all the tissues that surround the joint capsule: muscles, tendons, and ligaments. A person with a third-degree sprain or strain can no longer use the injured part of the body and will experience pain and visible bruising. X-rays may show that even though bones have not been broken, they may have been chipped. Doctors call such bone chips avulsion (a-VUL-shun) fractures. Medical professionals usually advise patients to protect the injured area for eight to 10 weeks and may order surgery to repair damaged joints.

How Do Doctors Treat Strains and Sprains?

Doctors who treat strains and sprains use the expression “RICE DIETS” to describe the steps required for healing. The “RICE” part of the term refers to first-aid practices, whereas “DIETS” refers to more definitive therapies performed by or under a doctor's supervision.

* , or other anti-inflammatory medications during the first few days after the injury.
  • I: Incision, drainage, and injection. Third-degree sprains sometimes require these procedures.
  • E: Exercise. Patients may be taught how to do certain leg exercises that will help them after their injuries.
  • T: Therapy. Patients may benefit greatly from physical therapy to get the injured part of the body back in use without hurting it again.
  • S: Surgery. A bad strain or sprain may need surgery to repair damaged tissue or fractured (broken) bones.
  • Can Strains or Sprains Be Prevented?

    Many strains and sprains can be avoided through planning for safe environments and activities. Precautions at home include the following:

    Rules for athletes include starting slowly, stretching frequently, and always remembering to warm up and cool down before and after strenuous exercise.

    See also Carpal Tunnel Syndrome • Foot Disorders: Overview • Knee Injuries: Overview • Muscle Spasms and Cramps • Repetitive Stress Syndrome • Sports Injuries: Overview • Tendinitis • Tennis Elbow (Epicondylitis) • Trauma


    Books and Articles

    Brody, Jane E. “After a Sprain, Don't Just Walk It Off.” New York Times, July 22, 2013. Available at: (accessed July 12, 2016).

    Young, Craig C. “Ankle Sprain.” Medscape Reference, January 3, 2016. (accessed July 12, 2016).


    American Physical Therapy Association. “Physical Therapist's Guide to Ankle Sprain.” (accessed March 13, 2016).

    National Institute of Arthritis and Musculoskeletal and Skin Diseases. “What Are Sprains and Strains?” (accessed July 12, 2016).


    American Academy of Orthopaedic Surgeons. 9400 West Higgins Rd., Rosemont, IL 60018. Telephone: 847-823-7186. Website: (accessed July 12, 2016).

    American Physical Therapy Association. 1111 North Fairfax St., Alexandria, VA 22314-1488. Telephone: 703-684-2782. Website: (accessed July 12, 2016).

    * inflammation (in-fla-MAY-shun) is the body's reaction to irritation, infection, or injury and involves swelling, pain, redness, and warmth.

    * edema (e-DEE-ma) means swelling in the body's tissues caused by excess fluid.

    * ibuprofen (eye-bew-PRO-fin) is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce fever and relieve pain or inflammation.

      This information is not a tool for self-diagnosis or a substitute for professional care.