Soft tissue injuries: muscle strain and ligament sprain

By Virginia Nsitem

Have you ever been diagnosed with a whiplash sprain or strain injury or back muscle tear? Have you ever twisted your ankle or knee joint? This article will explain the differences between a strain and a sprain.

Muscle Strain

A muscle is a soft tissue that functions to produce power and movement. Our bodies have well over 650 muscles! A muscle strain is an injury to the muscle. This type of injury typically occurs from over-stretching, overloading, or over-using the muscle.  Muscle strains can occur as a result of a motor vehicle accident, a slip and fall injury, a sport injury, a heavy work task, a quick movement, or even a normal daily task. When a muscle is strained or injured, tiny tears develop in the muscle. The tiny tears can lead to pain and inflammation. The tiny tears can also lead to bleeding which may cause bruising on the skin.

Some commonly strained muscles include:

  • Back muscles
  • Neck muscles
  • Shoulder muscles
  • Hamstring muscles
  • Quadriceps muscles
  • Chest (pectoralis) and rib muscles
  • Abdominal muscles

Symptoms of muscles strain include:

  • Pain at the injured area
  • Pain with movement of the muscle
  • Weakness of the injured muscle
  • Decreased movement of the muscle and related body parts
  • Swelling and possibly bruising

A simple way to classify muscle strain injuries is to use a system of 3 categories. A Grade I muscle strain is an injury that causes minor pain and minor loss of movement and function. Typically, these injuries heal quickly (1-2 weeks). A Grade II muscle strain is a more serious injury and involves some tearing of the muscle tissue. Grade II muscle strains result in moderate pain and loss of movement and function. These injuries require more time to heal (several weeks). A Grade III muscle strain is the most serious of the muscle injuries and involve complete tearing of the muscle tissue. Often, intense rehabilitation and even surgery is required to recover from this type of muscle injury.

Ligament Sprain

Ligaments are tissues that join bones to other bones. They are very fibrous type tissues. An injury to a ligament is called a sprain. This type of injury usually occurs from over-stretching, falling, performing repetitive tasks, or making an awkward or excessive twisting movement. A ligament sprain can cause the connection between the bones that it joins to become loose or unstable. One of the most common ligament sprains is the ankle sprain, which usually occurs from twisting the ankle. Sprains can occur at the elbow, wrist, finger, knee, spine, and other joints in the body.

Typical symptoms of a ligament sprain include:

  • Swelling
  • Inflammation
  • Pain
  • Difficulty moving the affected joint
  • Bruising
  • Injury felt or heard as a “pop”

Similar to muscle strains, ligaments sprain injuries can also be classified in three simple groups. A Grade I sprain is a mild tear that causes only minor symptoms, and you are able to continue with most of your activities with minimal discomfort. A Grade II sprain is a moderate tear of the ligaments that can lead to some instability of the joint. A Grade III sprain is when the ligaments completely tear or rupture, and this type of injury causes a great degree of instability to the joint.


Treatments for soft tissue injuries

Before treatment and rehabilitation can begin, it is important to get an accurate diagnosis. Chiropractors specialize in diagnosing, treating, and rehabilitating injuries of the muscles, joints and nerves.  Soft tissue injuries are typically diagnosed based on your symptoms, the examination, and on occasion, the findings on diagnostic ultrasound, CT scans, or MRI studies. Serious sprain or strain injuries may require a referral to a specialist to determine if surgery is needed. It is also important to rule out more serious conditions that may be causing your pain and symptoms.

Your chiropractor may advise you to follow the PRICE protocol which is Protection (protect the joint from further injury using special braces or splints), Rest (rest the injured muscles, ligaments, and joints), Ice (apply ice compresses to reduce the pain and inflammation), Compression (use bandages or special joint wraps to provide support to the joint), and Elevation (elevate the affected region to decrease swelling).

Rehabilitation may also include:

  1. The use of heat or cold to ease the joint pain.
  2. Therapeutic Laser therapy to reduce inflammation and pain.
  3. Physical therapies to improve the function of the muscles and ligaments, and restore proper movement to the joints.
  4. Gentle Exercises including stretching and strengthening exercises are important physical activities that help improve the pain and symptoms, and also improve overall fitness.
  5. Massage therapy and Acupuncture are helpful for providing a pain-relieving effect throughout the body, an anti-inflammatory effect, and a general sense of improved well-being.
  6. Gradual return to daily activities and sports. It is important to follow the guidance of your chiropractor to avoid returning too early and risking re-injury.


Stop the Pain … Before the Pain Stops You!

(Dr. Virginia Nsitem is a chiropractor specializing in laser therapy for muscle, joint, and nerve injuries, and is a Fellow of the Royal College of Chiropractic Sports Sciences in Canada. She may be reached at (905) 275-4993, or by email at )