Sprain, Strain, or Fracture: Which is It?

Musculoskeletal pain can occur for any number of reasons, however acute musculoskeletal pain is generally the result of an injury. Athletes are at an increased risk of musculoskeletal injuries as the U.S Department of Health and Human Services estimates that 8.6 million sports injuries occur annually. Sports injuries are not the only cause of acute musculoskeletal pain, however. Even something as simple as taking a misguided step can cause an injury result in acute pain. 

If you have developed acute musculoskeletal pain, you may be wondering if you have a sprain, strain, or fracture. While fractures are sometimes easier to identify from the other two types of injuries, sprains and strains are often confused with one another. Although all three injuries have similar treatments, knowing which injury you have can help you make sure that the proper steps are taken for it to heal thoroughly. While only your orthopedic specialist can accurately determine the type of injury present, here is a brief guide on these three types of common musculoskeletal injuries: 


When something is sprained, this means that the ligaments have been overstretched or torn. Ligaments are found within the joint and are responsible for holding bone together with other bones that make up the joint. The most common location for a sprain is the ankle joint, however sprains can also affect other joints such as the knee, wrists, and thumbs. Sprains can occur in these joints from walking on uneven surfaces, overextending the joint during a fall, pivoting the joint too far, or landing awkwardly after a jump. Although sprains produce similar symptoms to the other two types of injuries such as bruising, pain, and swelling, one key difference is that a “pop” sound is usually heard at the moment the injury occurred. Since sprains affect the joints, they also result in limited joint mobility. The majority of mild sprains can simply be treated using the RICE method, however severe sprains may require surgery or other treatments. 



When something is strained, this means that the muscles or tendons have been overstretched or torn. Tendons are responsible for connecting muscle to bone. In cases where a strain affects the muscle, it may be known as a pulled muscle. Strains commonly affect the lower back, hamstrings,  Achilles tendon, hands, and elbows, and are usually caused by quick starts, throwing, jumping, or gripping. Since strains affect the tendons and muscles, they can produce symptoms such as muscle spasm and weakness in addition to the traditional pain, bruising, and swelling. Like mild sprains, mild strains can usually be treated with the RICE method, however severe strains may require other types of treatment. 


Unlike sprains or strains, fractures do not affect the soft tissue and are characterized by a bone that has cracked or broke. Open fractures are easy to diagnose since the broken bone penetrates the skin and becomes visible. Closed fractures, on the other hand, can be harder to differentiate, especially if they are mild, because they cannot be seen without the use of x-rays. Fractures generally occur as a result of a sudden forceful impact, but there are some cases where they can occur after repeated stress to one area. Although fractures produce pain, swelling, and bruising, they also produce additional symptoms such as an inability to move or exert any weight on the area, a grating sensation, and an unusual bend or angle around the affected area. Mild to moderate fractures are usually treated by immobilizing the bone with plastic casts or braces, while more severe fractures may require immobilization through the surgical placement of screws, rods, or external fixators. 

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