One of the most common questions I get is “what is an ankle sprain vs strain?” It’s common to confuse them, especially with how they are spelled. Plus, they’re two of the most common ankle injuries.
In a nutshell, a sprain means some form of damage to a ligament. Whereas a strain pertains to a muscle or tendon tear.
You’ll learn about each one below, as well as how to tell the difference between them. Here are the topics covered, click on them to easily navigate through the article:
How does a sprained ankle occur?
Most sprains occur when you unexpectedly and forcefully exceed the range of motion available in your ankle. This may happen from a misstep or a bad fall.
This in turn can damage your ligaments. These are tissues that restrict movement and keep the joint stabilized.
The level of damage can range from an overstretched ligament – i.e. mild sprains – to a complete tear.
Our ankle might arguably be the most commonly sprained joint in the body. Data shows that daily, there’s 1 ankle sprain per 10,000 people. (1)
Further reading: Ankle sprains – the complete guide.
How do ankle strains occur?
Ankle strains usually affect the calf muscle and can happen in two ways.
The first is when the muscle is stretched more than it’s capable of. This is often a result of a forceful movement from your foot.
The second is when the muscle is fatigued. In this state, it absorbs less energy compared to normal, reducing its tolerance to stretching. This ultimately makes it prone to strains. (2)
The type of strain will depend on how badly you pulled your muscle. As with sprains, the classification ranges from mild to severe.
How do you know if your ankle is sprained or strained?
These two common soft tissue injuries have identifiable symptoms, such as:
1) A distinct moment during your injury
For sprains, the distinct moment can be twisting your ankle forcefully and an audible pop in the area. The sound may not be present with a mild sprain, though.
For an ankle strain, the distinct moment can be a dull ache at the back of your calf muscles. But if it’s severe, you might also feel an audible pop on your heel, followed by a feeling of getting hit on your calf. (3)
If that happens, please head to the nearest hospital to get your ankle checked.
2) Location of pain, swelling, and bruising
A sprained ankle can be felt either on the outer, inner, and/or frontal side of your ankle. In contrast, the symptoms from a strained ankle will likely be felt right on your calf muscles.
3) Limited range of ankle motion
In ankle sprains, you’ll have difficulty moving your foot to the opposite side of the injury. For example, if you had an outer ankle sprain, it will be painful to point your foot inwards.
For an ankle strain, you’ll likely have the hardest time pointing your foot upwards.
4) Muscle spasms
Muscle spasms, or cramps, are when your muscles are constantly tightening or contracting involuntarily. (4)
This can also happen after a strain, right on your calf muscles. But it’s not as commonly seen in sprained ankles.
Treatment options for ankle sprains and strains
RICE therapy is a useful first-aid treatment for soft tissue injuries like sprains and strains. It’s an acronym for (5):
- Rest, to avoid unnecessary stress on your injured ligaments/muscles.
- Ice, to reduce inflammation and pain.
- Compression, to reduce swelling.
- Elevation, to limit bleeding and swelling.
This can help: How to apply ice the right way.
2) Pain medications
Nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids are two common pain medications that can help ease your symptoms.
3) Wrap your ankle or calf
This can promote healing by reducing symptoms and increasing stability. Now, there are three types of materials commonly used for ankle injuries (8):
- Elastic bandage – can provide some support and swelling reduction.
- Athletic tape – helpful in restricting excess motion.
- Kinesio tape – to enhance your ankle’s sense of balance to possibly avoid further injury.
Try this: How to wrap an ankle sprain?
4) Ankle exercises
Exercises, if done consistently, play a key role in building up your strength and durability. You just have to make sure your symptoms have settled to avoid mishaps and flare-ups.
Check this out: The 12 exercises you need to heal your sprain.
5) Physical therapy
There are different strategies that a physical therapist can use to help you recover:
- Provide medical advice on what you should and shouldn’t do while you are injured.
- Teach proper form and progression on therapeutic and strengthening exercises.
- Improve your healing potential with thermotherapy and skilled manual treatments.
- Detect and correct poor movement to prevent future sprain or strain.
- When you have tried and failed all nonsurgical options.
- Chronic strains of about 4 to 6 months with the presence of joint stiffness.
- A completely torn tendon or ligament.
- An ankle bone fracture.
Sprain vs. strain: what’s the difference?
A sprain describes ligament damage, while a strain is a muscle injury.
How do sprains happen?
Most sprains take place when you overextend or stress a ligament out of its normal capacity.
How do strains happen?
It can result from overstretching the muscle, or after it’s fatigued due to repetitive motions. (11)
Conclusion: Is sprain and strain the same thing?
Sprains and strains may almost be mistakenly pronounced in the same way. But they mean different things.
A sprain implies that you may have damaged your ligaments. In contrast, a strain may mean the injury occurred on your muscle or tendons.
A few home remedies or guidance from your doctor or physical therapist may help you recover quickly from any of them.
- Hubbard, Tricia J, and Erik A Wikstrom. “Ankle sprain: pathophysiology, predisposing factors, and management strategies.” Open access journal of sports medicine vol. 1 115-22. 16 Jul. 2010, DOI: 10.2147/oajsm.s9060
- Mair, S D et al. “The role of fatigue in susceptibility to acute muscle strain injury.” The American journal of sports medicine vol. 24,2 (1996): 137-43. DOI: 10.1177/036354659602400203
- Hsu D, Chang KV. Gastrocnemius Strain. [Updated 2021 Aug 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534766/
- Bordoni B, Sugumar K, Varacallo M. Muscle Cramps. [Updated 2022 Feb 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499895/
- van den Bekerom, Michel P J et al. “What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?.” Journal of athletic training vol. 47,4 (2012): 435-43. DOI: 10.4085/1062-6050-47.4.14
- Ghlichloo I, Gerriets V. Nonsteroidal Anti-inflammatory Drugs (NSAIDs) [Updated 2021 May 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547742/
- Cohen B, Ruth LJ, Preuss CV. Opioid Analgesics. [Updated 2021 Oct 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459161/
- Kaminski, Thomas W et al. “Prevention of Lateral Ankle Sprains.” Journal of athletic training vol. 54,6 (2019): 650-661. DOI: 10.4085/1062-6050-487-17
- Al-Mohrej, Omar A, and Nader S Al-Kenani. “Acute ankle sprain: conservative or surgical approach?.” EFORT open reviews vol. 1,2 34-44. 13 Mar. 2017, DOI: 10.1302/2058-5241.1.000010
- Bryan Dixon, J. “Gastrocnemius vs. soleus strain: how to differentiate and deal with calf muscle injuries.” Current reviews in musculoskeletal medicine vol. 2,2 (2009): 74-7. DOI: 10.1007/s12178-009-9045-8
- “Sports Injuries”. National Institute of Arthritis and Musculoskeletal and Skin Diseases. September 2021. https://www.niams.nih.gov/health-topics/sports-injuries