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Sprain vs strain How to tell a ligament injury from a muscle injury, and how each one heals
Sprain vs strain comes down to the tissue that is hurt. A sprain is a stretched or torn ligament, the tough bands that join bone to bone at a joint, such as a rolled ankle or a twisted knee. A strain is a stretched or torn muscle or tendon, such as a pulled hamstring or a tweaked lower back. Sprains usually cause joint swelling and bruising and feel unstable; strains cause pain when the muscle contracts or stretches. Both are graded 1 to 3, and most mild ones heal in two to six weeks with early, guided movement.
People use the two words interchangeably, and both injuries cause pain, swelling and a few weeks of frustration. The difference matters, though, because ligaments and muscles heal at different speeds and need different rehab. The first video shows a ligament injury being rebuilt with strength and agility work.
Sprain vs strain: the key differences
- Tissue: a sprain affects a ligament (bone to bone); a strain affects a muscle or tendon (muscle to bone)
- Common spots: sprains in the ankle, knee, wrist and thumb; strains in the hamstring, calf, groin, lower back and shoulder
- How it happens: sprains from a twist, roll or fall onto the joint; strains from a sudden stretch or a hard effort such as sprinting or lifting
- How it feels: sprains bring joint swelling, bruising and a giving-way feeling; strains bring pain or cramping when you use or stretch the muscle
Grades of sprains and strains
- Grade 1: overstretched fibres, mild pain, little loss of strength or stability; often one to three weeks
- Grade 2: a partial tear, more swelling and bruising, a weak or loose feeling; often three to eight weeks
- Grade 3: a complete tear, severe pain or sometimes surprisingly little, with the joint unstable or the muscle unable to work; this needs a physician’s check
Our injury recovery timeline explains why ligaments usually take longer than muscles.
First-aid for the first few days
Protect the area, use ice for 15 to 20 minutes a few times a day, a compression wrap and elevation to limit swelling. Start gentle, pain-free movement within a day or two rather than resting completely; long rest leaves the tissue weaker and stiffer.
Rehab for a sprain or a strain
For a sprain, rehab restores motion, then strength and balance around the joint, because a sprained ankle or knee is likely to give way again without it; see ankle sprain recovery. For a strain, rehab gradually loads the muscle with lengthening exercises so it heals strong and flexible; see hamstring strain recovery. Both finish with sport or work drills before a full return, as in sports injury recovery; sports medicine covers athletes returning to play. A sudden “pop” with bruising in the upper arm can point to a larger muscle or tendon tear; our guide to arm muscle tear treatment explains how those tears are graded and treated.
When to get it checked
- You cannot put weight on the leg or use the arm
- The joint feels loose, locks or keeps giving way
- You heard a pop with immediate swelling
- Numbness, a cold or pale limb, or a visible deformity, which need urgent care
- No clear improvement after a week or two
The common injuries physical therapists treat post covers more injuries.
More videos from sprain and strain rehab
More clips from our YouTube channel @precisioncaremedical showing how sprains and strains are examined and rehabilitated.
Related care at Precision Care Medical & Sports Performance
Sprain and strain rehab near you
Looking for a physical therapist near me after a sprain or strain? For physical therapy in Brooklyn, physical therapists Zoya Reznik, DPT, OCS and Maggie (Yi) Zhang, DPT, with physical therapist assistants Dennis Furman, PTA and Leila Nahmoud, PTA see patients at our Brooklyn physical therapy office on Shell Rd, close to Brighton Beach, Coney Island and Bensonhurst.
For physical therapy on Staten Island, physical therapists Victoria Lynn Kain, DPT and Nicholas “Nick” Ursini, DPT treat patients at our Staten Island physical therapy office on Richmond Rd, a short drive from New Dorp, Midland Beach and Great Kills. Physical therapy is not offered at the Manhattan office. Request an appointment or call the office closest to you.
Questions patients ask
Is a sprain or a strain worse?
Neither is always worse; it depends on the grade. A complete ligament tear (grade 3 sprain) or a complete muscle or tendon tear (grade 3 strain) are both serious and need a physician’s check.
How can I tell if I have a sprain or a strain?
A sprain follows a twist or roll at a joint and causes joint swelling and instability. A strain follows a sudden stretch or effort and hurts when you use or stretch the muscle.
Which heals faster, a sprain or a strain?
Mild strains often heal a little faster because muscle has a good blood supply. Ligaments heal more slowly, so a moderate sprain can take six to eight weeks or longer.
Should I use ice or heat for a sprain or strain?
Ice helps in the first few days to calm pain and swelling. After that, gentle heat before exercise can ease stiffness, especially for a muscle strain.
Do I need physical therapy for a sprain or strain?
Mild injuries often recover with a home program. Physical therapy helps when you cannot bear weight, the joint feels unstable, or you are returning to sport or a physical job.
Where can I get sprain and strain rehab near me?
Precision Care Medical & Sports Performance offers physical therapy at two offices:
- Brooklyn2781 Shell Rd, Suite 101, Brooklyn, NY 11223(718) 648-1234 · Get directions
- Staten Island1630 Richmond Rd, Suite 101, Staten Island, NY 10304(718) 339-7100 · Get directions
Physical therapy is not offered at the Midtown Manhattan office.
Educational only, not medical advice. These videos and this article explain common problems and treatments in general terms. They are not a diagnosis or a treatment plan for you. Results vary from person to person. See a qualified clinician about your own symptoms, and call 911 or go to an emergency room for an emergency.
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