Strains and Sprains

By Adelaide Women's Physio | January 31, 2017


Tendons are bands of fibrous tissue that attach muscle to bones.

A strain is a soft tissue injury to muscle fibres or tendons. This commonly occurs when the fibrous tissue is stressed by being lengthened too far or shortened too quickly.

Bones are held together by fibrous bands called ligaments. A sprain is a soft tissue injury of the ligament. This occurs when the ligament is overstretched.


  • Pain
  • Swelling
  • Bruising
  • Muscle spasm/tightness
  • Stiffness
  • Loss of function


There are recognised stages of healing of injured soft tissue as a result of a sprain or strain.

The initial, acute phase of healing is generally in the first 48 to 72 hours after injury. This is the inflammatory stage and requires the R.I.C.E. approach, to prevent intra-muscular bleeding –

REST – to prevent further damage.

ICE – 15 to 30 minutes every 2 to 4 hours.

COMPRESSION – of the injured area to minimise swelling and provide support.

ELEVATION – of the limb to maintain reduction of swelling.

Seeking medical advice in this early acute phase may be warranted.

The second stage of the soft tissue healing is the sub-acute repair or granulation phase. This has a time frame of 3 to 6 weeks, where there is a focus on the repair of cells within the soft tissue. This includes the growth of new capillary beds for blood supply.

A third and fourth stage of healing occurs in a 3 week to 9-12 month time frame. The third phase is concerned with the collagen bonding of the soft tissue fibres. Cross-linking of the collagen fibre needs to occur in accordance with the movement forces placed on the injured tissue. The fourth stage is where the scar tissue matures and strengthens with appropriate loading and mobilisation forces.


Graded mobilisation of the strained or sprained tissue is now critical with appropriate exercise and selected movement directions. The skills of a manual physiotherapist can now be important in guiding a patient in their rehabilitation program. Producing mobile scar tissue that will handle the daily forces the tissue is subject to is vital.

Many people think once the pain and swelling has gone they can return to full activity either at home, at work, in the gym or in a sporting event.

Repeated micro-trauma can then easily occur because muscle strength, core activation, joint stabilisation and balance reactions have not been given the rehabilitation focus required for full recovery of the scar tissue to occur.