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Muscle Strain or Ligament Sprain!
by James Wilson BSc (Hons) Ost Med. DO - find out more about James.
The base level is that both of the above injuries can lead to significant pain and both have the potential to cause severe limitation of physical activity. Understanding a little about the mechanism of these injuries and the difference between the two could lead you into applying or receiving the correct treatment sooner and therefore hopefully reducing the time you are out of action because of it.
So let’s start at the beginning- what’s the difference?
Ligaments attach bone to bone. Muscles do not attach to bone instead they are joined to the bone via a Tendon.
Ligaments support joints. Muscles move joints.
A muscle is a structure formed by many bundles of specialised fibres arranged in such a way that when told to do so by their supplying nerve they may contract. This contraction (shortening in length) is unique to muscle and is what causes movement at a joint, such as bending your arm. The contracting muscle is only able to move a joint because there are tendons at either end attaching into the bone.
A ligament is a thick band of connective tissue which has very little stretch property and no contractile property; a ligament is all about strength. Ligaments limit or completely prevent certain joint movements.
How are they injured?
Potentially any muscle or ligament in the body may be injured if sufficient load is placed upon it. Both ligaments and muscles are succeptible to injury following Repetitive Strain, indeed this mechanism of injury could be considered a cause of almost all soft-tissue injuries. However, the way in which you have moved or the type of activity you were undertaking (beforehand or at the time) may give a better idea as to which tissue you have injured.
Muscle.
- Contraction sharply against excessive load, eg. picking up an object that is simply too heavy.
- Stretch too rapidly, eg. reaching to catch a falling object or as you land from jumping down.
- Overstretch, eg. reaching down and across to pick up the pen you just dropped on the floor.
Ligament.
- Excessive or Prolonged load, eg. prolonged bending during DIY or when mending or servicing machinery.
- Loading a Ligament at speed where by the surrounding muscles do not have time to react to protect the area, eg. Whiplash Type Injuries.
How does each Tissue react to injury?
Our bodies’ natural reaction to injury is to create pain (to reduce or stop us from continuing that activity) and to create inflammation to cause healing.
As a guide because Muscle is much more vascular than Ligament (ie it has a better blood supply) it will tend to react to injury more quickly and likewise will tend to heal more quickly. A strained muscle then will frequently be sore immediately it is injured because it will bleed. Over the following few hours the muscle will stiffen and will gradually become less painful, to the point it will only be painful when the patient attempts to contract the muscle. The bleeding may accumulate under the skin (seen as bruising) or within the muscle itself (haematoma.)
With a Ligamentous injury although the patient is often aware they have “done something” during activity, the pain is frequently not present until several hours afterwards, indeed with many it is not until they try to get up the next morning that they will realise the stiffness and pain. Once inflamed, ligament injuries will often ache continuously.
It is worth noting at this point that it is not uncommon to damage both Muscle and Ligament at the same time, thus creating a mixed pattern of the above.
Common Sites of Injury :
Muscle: Spinal, front of the thigh (quadriceps,) calf (gastrocnemius,) upper arm ( biceps,) front of shoulder ( deltoid.)
Ligament: Ankle (often outer,) Knee (often inside) , Wrist, Sacroiliac ( one side of the lower back,) Spinal (for example with Whiplash Type Injuries.)
Treatment.
With all injuries never forget R.I.C.E.( Rest Ice Compression Elevation) as applied early it is widely believed to reduce the severity and duration of the injury.
For most injuries the initial rest period should not exceed 48hours, and ideally within this time some short periods of gentle movement and careful activity will be beneficial to healing.
Ideally any moderate to severe injuries should be investigated by a Health Professional at this stage.
Generally as pain decreases, mobility should improve and therefore the amount of activity that can be performed relatively comfortably should increase. Gentle stretching of the area performed frequently will help to disperse inflammation and aid in restoration of mobility.
There is a multitude of treatment modalities available that can help to manage symptoms and some will help to reduce the duration of the complaint by promoting healing and improved function. Hands on therapies (such as that of your local Osteopath) will be able to help you by diagnosing the problem, physically treating it, providing appropriate aids for comfort and healing (such as supports, taping, TENS machines, supplements etc,) and advise on stretching, strengthening and injury prevention.
So what about Prevention?
To be truly preventative the list of areas we could look into seems almost endless and even then there is no cast iron guarantee that anybody can give you that this injury or a different one will not happen in the future. I think the base level is to look at the following few ideas of areas that could be improved and see which really do apply to you – and remember that even changing a few seemingly minor things over a long period will almost certainly make a positive difference.
- Improvement of strength, flexibility, co-ordination and fitness.
- Attention to Diet and Nutrition.
- Adjustment of Training Schedules or changes to Daily / Work Routines.
- Thinking about Posture.
- Balancing work- leisure-family commitments.
..and a final thought!
If we are to function well on all levels surely everything in life is about balance rather than doing a select few things perfectly?!
Further information is available on our website www.molfordhousesurgery.co.uk. Alternatively I am always pleased to answer any questions you may have. You can call me at Molford House Surgery on 01769 574830.
The information provided on these pages is intended as a general guide only and in no way constitutes a complete service for diagnosis or treatment. You must not rely solely on this information and it is therefore your responsibility to seek a professional opinion should you be concerned about your particular case.
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