These terms are often used interchangeably, but refers to damage or overstretch injury to either the muscle/tendon or ligament. Although very common in Sport Injuries, the condition also occurs in Motor Vehicle Accidents and slip and fall cases.

Sprain = Tearing of Ligament (Bone to Bone attachment)

Strain = Tearing of Muscle Fibers and/or Tendon


To understand the healing process, it’s important to understand the whole picture behind the injury. The first thing the body will do is Bleed. When the ligament ruptures, its blood vessels are also damaged. Platelets in the blood become activated when they suddenly come into contact with proteins not normally found in the bloodstream. They release the growth factors, which can trigger a number of the surrounding cells. Some of which are endothelial cells that can form new blood vessels and mesenchymal stem cells that can start forming a new ground substance with collagen. At first, the new collagen is sparse and of Lower quality (type lll collagen). This new material looks like a watery gel; a pink colored granulation tissue, which is also seen after some time in open skin wounds and called proud flesh. The collagen though is haphazardly organized, but the new tissue is plentiful. It becomes a large nodule (tendon callus) that completely encloses the old injury site.

For the new tissue to eventually gain more stretch-like properties, the collagen needs to achieve a higher quality and, above all, be organized in neat bundles aligned in the direction of strain. If the muscle pulls the damaged tendon and then releases it, we have a deformation cycle that the cells are able to detect. They also then receive the information they require regarding orientation. This is why the elasticity of the early callus is important; the tissue must be able to be pulled out and then return to its original shape in order to receive information about orientation. Hence the need for early Physical Therapy intervention!


Although sprains and strains can happen throughout the body, this injury in the shoulder can lead to other ailments such as shoulder impingement syndrome and rotator cuff injuries if left untreated. It will always lead to early arthritis and degenerative changes if not effectively treated and maintained for years after the initial injury.


The treatment process is usually described as having Three phases. The first being inflammation control. This can be treated in many ways at the office and is tailored specifically to what your body is best responding to. Rest and ice are highly recommended as home therapies to avoid re-injury. The second phase involves careful monitoring of progress as different therapies are introduced. Eventually, the tendon and ligaments are strong enough to withstand physical exertion, which helps in the complete recovery and the damaged tissue. In order to completely regain range of motion and eliminate scar tissue, Graston Therapy will be utilized to promote an elongation of muscle fibers. This therapy might not feel the greatest at first because of how inflamed the muscle might still be, but it crucial to avoid re-injury in the future.