October 2010 Newsletter

Archived Newsletters

Did he say “Sprain” or “Strain”?
By Dr. Stephen A. Hunt

When New York Yankees first baseman Mark Texiera slid into first during the American League Championship Series, most people knew something was not right. After all, he’s not Brett Gardner trying to beat out a tag with blazing speed. The instant slow motion replays told us the story that he had strained his hamstring which caused him to try to slide and would cost him the rest of the playoffs. Over the next several days, a multitude of reports from analysts and news articles discussed the nature of the injury and its prognosis. Often times the words “sprain” and “strain” appeared interchangeable in the conversation or story. There are times in the office when patients have confusions about these injuries, and we sought to alleviate some of the confusion about these injuries…

Sprains
Sprains are injuries to ligaments. Ligaments are structures that connect two bones together. Sprains occur when the forces pulling the bones apart damage the ligaments (think Ankle Sprain). Sprains are graded on the severity of the injury. Grade I sprains are when the ligaments get stretched but the fibers remain intact. Grade II sprains are when the ligaments are stretched and have a partial tear. Grade III sprains are when the ligament is completely torn. An overwhelming majority of ligament sprains heal without surgery. Most sprains require some activity modification, pain medication, bracing, and therapeutic exercises for complete recovery. A handful of severe sprains (grade III) are recommended to undergo surgical fixation for complete recovery (ACL injuries).

Strains
Strains are injuries to muscles and tendons. Based on the reports, this is the type of injury Mark Texiera sustained to his hamstrings. Tendons are the connections between muscles and bones. Muscles contract to move our joints and absorb the forces of gravity to protect our bones and joints. Sprains are also graded on the severity of the injury and the scale is similar to that of sprains. Most sprains occur at the junction of the muscle and tendon, but some occur at the tendon bone interface (think rotator cuff tears). Again, the majority of sprains can be treated without surgery by activity modification, pain medication, bracing, and therapeutic exercises resulting in a complete recovery. Surgical repair may be indicated for some complete tears of the muscles or tendons off the bone to restore normal function and reduce pain.

The risk of suffering both strains and sprains can be reduced by regular exercise. In particular, a good stretching program combined with a combination of cardiovascular and strengthening programs will help prevent these injuries. Unfortunately, not all injuries are preventable and even the best athletes will experience these setbacks sometime in their athletic career.