Two common diagnoses in any chiropractor's office are the conditions "sprain" and "strain." Just what do these two terms actually mean? Are they the same thing? No, they are NOT the same thing.

     Simply put, a sprain is an injury to a ligament and a strain is an injury to a muscle and/or its tendon. Next to spinal misalignment (Subluxation), these are by far the two most common injuries we chiropractors treat.  Both of these conditions cause the characteristics pain and stiffness most people usually seek chiropractic care for. A basic, in office chiropractic exam can determine if your pain is caused by a sprain, strain, both, or by something entirely different. It is important to determine this as they are treated differently and heal at different rates.

     SPRAIN: injury to a ligament. Ligament is a strong, inflexible tissue that connects one bone to another over a joint. Its function is to keep a joint from moving too far out of its normal range of motion (ROM). You can see ligaments in action by bending your finger back and forth. The reason your finger bends back straight, then stops, is because ligaments surrounding the joints on the underside of your finger suddenly become taunt and prevent further backward motion.  Injury to a ligament (sprain) occurs if the joint is suddenly moved beyond its normal ROM. The fibers of the ligament literally tear  - causing pain, swelling, bleeding, and joint dislocation (think: sprained ankle).  Arthritis may eventually affect the joint due to "joint instability." The severity of sprains (and strains) is graded at levels of 1 through 4, where 1 is when less than 50% of the ligament is torn, and 4 is when the ligament is totally ripped in half and has taken a piece of bone with it (avulsion fracture). Grades 1 and 2 can usually be treated successfully in a chiropractor's office with therapies that speed up healing, decrease pain, inflammation and edema, and adjustments that realign the misaligned joint. Grades 3 and 4 usually require surgery to reattach the two ends of the ligament. Grades 1 and 2 heal faster and more completely than grades 3 and 4. Sprains are usually more serious injuries than strains and heal slower.

     STRAIN: injury to a muscle or tendon. The muscle gradually becomes a tendon at each end, and it is the tendon that attaches to bone. Obviously, the function of muscle is to contract and move the bones so that our bodies can move. Injury occurs when a muscle is trying to move a force (weight) greater than its ability to contract (strength). Like in a ligament injury, the fibers in the muscle or tendon tear - creating pain, swelling, bleeding, and spasm. A bruise may even appear on the skin above the injury. As with sprains, severity grading is 1 through 4, where grade 1 is less than a 50% tear and grade 4 is complete tearing with a piece of bone broken off with the tendon. Grade 4 strains have ended many an arm-wrestling career. Grade 1 and 2 can usually be successfully treated in  office, where grades 3 and 4 usually require surgery.

     Sprains and strains can affect the quality of life anywhere from a mild discomfort for only a few days to putting you on the permanently disabled list. Without a proper diagnosis and early treatment both sprains and strains can get worse or reoccur over time, leading to chronic pain, stiffness, weak muscles, and early-age arthritis. Don't ignore pain - it's your body's way of warning you that something is wrong.