Strain or Sprain?
When I read or look up resources on the internet or even in industry articles, I often notice sprain and strain are mistakenly interchanged. Over the years, I learned much from clients who had pain resulting from common injuries like rolled ankles, shoulder injury and whip lash. Learning the difference of sprain and strain has helped me to effectively and safely treat injury pain.
Both sprain or strain are injuries that can occur during everyday life activities as well as an incidental accident. The symptoms which result from strain or sprain are similar and the self-care protocol reflect that. However, the actual injury is different and the manual therapy protocol is distinctive.
It is important to remember that both tendons and ligaments are connective tissue which are avascular. Their lack of blood flow should be taken into consideration, along with the nature of injury.
Acute injury should always be followed by a doctors visit and immediate RICE protocol; Rest, Ice, Compress and Elevate.
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Strain is a tear or injury to the muscle or tendon. Tendon connects muscle to bone.
When muscle is strained, initial treatment includes ice massage and manual lymphatic drainage for pain and inflammation. As the muscle heals, alternating heat and cold can be applied to increase blood flow to the muscle. When the healing cycle is complete cross fiber massage can be applied to break up fascia adhesion or possible scar tissue.
When a tendon has a strain, stretching or manual manipulation of origin or insertion of the muscle is contraindicated, depending on the location of the injury. Manual manipulation of the injured tendon can potentially cause more damage. Increasing the blood flow to the muscles and surrounding muscle tissue is the best way to safely treat a sub-acute strained tendon.
When a tendon is strained, waiting until it has healed before restoring length and strength, is imperative. Statistics show that out of 62% of hamstring strains in the NFL, 16% of the cases were likely to become reinjured due to premature sports activity. Once healed, stretching and acupressure can restore length and mobility while preventing future injury.
Sprain is a tear or injury to the ligament. Ligament connects bone to bone. Initial treatment of a sprain should always be ice. If a sprain results in extreme swelling, redness and inability to move or instability of a joint; an immediate doctors visit is appropriate. These symptoms can indicate a detachment of ligament from bone.
Stretching or manipulation of an acutely injured ligament is contraindicated. Manual Lymphatic Drainage Massage can be safely initiated in the sub-acute stage of the healing process. While Manual Lymphatic Drainage Massage can help speed up recovery, it should be discretionally used, especially in the case of hypermobile joints. It’s always a good idea to check in with a clients doctor to know the severity of injury and to see if and when it is appropriate for massage treatment.
If a ligament has to be surgically reattached or has a significant tear, it may take several months to heal. Often shortening or tightening of a ligament will occur because of the length of time necessary to rest and heal. Surrounding muscles are usually effected and will most likely become shortened or tight from lack of movement or over compensation.
After a ligament has substantially healed, Medical Massage Therapy and Physical Therapy is a perfect combination to assist in a healthy recovery. Medical Massage can assist in regaining ligament length and joint mobility by use of acupressure and stretching. If there are ischemic or tight muscles, massage can assist in restoring healthy tissue while Physical Therapy can assist in strengthening the muscles.
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Disclaimer: This is written as a reference for massage therapists and is not intended as a replacement of medical advise or medical treatment.
