You’re out on a run, power walk or hike—then suddenly, your foot rolls on uneven ground. Now it’s swollen and throbbing, and you’re left wondering: Is this a sprain or a strain?
Both are common soft tissue injuries, but they affect different parts of your body. Figuring out whether you’ve got a sprain or a strain can make a big difference in how you treat it—and how quickly you get back on your feet.
What Is a Sprain?
A sprain happens when a ligament— the tough, stretchy tissue that links bones together at a joint—gets stretched or torn. Sprains often occur in the ankle, wrist or knee after a sudden twist or impact—like landing awkwardly after a jump or tripping during a workout.
“Pain can range from some discomfort to more severe pain that lasts for several days,” says J. R. Barley, D.O., a Primary Care Sports Medicine Physician at Riverside. “Normally, sprains heal on their own.”
Common sprained ankle symptoms include:
- Sudden pain at the site of injury
- Bruising and swelling
- Instability or trouble putting weight on the joint
- Decreased range of motion
Understanding the Grades of an Ankle Sprain
Not all sprains are the same—ankle sprains are typically classified into three grades based on the severity of the ligament damage. Knowing the grade of your sprain helps guide treatment and recovery expectations.
Grade 1 (Mild)
- Slight stretching or microscopic tearing of the ankle ligaments
- Mild tenderness and swelling
- Little to no joint instability
- Most people can walk with minimal discomfort
Treatment: Follow the RICE approach—rest, ice, compression, and elevation—while gradually reintroducing movement and using support if needed.
Grade 2 (Moderate)
- Partial tearing of one or more ligaments
- Noticeable swelling, bruising, and joint stiffness
- Some difficulty bearing weight
- A feeling of looseness in the ankle may be present
Treatment: May require a brace or walking boot, physical therapy, and a longer healing time than Grade 1.
Grade 3 (Severe)
- Complete tear of a ligament
- Significant swelling, bruising and instability
- Unable to bear weight on the ankle
- A popping sound or sensation may have occurred at the time of injury
Treatment: Often includes immobilization, physical therapy, and in some cases, surgical repair. Healing time can vary and may range from a few weeks to several months based on the individual and the severity of the injury.
For mild sprains, home care using the RICE method is usually effective during the first 24–48 hours:
- Rest: Take a break from movements or activities that cause pain or make the swelling worse.
- Ice: Place an ice pack wrapped in a towel on the injury to reduce swelling—aim for 20 minutes at a time, 3-4 times per day.
- Compression: Use an elastic bandage to reduce swelling—but not so tight that it affects circulation.
- Elevation: Keep the injured area above heart level to reduce swelling, even while you sleep.
You may also take over-the-counter medications like ibuprofen for pain relief and inflammation.
What Is a Strain?
A strain occurs when muscles or the tendons (which connect muscle to bone) are overstretched or torn. Strains often affect the back, legs, or arms and may be acute (sudden) or chronic (due to repetitive motion or overuse).
Strain symptoms may include:
- Pain or tenderness in the muscle
- Muscle spasms
- Swelling or bruising
- Limited movement or stiffness
Common causes of muscle strain include improper lifting, inadequate warm-up, or overtraining without enough rest. As with sprains, you can treat most strains at home with RICE, followed by gentle movement as the pain subsides.
When to See a Sports Medicine Provider
“With sprains and strains, if pain doesn’t get better on its own in a few days, be sure to see your care provider,” says Dr. Barley. “You may need an X-ray to rule out a break. A severe tear may require surgery. You also may need crutches to stay off an injury.”
If you experience any of the following, it’s time to seek care:
- Persistent or worsening pain and swelling
- Unable to walk, lift or apply pressure to or with the injured area
- Numbness, tingling or poor circulation
- Feeling or hearing a “pop” as the injury happens
In more serious cases, your provider may order imaging (like X-rays or MRI) to check for fractures, torn ligaments, or tendon injuries. Severe strains or sprains may require physical therapy, a brace or even orthopedic surgery.
Supporting Your Recovery
As pain and swelling decrease, your health care provider may recommend rehabilitative exercises to restore strength and flexibility. This is especially important for athletes or active individuals looking to return to play.
Your care plan may include:
- Guided physical therapy
- At-home stretches and strengthening
- Gradual return to activity
- Injury prevention strategies
Don’t Play the Guessing Game—Get the Right Diagnosis
Sometimes, it’s hard to tell whether you have a sprain, strain or something more serious. If you’re unsure, or if the injury doesn’t improve with self-care, call the Riverside Sports Medicine hotline at 757-534-6767, 7am-10pm 7 days a week for an appointment. Or visit urgent care or your primary care provider. Acting early can speed recovery and prevent long-term damage.
For expert care, Riverside’s sports medicine specialists can help you heal and get back to the activities you love—safely and confidently.
