Sprains and Strains

A sprain is caused by the stretching or tearing of a ligament, the tissue that connects cartilage and bone. Sprains vary by degree of injury from a first-degree sprain (a minimally stretched ligament) to a third degree sprain (a complete tear). Areas most vulnerable to sprains are the ankles, knees and wrists.

Signs of injury include:

  • Tenderness or pain
  • Bruising or inflammation
  • Swelling
  • Inability to move a limb or joint
  • Joint looseness or instability (in the worst cases)


Closely related is a strain, the stretching or tearing of muscle or tendons, the ligaments that connect muscles to bone. A strain can be caused by overstretching. Symptoms may include muscle spasms, pain and loss of strength. The most severe strains can lead to permanent damage and loss of function.

How is a sprain treated?

If the sprain is recent, a physical therapist may first treat it with ice and then heat. If the injury is to the lower body and affects gait or walking, crutches or a cane may be prescribed.

A therapist works with patients on exercises to build range of motion and promote stretching and strengthening. Other treatments include massage, ultrasound, bandaging or taping, and possibly a brace or another form of immobilization.

Physical therapists treat strains by first alleviating pain, and then working with the patient to heal the injury and prevent recurrence.

If the strain is recent, the first treatments may involve ice and possibly heat if the swelling has stopped. Then the therapist may massage the wounded area, or use ultrasound treatment to promote healing.

Often treatment includes stretching, both manual stretching by the therapist and self-stretching performed by the patient. In addition, the therapist teaches exercises to both quicken healing and prevent recurrence by building the muscles associated with the injury.