How To Tell The Difference Between Muscle Spasm, Sprains, and Strains

January 14, 2013 by Dr. Ihsan O. Erhuy

With the NFL continuing into the playoffs, many of us are sitting by watching the injury reports to see which of our favorite players may or may not be participating in this week’s games. Even what many consider a minor injury such as a spasm, sprain, or strain can keep a player from performing to the best of their abilities, or even being able to participate at all.  Sprains and strains are two of the most common types of soft tissue injuries.

To provide a better understanding of how these injuries can affect the body, let’s have a quick look at the body’s musculoskeletal system. The skeletal system is made up by the bones in your body, which form your skeleton.  The skeletal system provides for your body’s shape and also protects your vital organs such as the heart, lungs, and brain. The muscles that move your body are attached to the bone with tendons. The contraction of the muscle provides the ability for you to move your bones at the joints. The joints are held together with the connections of the muscles and ligaments. The ligaments are made up of a fibrous tissue which attaches a bone to another bone.

Spasms, sprains, and strains have very similar symptoms such as pain, swelling, and decreased range of motion, and they all involve soft tissue, but they are each a very different type of injury.

Spasm – A spasm is an involuntary contraction of muscle. This can occur suddenly, due to trauma, and can eventually lead to a chronic spasm, which will shorten the muscle over time. A muscle which has shortened overtime has decreased range of motion, and an increased risk for re-injury.

Sprain – A sprain happens when a ligament is stretched beyond its normal length, which causes a stretching, weakening, or possible tearing of the ligament.  Sprains can occur at any joint in the body, as they all have a ligamentous component, and  the most common joint sprained is the ankle.

Strain – A sprain is an overstretched ligament, where a strain is an overstretched muscle or tendon. This is most commonly referred to as a ‘pulled’ muscle or tendon.

Causes and Symptoms of Muscle Spasm’s Sprians and Strains

The symptoms for these three injuries are relatively similar, but have some distinctions:

Spasm- A muscle spasm can occur from an acute injury or prolonged contraction due to chronic muscle imbalance. What we see mostly in sports is a short painful muscle contraction due to overuse.  The symptoms of the muscle spasm may feel different depending on which muscle in the body is affected. For example, a spasm in the cervical musculature may be interpreted as a headache, and a spasm in the pectorals or chest muscle can be interpreted as a tightness or deep chest pain.  The most common symptoms of a skeletal muscle spasm are pain, tightness, and decreased range of motion, and many muscle spasms can be palpated (felt) through light touch. The musculature affected by the spasm will often feel like a lump or ball in the muscle, will often be tender to the touch, and may produce radiating pains, similar to what you experience with a trigger point.

Strain- A strain is generally caused by an acute injury to the muscle due to overuse or a trauma. The strains can vary from minor, which will not keep you out of much physical activity, to a tear, which can keep you out for usually around 6 weeks. Most common symptoms of a muscle strain are pain and swelling. You could also experience bruising to the area of injury, pain while resting, or pain while moving the injured muscle.

Sprain- A sprain is almost always caused from an acute injury. The most common sprain is a lateral ankle sprain, also referred to as rolling the ankle. Sprains can range from a minor stretch or inflammation of the ligament to a full blown tear. A complete tear through the ligament will cause major instability and will require surgery. The ankle sprains we most commonly see in football come from lineman rolling over on another player’s foot, or from a running back being tackled. The most common sprain in a quarterback or receiver is an AC joint sprain. This can happen while throwing, or falling to the ground – jarring the shoulder from a tackle.  Depending on the severity and location of the sprain, the treatment can last from two weeks to more than six. For more on the specifics of ankle, shoulder and knee sprains, check out our previous articles on ( The most common symptoms of a sprain are localized pain, decreased range of motion, inability to bear weight on injured joint, and instability of joint. If a sprain is not properly cared for, you run the risk of chronic sprains to that joint, along with future pain and lost motion due to the buildup of scar tissue.

Treatments of Muscle Spasm’s, Sprains and Strains

The treatments for all these injuries in the acute phase are very similar.  The key at the beginning of treatment is to reduce inflammation, which will increase range of motion and decrease pain. If you injure yourself in a sporting event or simply just at home working around the house, your first step should be to get ice on the area right away. The ice will help control pain and decrease swelling. The next step should be to see your doctor as soon as possible and get a proper diagnosis, which will determine your treatment plan. Once the appropriate diagnosis has been made, your doctor should give you recommendations as to when you can appropriately return to activity and how long treatment should last.

In addition to ice, another therapy we use at Mountain View Pain Center to reduce inflammation is to use an electric current called interferential. This electric current will push inflammation out of the joint and reduce pain. In addition to the electric currents we also use kinesio tape. Kinesio tape  can be worn for three days, including in the shower, so while you are in between treatments,  you have joint support, without reduction of range of motion- in which is often the case when normal athletic tape is used.

Once the inflammation and edema has been reduced, your doctor will usually begin rehabilitation or physical therapy for strengthening, and to reduce your chances for re-injury. In the case of a sprain vs. a spasm, the treatment should vary in the rehab stage.  A sprained area should not be stretched. Stretching will lengthen the already stretched and lengthened area, which just makes the injury worse. However, a spasm should be stretched, as the muscle is in constant contraction. Stretching will help lengthen the muscle and break the spasm. A strain and a sprain should have therapy exercises, which will strengthen the muscle and joint to resolve any muscle imbalance and prevent the reoccurrence of future injuries.

After the initial pain and inflammation phase it is important to continue with rehab or therapy to decrease the buildup of scar tissue in the affected muscles, ligaments, or joints. If the injury is left to heal on its own, then the body will lay down collagen or scar tissue to prevent from further injury. The problem with scar tissue is that it will reduce the range of motion of the muscle or joint, which can lead to further injury, or increase chances of early degeneration. At Mountain View Pain Center, we remove the scar tissue with muscle release techniques, as well as ultrasound.

A prompt examination will help your doctor provide the best care for your injury. How your doctor will reaches a diagnosis is heavily dependent on the history you provide, so make sure to explain how the injury occurred, in as much detail is possible, whether you feel it is pertinent or not.

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