Strains vs Sprains (and the role of your brain in your recovery)

Muscle injuries are common, and two terms that often get confused are strains and sprains. While they may sound similar, they affect different parts of the body and require distinct approaches to recovery. Let's explore the differences between strains and sprains and the recovery process for each.

Strains occur when muscle fibers stretch or tear. This is usually due to overuse, improper lifting techniques, or sudden movements. It’s very common, for example, to strain a back muscle when gardening, when picking up heavy objects (or little people!) or over-exerting ourselves in sport (I recently strained my oblique muscles doing a new move on teh Pilates ‘chair’)….

Gardening can be a ‘fertile’ area for back strain….

Common symptoms of a muscle strain include pain, swelling, muscle weakness, and a limited range of motion. It feels like a ‘tweak’ each time you move in a certain direction.

On the other hand, sprains affect ligaments, which are the tough bands of tissue that connect bones to each other. Sprains typically happen when ligaments are stretched beyond their limits. This causes them to tear, partially or fully (this is referred to as a Sprain grade, usually 1-4). Joints most commonly affected include ankles, shoulders, wrists and thumbs. Symptoms of sprains include pain, swelling, bruising, and instability in the affected joint. When we sprain a ligament, we also lose some proprioception in that joint, which is why it’s important that muscles can take over this function whilst ligaments heal (a sprain can take between 2 weeks and 6 months to recover, dependant upon it’s grade). It’s also worth noting that some soft tissue damage takes time to heal because typically it has a lower blood supply; this is especially true of our extremeties such as the hands and feet.

The recovery process for strains and sprains involves similar principles, such as rest, ice, compression, and elevation (RICE). However, the specific treatment plan may vary depending on the severity and location of the injury.

When you strain a muscle, it's not just your body that feels the pain—it's also your brain working to interpret and respond to the signals sent by the injured tissue. Understanding how the brain processes pain after a muscle strain can provide valuable insights into managing and alleviating discomfort. Also, knowing the expected recovery time is key to managing your own expectations (Strain recovery can vary from 1-2 weeks for a minor strain, to 3-6 months for a complete muscle tear).

When a muscle is strained, microscopic damage occurs to the muscle fibers. This triggers a cascade of physiological responses. Specialized nerve endings called nociceptors detect this tissue damage and send electrical signals to the brain via the spinal cord. These signals travel along specific pathways, known as the spinothalamic tract, to reach the brain's somatosensory cortex, where they are processed and interpreted as pain.

The brain receives these signals and assesses various factors to determine the intensity and location of the pain. It also considers contextual information, such as previous experiences with pain, emotional state, and attention level, which can influence the perception of discomfort. Additionally, the brain releases neurotransmitters and hormones, such as endorphins and cortisol, to modulate the pain response and promote healing.

One intriguing aspect of pain perception is its subjective nature. Two individuals experiencing the same degree of muscle strain may describe their pain differently based on factors. These may include pain tolerance, psychological resilience, and cultural background. This variability highlights the complex interplay between biological and psychosocial factors in shaping the experience of pain.

In the case of chronic muscle strain or persistent pain, changes can occur in the brain's neural pathways, leading to heightened sensitivity and amplification of pain signals—a phenomenon known as central sensitization. This process involves neuroplasticity, whereby the brain rewires itself in response to ongoing pain stimuli. As a result, individuals with chronic muscle strain may experience increased pain sensitivity and decreased pain threshold over time. However, if we educate ourselves around the expected recovery time for our injury, and the appropriate process for our recovery, we can be confident hat we can gain full recovery.

Managing pain after a muscle strain involves not only addressing the underlying tissue damage but also targeting the brain's response to pain. Strategies such as mindfulness meditation, cognitive-behavioral therapy, and relaxation techniques (and mindful movement such as Pilates) can help modulate pain perception. This is by promoting relaxation, reducing stress, and fostering a sense of control over pain. Importantly, we also use movement (and specifically graded load) to start to rebuild muscle and ligament strength.

Here are 5 top reasons that Pilates can help your recovery:

1. Gentle, low-impact movement that can be modified to suit you.

2. It improves your range of motion and flexibility

3. It strengthens core muscles and helps distribute load

4. It promotes balance, awareness and postural alignment

5. It fosters self-awareness, and mind-body connection, preventing further injury.

By gaining insights into how the brain interprets pain after a muscle strain, we can develop more effective approaches to pain management and rehabilitation. Empowering individuals with knowledge about the mind-body connection, and movement strategies to help in their recovery can enhance their ability to cope with pain and get back to doing what they love.

Graded load, and mindful movement will help your recovery.