Sprains and Strains

Sometimes referred to as: twisted ankle, pulled muscle

Interview between:

  • Andrew Cunningham, MD

  • Steven Winiarski, DO

A sprain is an injury to the tissue that connects two bones together, while a strain is an injury to a muscle or the tissue that attaches a muscle to a bone.

Cases Per Year (US)

Not all types of sprains and strains are well documented, but to give a subset example: among the 1 million ankle injuries per year, about 85% of them are sprains.

General Frequency

Many people get sprains and strains during their lifetime. Insufficient warm up, poor conditioning, and participation in contact sports are among the major contributing factors.


Most heal well, but more serious injuries can result in chronic joint or muscle pain, swelling, and an unstable joint.



What is a sprain?

A sprain is defined as damage to a ligament–the fibrous connective tissue holding a joint together–when the joint is forcefully taken out of its normal range of motion. 

The most commonly sprained joints are the ankle, knee, and wrist. Typical symptoms are pain, swelling, and bruising. 

What is a strain?

A strain is an injury to a muscle or tendon due to overstretching, especially when the muscle is being actively contracted. The injury typically occurs at the junction of the muscle and tendon where forces are greatest. Symptoms include pain with muscular contraction and swelling. With more severe injury, bruising can also occur.

Due to their particular anatomy, the hamstring and quadriceps are the most commonly injured muscles. 

How is severity graded?

Strains and sprains are graded on a three point scale. 

Grade 1 injuries, the mildest, occur when tissue fibers are stretched and undergo microscopic damage. These injuries can produce pain and swelling, but rarely cause bruising. 

Grade 2 injuries involve a partial tear of tissue fibers. These injuries also produce pain, swelling, and bruising. 

Grade 3 injuries, the most severe, represent those with a full tear of the affected muscle or ligament. In these cases, there is significant swelling, bruising, and weakness of the affected limb or joint.





Connect with our physicians

Andrew Cunningham, MD and Steven Winiarski, DO are both members of the Galileo Clinical Team. Connect with one of our physicians about Sprains and Strains or any of the many other conditions we treat.

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