Strains and Sprains

Strain

stretching or tearing of the musculotendinous unit or muscle belly

may be partial or full tear

sprain

an injury to the ligamentous structures around a joint

often more bruising

First degree sprain/strain

“Mild”

injury to a few fibers without loss of tissue integrity

• no loss in stability

• no or limited loss of strength

• no or limited loss of movement/function

• minor swelling

Second degree strain/sprain

“Moderate”

partial tearing of tissues with a clear loss of function

• pain

• moderate functional impairment

• swelling and local hemorrhaging

• varying degrees of loss of stability or loss of strength

• abnormal motion are present

Third degree strain/sprain

“Severe”

complete loss of structural or biomechanical integrity

• pain

• significant functional impairment

• swelling

• diffuse hemorrhaging and abnormal motion

• often requires surgical repair or reconstruction

How could you differentiate between lumbar strain and sprain

sprain - instability

strain - often to errector spinae; tenderness to palpation, muscle spasm over involved muscle

most commonly strained quadricep and location of injury

distal musculotendinous junction of rectus femoris

most commonly strained hamstring and location of injury

proximal musculotendinous attachment of biceps femoris near ischial tuberosity, may occur concomitantly with an avulsion fracture

signs and symptoms of a hamstring strain

• pain in gluteal area; proximal tendon or mid belly

• point tenderness with palpation ± swelling

• pain with muscle contractions

signs and symptoms of a quadriceps strain

• pain and swelling with palpation at the injured site and with contraction

• Gait deviations

Signs and symptoms of a lumbar strain/sprain

• tenderness with palpation or muscle spasm over involved muscle

• diffuse pain felt over the area of the low back

  • may spread into buttocks

most commonly strained hip flexor/adductor

“groin pull”

• adductor longus - adductor

• iliopsoas - hip flexor

• adductor longus > iliospoas

signs and symptoms of a hip flexor strain vs adductor strain

Hip flexor: pain in groin area, medial and anterior thigh

Adductor: pain in groin area and medial thigh

Both:

• pain with muscle contractions and palpation; ± swelling

• Gait deviations

etiology of hip flexor/adductor strains

• indirect injury

• usually involves strong eccentric load placed on the muscle that exceeds its deformation capacity

• activities that involve sprinting, kicking, lunging, jumping

hip flexor/adductor strain definition

tissue deformation in response to stress of:

• iliopsoas, rectus femoris, sartorius

• adductors, gracilis, and pectineus muscles

occuring at the musculotendinous junction or muscle belly

hamstring strain etiology

• indirect injury

• usually involves strong eccentric load placed on a muscle that exceeds with deformation capacity

• activities that include sprinting, lunging, kicking, jumping