Sprains or strains

Physical Therapy for Sprains and Strains

Both sprains and strains are two similar injuries that share many of the same symptoms, including swelling, bruising, and pain. Often, when a person first experiences either of these injuries, they may not know the difference or severity, but fortunately, with some simple diagnostics, initial treatment often starts out the same. This will often include physical examination along with compression, elevation, and a type of stabilization, such as a brace. Sprains, no matter how mild, may seem to heal on their own, but no matter how mild the sprain, you should seek the care of a Physical Therapist to help improve mobility early on and prevent reinjury.

But first, How can you tell the Difference between a Sprain and a Strain?

Ligaments, which are the bands of tissue that connect and stabilize your bones, can suffer tears and overstretching. This overstretching and/or tearing of the ligaments is called a sprain. A strain, on the other hand, is the overstretching or tearing of a tendon. A tendon connects muscles with bones in order to help the body move. Sprains and strains are classified in a grading process from one to three, with grade 1 being the least severe, and grade 3 being a complete tear of the ligament or tendon, or the most severe. 

Fortunately, physical therapy interventions can help you rehab even a grade 3 sprain or strain. In rare cases, you may require surgery; however, physical therapy outcomes for most strains and sprains are positive. Your therapist will put you on a timeline to recover your strength, range of motion, and stability, so you can get back to your daily activities as soon as possible.

Types of Sprains and Strains

Sprains and strains come in three grades of severity. Your physical therapy treatment will depend on the grade/severity of your sprain or strain. Check out the list below to understand the symptoms you may experience for a strain or sprain of each grade:

  • Grade 1 – (mild – tear of minimal amount of fibers) – little to no swelling, there will still be stability in the affected area, and the impact on your range of motion and strength will be mild.
  • Grade 2 – (moderate – tearing of fibers is moderate) – as compared with grade one, grade 2 strains or sprains will have visible swelling. You will likely experience stiffness; noticeable, decreased range of motion; and decreased stability in the affected area.
  • Grade 3 – (severe – a total tear of the tendon or ligament) – you will notice a severe amount of swelling, a loss of nearly all stability, poor range of motion due to severe swelling and pain, and a near total loss of strength in the affected area.

Symptoms: How do I know if I have a Sprain or Strain?

Strains or sprains usually come with a number of symptoms, including pain, swelling, decreased range of motion, weakness, and bruising in the affected area. If you have these symptoms, you may have experienced a sprain or strain. These symptoms can also accompany other conditions, so it is important to be evaluated by a medical provider like a physical therapist. 

  • Pain
  • Swelling
  • Decreased range of motion
  • Weakness
  • bruising

How Do Physical Therapists Treat Sprains or Strains?

Physical therapy is one of the best and most common treatments for strains and sprains. With the exception of rare, grade 3 strains or sprains that require surgery, physical therapy is a necessary complement to other nonsurgical remedies such as the RICE method and NSAIDs for swelling and pain. Your physical therapist will give you a number of exercises to help alleviate pain, recover range of motion, and build up strength in the affected area.

Physical Therapy Treatments for Sprains and Strains

Physical therapy treatment for sprains and strains slightly differs. Treatment for a sprain is focused on strengthening and stretching the injured joint to promote joint function, while treatment for a strain will focus on allowing the muscle to heal while simultaneously keeping a base level of strength and flexibility (thereby avoiding too much muscle wasting or atrophy).

Physical therapy for sprains may include:
  • Strength training in the muscles surrounding the affected joint
  • Flexibility training for the muscles surrounding the affected joint
  • Hot and cold therapy for pain and swelling
  • Range of motion/mobility exercises to keep the joint functional
Physical therapy for strains may include:
  • Strength training in and around the affected area that does not cause setbacks to the affected muscle(s)
  • Manual therapy
  • Lymphatic massage
  • Dry Needling
  • Therapeutic Cupping
  • Flexibility training in and around the affected area
  • Hot and cold therapy for pain and swelling

Physical Therapist Evaluation of a Strain or Sprain

Your Physical Therapist will evaluate you by asking about a history of the injury. Questions may include:

  • How did the injury occur?
  • Did you hear or feel a popping or tearing sound?
  • What movements are causing you pain or difficulty?
  • What daily activities or sports would you like to return to after rehab?

Following these history questions, your physical therapist will perform a physical examination of the sprain or strain.

During a physical examination for a sprain, your PT may:
  • Palpate the area to assess your level of pain and to understand if surrounding structures are injured in addition to the ligament
  • Assess your strength
  • Assess your swelling
  • Assess your range of motion
During a physical examination for a strain, your PT may:
  • Assess swelling, pain and/or bruising
  • Look for divots in the muscle, which may indicate torn fibers
  • Test passive flexibility of the affected muscle
  • Assess strength of the affected muscle

The collection of your injury history and assessing your physical condition will help your physical therapist understand your injury better and recommend the appropriate course of treatment.

Preventing a Sprain or Strain Injury

Preventing a strain or a sprain is not always possible, but doing the following may reduce your risks of suffering these injuries:

  • Properly warm up and stretch prior to sports or exercise
  • Wear the correct footwear for your sport or activity
  • Be sure to exercise regularly to maintain strength and flexibility
  • Maintain a healthy body weight
  • Perform your physical therapy exercises consistently to gain balance, strength, flexibility, and proper mechanics

PT Exercises for Sprain or Strains

While you may not be able to prevent injuries and some generic health conditions to your knee, there are specific exercises that help strengthen the knee area. The right exercises can be preventative, while physical therapy and post-injury or illness exercises can help you regain movement, strength, and mobility in that part of your body. Your physical therapist will help you get started with appropriate exercises for your knee condition, showing your proper form and technique, and working out a safe number of repetitions per day.

When to see a Physical Therapist for Your Sprain or Strain

A sprain or strain can be an annoying and sometimes very painful setback. You may want to start right away with physical therapy or require physical therapy after orthopedic treatment for a tendon or ligament injury. At Evolution Physical Therapy, our skilled physical therapists are here to effectively treat your sprain or strain injury. With convenient locations in California, Colorado, Connecticut, and Long Island, our specialist PT providers offer a range of physical therapy services and help to provide you with the treatment, education, and additional support you need on your road to recovery. Contact us today to set up an appointment at a location near you, or fill out our Request an Appointment form.  Let us help you on the road to recovery!