Sprains, strains, breaks: What's the difference?

POSTED: 10:10 AM MST Dec 20, 2012    UPDATED: 12:48 PM MST Jan 03, 2013 
Kids sports injury in youth soccer

By David Elmore, Pure Matters

If you've sprained your ankle, you know what severe pain is.

But maybe that "sprain" was a "strain" or possibly even a "break."

The amount of pain in each case can be virtually equal, so oftentimes the only way to find out what you have is to see a doctor.

Just the facts

Here are some facts on musculoskeletal injuries:

Health care providers attend to millions of Americans with musculoskeletal injuries each year, according to the American Academy of Orthopaedic Surgeons (AAOS). More than one in four Americans has a musculoskeletal condition that needs medical attention.


A sprain is caused by trauma -- a fall, twist or blow to the body, for example -- that knocks a joint out of position and overstretches or even ruptures supporting ligaments. Some examples: When you land on an outstretched arm, slide into a base, land on the side of the foot or run on an uneven surface.

Although the intensity varies, pain, bruising and inflammation are common to all three categories of sprains: mild, moderate and severe. You may feel a tear or pop in the joint. With a severe sprain, ligaments tear completely or separate from the bone. This loosening interferes with joint function. A moderate sprain partially tears the ligament, producing joint instability and some swelling. A ligament is stretched in a mild sprain, but there is no joint loosening or instability.

Sprains happen most often in the ankle, and are more likely if you've had a previous sprain there. Repeated sprains can lead to ankle arthritis, a loose ankle or tendon injury.


Acute strains are caused by stretching or pulling a muscle or tendon. Chronic strains are the result of overuse of muscles and tendons, through prolonged, repetitive movement. Inadequate rest during intense training can cause a strain.

Typical symptoms of strain include pain, muscle spasm, muscle weakness, swelling, inflammation and cramping. In severe strains, the muscle and/or tendon is partially or completely ruptured, leaving the person incapacitated. Some muscle function will be lost with a moderate strain, in which the muscle/tendon is overstretched and slightly torn. With a mild strain, the muscle/tendon is stretched or pulled, slightly.

These are some common strains:


Bone breaks, unlike sprains and strains, should always be looked at by a health care provider to ensure proper healing. Call your provider if the pain does not subside.

Athletes are most susceptible

All sports and exercises, even walking, carry a risk of sprains. The areas of the body most at risk for a sprain depend on the specific activities involved. For example, basketball, volleyball, soccer and other jumping sports share a risk for foot, leg and ankle sprains.

Soccer, football, hockey, boxing, wrestling and other contact sports put athletes at risk for strains. So do sports that feature quick starts, such as hurdling, long jump and running races. Gymnastics, tennis, rowing, golf and other sports that require extensive gripping put participants at higher risk for hand strains. Elbow strains frequently occur in racquet, throwing and contact sports.

Treating injuries

A severe sprain or strain may require surgery or immobilization, followed by physical therapy. Mild sprains and strains may require rehabilitation exercises and a change in activity during recovery.

In all but mild cases, your health care provider should evaluate the injury and establish a treatment and rehabilitation plan.

Meanwhile, rest, ice, compression and elevation (called RICE) usually will help minimize damage caused by sprains and strains. You should start RICE immediately after the injury.

RICE relieves pain, limits swelling and speeds healing, and it is often the best treatment for soft-tissue injuries, such as sprains and strains. Here's what to do:

Do all four parts of the RICE treatment at the same time. If you suspect a more serious injury, such as a broken bone, call your health care provider immediately.


No one is immune to sprains and strains, but here are some tips developed by the AAOS to help reduce your injury risk: