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Sprains and strains are a common type of injury that affect muscles and ligaments.
Ligaments are strong bands of tissue around joints that connect one bone to another. They help to keep bones together and stable.
Symptoms of sprains and strains include:
A sprain occurs when one or more of your ligaments have been stretched, twisted or torn, usually as a result of excessive force being applied to a joint. The most common locations for a sprain to occur are:
A strain occurs when the muscle fibres stretch or tear. They usually occur when the muscle has been stretched beyond its limits or it has been forced to contract (shorten) too quickly.
Strains can develop as the result of an accident, or during physical activities, such as running or playing football.
Read more about the causes of sprains and strains.
The most common types of strains are:
Most sprains and strains can usually be treated with self-care techniques, such as PRICE therapy – protection, rest, ice, compression and elevation. doctor if you are in severe pain, or if the injury is not improving or is getting worse.
Painkillers can be used to help ease any pain, and stronger ones may be prescribed if you have a serious injury.
Most people will be able to resume normal activities within six to eight weeks. Severe muscle strains may take longer.
There are a number of ways you can help to prevent sprains and strains, including:
Read more about preventing sprains and strains.
Sprains and strains are very common.
Symptoms of a sprain or strain depend on how severe the injury is. They often include pain, swelling and tenderness.
Common symptoms of a sprain include:
The swelling from a sprain will often occur soon after the injury. However, the bruising may not show until some time later or it may not show at all. Bruising can sometimes occur some distance from the affected joint, as blood from the damaged tissue seeps along the muscles and around the joint before coming close to the skin.
The symptoms of a muscle strain will depend on how severe the injury is. Symptoms can include:
There are two grading systems used to assess how serious a sprain or strain is.
The grading system for sprains uses a series of grades from one to three:
The grading system for muscle strains uses a series of degrees:
You should visit your doctor or another healthcare professional if you have a sprain or strain and:
The main causes of sprains and strains are sporting activities or accidents that involve a fall or collision.
Sprains or strains are most likely to occur if you:
Ankle sprains can occur if you lean onto the outside of your foot. This causes your whole body weight to press down suddenly on the outer ligament of your ankle which can stretch or tear it. Ankle sprains sometimes occur when walking or running over rough or uneven ground.
Sprains and strains often occur when playing sports, because of the physical contact and sudden acceleration and deceleration involved in sports.
Sports injuries often occur when someone begins to take part in a sport for the first time and their muscles are not used to the physical stresses involved.
Alternatively, experienced athletes may injure themselves when they are at the peak of their training because the increased demands on their muscles can suddenly cause them to become strained.
Competitive athletes such as sprinters, long-distance runners, gymnasts and footballers have a high risk of recurring muscle strains due to the intense nature of their training and the overuse of specific muscle groups.
Children are also at risk of getting sports injuries because they are still developing physically. However, while there is an increased risk of injury when playing sports, it is important to remember that they also have important health benefits and can help increase a child’s confidence and self-esteem.
Read more about sports injuries.
There are a number of things that make you more likely to develop an injury. These are described below.
Read more about preventing sprains and strains.
When diagnosing a strain or sprain, your doctor will ask about how you injured yourself and will perform a physical examination. In severe cases, an X-ray may be needed.
Your doctor will want to know about treatments you have already tried, as well as any medication you are currently taking that could affect the injury, such as anticoagulants (blood-thinning medication).
The affected joint or muscle will be examined to assess how severe your injury is. Your doctor will check for:
They will also assess:
If you have a severe sprain, your doctor may check whether the ligaments are loose. This is sometimes called joint instability, mechanical instability or ligamentous laxity.
Most people with sprains and strains do not need to have X-rays. However, your doctor may recommend an X-ray if:
Your doctor may also recommend an X-ray if you are over 55 years of age, and have an acute knee injury (see below). The reason for this is that people over the age of 55 have a higher risk of developing a fracture after this type of injury.
An acute knee injury is where the knee joint receives a sudden blow, or is damaged in some other way, such as being suddenly twisted out of position.
Most mild to moderate sprains and strains can often be treated at home using self-care techniques. Painkillers can also be used to ease pain.
Self-care techniques after a minor sprain or strain include:
These are described in more detail below.
PRICE stands for protection, rest, ice, compression and elevation.
For the first 72 hours after a sprain or muscle strain you should avoid HARM. This means that you should avoid:
Most healthcare professionals recommend you should not stop using a sprained joint because the injury will heal quicker if you begin to move the joint as soon as you are able to.
Your doctor will be able to teach you a range of exercises that will help you to improve the function of the joint.
An exception may be made in cases of severe ankle sprains. Studies have found people whose ankle joint was immobilised for 10 days with a short cast recovered normal ankle function quicker than those who were treated using exercise soon after the injury occurred.
The advice for muscle strains can be different. Depending on your injury, you may be advised to keep your injured muscle still for the first few days. Your doctor may arrange for a brace, cast or splint to help keep it as still as possible.
The aim of immobilising the muscle is to allow it to start healing so you can move it without tearing or pulling it again in the same place. After a few days you will probably be advised to start using the muscle again.
Paracetamol is usually recommended for painful sprains or strains. If this does not help, a stronger painkiller, such as codeine, only available on prescription, may be required.
Oral non-steroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen can also help reduce swelling and inflammation. However, NSAIDs should only be considered 48 hours after the injury has occurred because they affect the healing process.
Your doctor may also prescribe an NSAID cream or gel, such as ibuprofen or ketoprofen, to help treat pain. You should gently apply the cream or gel to the injured area and wash your hands immediately afterwards.
Ketoprofen can make your skin sensitive to light (photophobia). Avoid exposing areas of your skin to which you have applied cream or gel to direct sunlight or artificial sources of light, such as sunlamps or sun beds.
Your doctor may ask to see you after a few days to assess how well your injury is healing.
It is also recommended you contact your doctor if:
The length of time it takes to recover from a sprain or strain depends on how severe it is.
Generally, after an ankle sprain you will probably be able to walk one to two weeks after the injury. You may be able to use your ankle fully after six to eight weeks and you will probably be able to return to sporting activities after eight to 12 weeks.
In cases of muscle strains, the time it can take to return to sporting activities can range widely, from two weeks to six months.
There are several ways you can help prevent sprains and strains such as warming up properly before exercising and wearing suitable footwear.
Regular stretching and strengthening exercises as part of an overall physical conditioning programme can help reduce your risk of sprains and strains. Regular exercise will help joints stay flexible and reduce the likelihood of injury.
If you are prone to sprains and strains, taping, strapping or wrapping your knees, ankles, wrists or elbows can help while you are recovering from injury and when you first get back into regular activities.
However, for most people, it is best to regard taping, strapping or wrapping as a short-term protective measure. You can protect your joints in the long-term by strengthening and conditioning the muscles around them.
You should always make sure you wear footwear that supports and protects your feet and ankles whether you are:
If you wear high-heeled shoes, you are more likely to sprain your ankle than if you wear flat shoes.
Read more information about [choosing sports shoes].
You can help prevent sprains and strains by following the advice listed below.
Complications of a sprain or strain can include a fracture, dislocation or muscle and tendon injuries that need treatment in hospital.
If you have a sprain or strain with a lot of bruising and swelling it may indicate the bone is fractured (broken). Other signs of a fracture can include:
Read more information about:
Dislocated joints can also be a complication of sprains and strains.
Pain and recurring swelling can be common complications after an ankle sprain, particularly on the outer (lateral) side of the ankle.
If you are unable to use or tighten a strained muscle it may mean a tendon attached to the muscle is ruptured.
If you twist your knee and feel a tearing sensation followed by severe pain, it could be a cartilage injury.
If your injury has complications, your doctor may refer you to:
You may be referred to A&E or a specialist if you have:
Your doctor may also refer you to an orthopaedic specialist if your condition does not improve as expected.
Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.