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Whether you're an athlete, a weekend warrior or simply someone who tripped on the stairs, soft tissue injuries are common. You might hear doctors use terms like “sprain,” “strain,” and “tear” to describe your injury. These terms are often used interchangeably by the general public, but they actually refer to very different injuries.
By Arete Orthopaedic Centre
Medically Reviewed by Dr Wang Lushun
Sprain: An Injury to the Ligaments
A sprain refers to the overstretching or tearing of ligaments. Ligaments are strong, fibrous tissues that connect bones to each other and provide joint stability. When a joint is forced beyond its normal range (e.g. rolling an ankle inward or twisting a knee), the ligament can stretch or rupture.
Sprains are common in joints that undergo a lot of motion, especially the ankle, knee, and wrist. They often happen during sports, falls, or sudden twists. A mild sprain might simply stretch the ligament fibers without causing lasting damage, while a severe sprain can tear the ligament entirely.
Symptoms of a sprain usually include pain around the joint, swelling, bruising, and reduced ability to move the joint. In moderate to severe cases, the joint may feel unstable or give way when weight is applied.
Sprains are usually classified into three grades:
Grade I (Mild): The ligament is overstretched but not torn. Mild pain and swelling may occur.
Grade II (Moderate): There is partial tearing of the ligament with noticeable instability and moderate pain and swelling.
Grade III (Severe): There is a complete tear of the ligament, causing significant pain, swelling, and joint instability.
Strain: An Injury to the Muscles or Tendons
A strain involves the overstretching or tearing of muscles or tendons. Tendons connect muscles to bones, allowing movement of the joint. Unlike sprains, which affect ligaments and joints, strains affect the muscles responsible for movement.
Strains usually occur due to overuse, improper technique, sudden acceleration or deceleration, or lifting heavy objects. Common areas for muscle strains include the hamstrings, lower back, shoulders, and neck.
Symptoms of a strain include muscle pain, swelling, cramping, weakness, or muscle spasms. The area may feel tender to the touch, and moving the muscle may cause discomfort.
Just like sprains, strains can be graded based on severity:
Grade I (Mild): This refers to mild stretching with minimal muscle fiber damage. Pain is present but function is largely preserved.
Grade II (Moderate): This refers to a partial tear of muscle fibers, leading to more significant pain, reduced strength, and swelling.
Grade III (Severe): This refers to the complete rupture of the muscle or tendon, resulting in severe pain, loss of function and possibly a visible deformity.
Tear: A More Severe Form of Injury
A tear refers to a rupture of a ligament, tendon, or muscle. While strains and sprains can involve tears at varying levels of severity, the term “tear” is usually used to describe more serious injuries.
Tears may occur from sudden and forceful trauma, such as a fall, tackle or explosive movement during sport. They can also result from repetitive overuse or degeneration over time, particularly in tendons and muscles.
There are three main types of tears:
Ligament Tears: This includes a torn ACL in the knee, often resulting from pivoting or landing awkwardly
Tendon Tears: This includes a rotator cuff tear in the shoulder or an Achilles tendon rupture, often from overuse or sudden force
Muscle Tears: This includes torn quadriceps or hamstring, typically from sprinting or heavy lifting.
Symptoms of a tear are usually immediate and severe. A person might feel or hear a “snap” or “pop” at the time of injury. This is followed by sharp pain, significant swelling, bruising, and an inability to use the affected limb properly. In the case of complete tears, there may be visible deformity or a depression where the tissue has ruptured.
Treatment for Sprains, Strains and Tears
Most mild sprains and strains can be managed conservatively using the R.I.C.E. protocol: Rest, Ice, Compression, and Elevation. Anti-inflammatory medications may help reduce pain and swelling.
Physiotherapy is often important for both sprains and strains. Rehabilitation focuses on restoring strength and flexibility, which helps prevent future injuries.
In contrast, moderate to severe tears often require more intensive intervention. A partial tear may still respond to rest and rehabilitation, but a complete tear usually needs surgical repair.
When to See an Orthopaedic Specialist
Please seek medical attention if you:
Cannot move or bear weight on the injured limb
Hear a pop at the time of injury
Notice joint instability or a visible deformity
Experience significant swelling or bruising
Have persistent pain that doesn’t improve after a few days
An orthopaedic specialist can accurately diagnose your condition, recommend the right treatment plan, and guide you through a safe recovery. Prompt and appropriate care can make all the difference in returning to your normal activities pain-free as quickly as possible.
Dr Wang Lushun is a Senior Consultant Orthopaedic Surgeon with over 18 years of experience. Formerly heading
the Hip and Knee Division at Ng Teng Fong Hospital, Dr Wang is skilled in sports surgery, complex hip and
knee replacements, and minimally invasive surgery, including advanced robotic surgery. Trained in the UK and
France, Dr Wang is dedicated to providing comprehensive and effective orthopaedic care to all his patients.
Trusted
Leadership on Orthopaedic Advisory Boards
Skilful
Double Fellowships at Centres of Excellence
Experienced
Senior Consultant with Over 18 Years of Experience
