Muscle Strain”- Is It Always Serious?

The terms sprain and strain are commonly used in a cognate way, but in fact they are two different conditions. To understand the difference between strain and sprain, we have to know about muscle and ligament. Muscle is a contractile tissue which helps in movement and ligament is the fibrous tissue between the bones which stabilises the joints. When a muscle is injured or when the tissue that connects a muscle to a bone is injured, it is called a strain. When an injury is sustained by the tissue that joins two bones, it is called a sprain. In a broad perspective, sprain occurs in or near the joints and strains happen away from it.

Acute strains happen due to many causes some of which include road accidents, having a fall and not using the proper technique while doing heavy lifting. When a muscle is subjected to repeated injuries from the same movement, a chronic muscle strain happens. Acute strain is more common in young active adults, whereas chronic strain is prevalent in manual labourers and elderly people.

Sprains are classified into three degrees. A first-degree sprain is a tear of only a few fibres of the ligament. It is characterised by minimal swelling, localised tenderness but little functional disability. A second-degree sprain is the disruption of more ligamentous fibers with more loss of function and more joint reaction with mild to moderate instability. A third-degree sprain is the complete disruption of the ligament with severe swelling and bruising.

The symptoms depend on the severity of the injury and which part is affected. It may cause pain or tenderness, redness or bruising, limited motion, muscle spasms, swelling and muscle weakness.

Risk Factors:

Any sport that is rough and involves body contact like football, boxing, etc., increases the chance of muscle strains. Certain sports increase the chance of a specific area being strained. For example, basketball which involves jumping and sudden jerks can injure the Achilles tendon. Gymnastics can strain the hand muscles and racquet sports can strain the elbow.Tennis elbow is such a condition we commonly encounter.

Weak Muscles and Poor Tone: Optimal strength and tone of the muscles help to prevent abnormal or excessive movement of any joint. As muscles weaken in elderly people, the chances of strain and sprain increases.

Fatigue failure of muscle and ligaments need special mention here. When we keep our body in an irregular position for a longer duration or more frequently, the recoiling capacity of the ligaments are lost (similar to a rubber-band) and it eventually fails. This is the usual cause of neck and back pain for those who spend a lot of screen-time.

Prevention:

• Maintaining proper posture while lifting heavy weights.
• Regular endurance exercises to maintain proper muscle strength and tone.
• Proper stretching before sports and gym activities.
• Utilising protective gears and supports like running shoes, wrist/elbow bands and ankle braces while playing.
• In addition to muscle strength, bone strength is also vital to prevent fall injury. Regular exercises and calcium-rich diet help in improving bone quality.
• For those in physically challenging jobs, a suitable strength and conditioning program will help prevent injuries.

Management:

Pain and swelling due to ligament injury usually worsen after few hours of trauma, unlike fractures. Mild pain can be managed with rest, ice fomentation, analgesic medicines and compression at home. If the pain is intolerable, restricting your mobility, getting worse despite rest and is associated with tingling or numbness in that region, it is time to consult a doctor. Most of these conditions can be diagnosed with clinical examination and in some cases, a scan or X-ray may be needed to identify and quantify the muscle or ligament injury. Majority of the conditions can be treated with activity restriction or modification, physiotherapy and bracing. Severe injuries where the tissue is completely disrupted can be treated successfully through arthroscopic (keyhole) or open surgical repair. With the advances in arthroscopic techniques, return to pre-injury level of activity is possible in most cases.