What is the difference between a muscle strain and a ligament sprain?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: March 7, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

The primary distinction between a muscle strain and a ligament sprain lies in the type of tissue injured, with strains affecting muscles or tendons and sprains affecting ligaments. When considering the diagnosis and treatment of these injuries, it is crucial to understand that strains occur due to the stretching or tearing of muscles or tendons, often resulting from overuse, improper use, or overstretching, and commonly affect areas such as the lower back, hamstring, and neck muscles [ 1 ]. On the other hand, sprains involve the stretching or tearing of ligaments, which connect bones to other bones, typically due to a sudden twist or impact that forces a joint out of position, with the ankle, knee, and wrist being frequently affected [ 1 ]. Key differences in symptoms include pain, swelling, muscle spasms, and limited mobility for strains, and pain, swelling, bruising, and instability for sprains. Treatment for both often involves the RICE principle (rest, ice, compression, and elevation), with more severe cases potentially requiring physical therapy, bracing, or surgery, and healing times varying based on severity, from days to weeks for mild cases to months for severe cases. In the context of ankle sprains, for instance, the use of tape or a brace in combination with an exercise program is beneficial for patients with acute lateral ankle ligament rupture, as evidenced by recent clinical guidelines [ 1 ]. Understanding these distinctions is vital for appropriate diagnosis and treatment to minimize morbidity, mortality, and improve quality of life. Some of the key factors to consider in the management of these injuries include the severity of the injury, the patient's overall health status, and the potential for complications if left untreated or improperly managed. By prioritizing evidence-based practices, such as those outlined in recent clinical guidelines [ 1 ], healthcare providers can optimize outcomes for patients with muscle strains and ligament sprains.

From the Research

Definition and Classification

  • A muscle strain is defined as a stretching or tearing of a musculotendinous unit 2
  • A strain can be classified as first, second, or third degree, depending on the severity of the injury 2
  • A first-degree strain consists of minimal stretching of the musculotendinous unit without permanent injury, while a second-degree strain indicates partial tearing, and a third-degree strain indicates complete disruption of a portion of this unit 2

Comparison with Ligament Sprain

  • A ligament sprain, on the other hand, refers to an injury to a ligament, which is a fibrous connective tissue that connects bones to other bones 3, 4
  • Ligament sprains are often caused by sudden twisting or bending movements, and can range from mild to severe 3, 4
  • While muscle strains typically occur in muscles that cross two joints and contain a high percentage of fast-twitch fibers, ligament sprains often occur in areas such as the ankle, where ligaments are more prone to injury 5, 4

Symptoms and Treatment

  • Both muscle strains and ligament sprains can cause pain, swelling, and limited mobility, but the treatment approaches may differ 2, 5, 3, 4
  • Initial treatment for muscle strains typically consists of rest, ice, compression, and nonsteroidal anti-inflammatory drug therapy, followed by physical therapy to restore flexibility and strength 2, 5
  • Treatment for ligament sprains may involve immobilization, protected mobilization, or primary surgical repair, depending on the severity of the injury 3, 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Current concepts in the diagnosis and treatment of musculotendinous injuries.

Medicine and science in sports and exercise, 1984

Research

The sprained ankle: current therapy.

Foot & ankle, 1985

Research

Ankle sprains and other soft tissue injuries.

Current opinion in rheumatology, 1999

Research

Muscle strain injury: diagnosis and treatment.

The Journal of the American Academy of Orthopaedic Surgeons, 1999

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.