The Difference Between Sprains and Strains — and When to Go to the Doctor

There you were, crushing that at-home workout, when ouch — your hamstring did not like all those jumping lunges. This is not your standard sore muscle feeling, but a pain that leaves you limping the next morning. 

A quick Google search of your symptoms leads down a rabbit hole of muscle injury jargon: sprains, strains, tears … the list goes on. What’s the difference? 

“A sprain refers to a ligament injury, which is a bone to bone tissue connection,” explains Catherine Braden, a physical therapist at UW Medicine Sports Medicine Center at Husky Stadium. “The term strain refers to a muscle or tendon injury. Tears can occur in a muscle, tendon or ligament.”

Muscle injury grades

Because these terms can be difficult to differentiate, doctors often categorize muscle and ligament injuries into three grades bucketed by the severity of muscle fiber damage. 

In a Grade I strain, a few muscle fibers are stretched or torn. You may feel pain when you try to move your injured muscle in its full range of motion, but you’ll still be able to function close to normal and you can expect your injury to heal fairly quickly.

“With a simple Grade I strain or very simple ankle sprain, it may only take a few weeks to heal,” says Braden.

In a Grade II strain, more muscle fibers are stretched or torn. In addition to a higher amount of pain and tenderness, this level of strain can cause mild swelling, loss of strength and bruising. Depending on the location of the injury, a moderate strain can take up to 10 weeks to heal.

A muscle or tendon that is completely torn is a Grade III strain. When the muscle ruptures into two pieces, it results in a complete loss of muscle function, significant pain, swelling and discoloration. An injury this severe requires months of recovery time.

When to seek medical advice

Some injuries — like a Grade III strain — will be so painful and debilitating that paying a visit to your doctor is a no-brainer. 

“If you feel or hear a ‘pop’ or have numbness or tingling, or other signs of a nerve injury, you should go see the doctor right away,” says Braden.

There are other symptoms that warrant a trip to the doctor as well.

“High pain, inability to bear weight through a limb and/or pain when pressing on boney areas are just a few reasons one may need to be checked out by a doctor,” says Braden. “If things are not getting a lot better or worsen after a couple of days, you should also consult your doctor.” 

During your appointment, your doctor may check for areas of tenderness, weakness and lack of mobility. You might also need imaging tests (such as an MRI, X-ray or ultrasound) to rule out muscle tears or broken bones.

Having your doctor evaluate your injury can give you an idea of how long your sprain or strain will take to heal and inform your treatment plan, which may include rest, painkillers and physical therapy. 

“In very severe cases, these types of injuries may require surgical intervention,” says Braden.

This is often true for Grade III strains, where the muscle or ligament is completely torn. Surgery can be necessary to restore function and ensure the injury heals correctly.

Less pain and more gains

Dealing with a muscle or ligament injury can be painful and physically limiting. Fortunately, there are effective ways to ease the pain while you’re parked on the couch. 

One common treatment to help manage aching pulled muscles is the RICE method. Contrary to its carb-y name, RICE stands for rest, ice, compression and elevation. Doing these things relieves pain, limits swelling and speeds healing. 

Acetaminophen (such as Tylenol) as well as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen have also been shown to reduce pain in the short term.

Your doctor may also recommend physical therapy. The exercises prescribed to you will help stabilize and re-strengthen the muscle or ligament so that when you resume exercise, you don’t re-injure yourself.

Over time, you should see a decrease in discomfort and an increase in strength and mobility. But it’s important to note that some injuries heal faster than others.

“Recovery depends largely on injury severity and can range from a few weeks for something like a Grade I strain to months for a more severe injury,” says Braden. 

As your mother always said: Patience is a virtue.

Getting back to that workout

So you’ve rested and rehabbed your injury. How can you safely start exercising again?

Begin by slowly ramping up your athletic activity while paying attention to pain. For instance, if you’re returning from a running injury, start by alternating walking and jogging for a short distance. Over time, increase the time jogging and decrease the time walking, until you’ve reached a point where you can run again.

But, if your injury is sending you mixed signals as you try to reengage in your sport of choice, it’s best to back off and get it looked at. The sooner you figure out what's up, the sooner you can resume your workout pain free.

“As you try to get back to activity, make sure not to push through a lot of pain or swelling,” says Braden. “Listen to your body and if something isn't right, seek some professional guidance.”

How to get your sweat on — safely

No one is immune to sprains and strains. But you can reduce your risk of injury in simple, proactive ways.

Warm up before exercising. Incorporate weightlifting or bodyweight exercises to build muscle strength and stability. And, make sure you’re not over-doing it (yes, it is possible to exercise too much).

So, whether you’re all about running, hiking or that high-intensity at-home workout, get after it. Just be safe and smart — your muscles will thank you.