DIAGNOSIS: Diagnosis of a sprain is often made simply by the mechanism of injury and location of pain, but determining the severity (grade) may require imaging such as ultrasound or MRI if the physical exam alone is not enough. X-rays do not show injury to the ligament itself but are useful to rule out an associated bone fractures.
TREATMENT: Treatment for most 1st and 2nd degree sprains often initially involves ice, NSAIDs (non-steroidal anti-inflammatory drugs) and relative rest with a slow progression back to activities. Braces can be helpful in the acute stages. Physical therapy is often helpful to rehabilitate the injured joint to speed recovery and prevent future injuries. Sometimes, but not always, surgical intervention is required to repair 3rd degree sprains, such as the anterior cruciate ligament (ACL) of the knee.
PREVENTION: Stretching and "warming-up" prior to activity helps "loosen" the ligaments, making them more flexible and therefore decreasing the likelihood of a sprain.
A strain is a similar mechanism of overstretching, but this refers to an injury to the muscle or tendon. A tendon is the thick, fibrous end of a muscle that attaches to the bone. A strain is an acute stretch or tearing injury. Tears should not be confused with tendonitis, which is an inflammatory condition of the tendon often associated with repetitive overuse. Usually, the weakest area is the muscle tendon junction, tears can cause bruising (aka bleeding). This is commonly seen with a strain of the hamstring or calf muscles.
DIAGNOSIS: Although there is no formal classification system for strains, the extent of the injury can often be seen with MRI or ultrasound imaging.
TREATMENT: Treatment includes ice/heat, rest, NSAIDS and Physical Therapy. A more aggressive and still developing treatment for strains that are slow to heal is Platelet Rich Plasma injections.
PREVENTION: Just like a sprain, stretching and warming up muscles prior to activities will help decrease the chance of a strain.
MORAL: Get out there and have fun, but be sure to stretch first!