Sprains vs. Strains: Understanding Healing and Faster Recovery Strategies

You tweak an ankle, pull a hamstring, or wake up with a sore shoulder and everyone has an opinion. Ice it forever. Stretch it hard. Rest until it stops hurting. The problem is that sprains and strains are not the same injury, and treating them like they are can slow healing and set you up for the same flare-up a few weeks later.

Dr. Alexander Telfair discusses how the body actually repairs tissue, starting with the inflammatory phase and moving into regeneration and remodeling. We define a sprain as a ligament injury (bone to bone) and a strain as a muscle or tendon injury (muscle to bone), then explain why that distinction changes your rehab plan. We dig into joint stability, strengthening the tissues around the injured area, and why proprioception training matters so your body can react fast during real life movement like walking, jumping, squatting, and sports.

We also get practical about pain relief and recovery tools. Dr. Telfair explains the RICE protocol for the first 24 to 48 hours, why compression is often the missing piece, and when contrast therapy can help manage swelling by “pumping” circulation. We cover when heat is more useful than ice for chronic pain, why moist heat can work better than dry heat, and how shockwave therapy may support stubborn ligament, tendon, and muscle injuries by promoting blood flow, collagen production, and healthier tissue remodeling. 

If you are coming back from an injury, the goal is not just to feel better. It is to return stronger and more prepared, with a rehab plan that builds load tolerance through tools like eccentric training and isometrics and reduces the odds of re-injury. Subscribe, share this with a training partner, and leave a review with your biggest recovery question so we can tackle it next.

To learn more about Telfair Chiropractic visit:
https://www.TelfairChiropractic.com
Telfair Chiropractic  
630 S Orange Ave, Ste 300B, Sarasota, FL 34236  
941-685-2415 

Transcript

Welcome And Who This Is For

SPEAKER_00 0:00

Welcome to the Sarasota Pain Podcast with Telfair Chiropractic, hosted by Dr. Alexander Telfare. This is the show for active adults who want to move better, feel better, and stay in the game. Without jumping straight to extreme solutions, because let's face it, your body might have a few miles on it, but it's far from retired. Here we help you optimize your potential, one podcast at a time.

SPEAKER_02 0:27

Sprains and strains are incredibly common, but healing them the right way can be the difference between a quick recovery and an injury that keeps coming back. Welcome everyone. I'm Kayleigh Frankie, co-host and producer here in the studio with Dr. Alexander Telfair, chiropractic physician at Telfair Chiropractic. Dr. Telfair, how's your week so far?

SPEAKER_01 0:47

It's good. Yeah, I'm excited to be here. How are you doing?

SPEAKER_02 0:50

I am doing well. I'm excited to be here and learn from you today. This is something that every active person deals with at some point. How do sprains and strains actually heal? And what can people to do to speed up that recovery process? Walk us

How The Body Heals Tissue

SPEAKER_02 1:04

through it.

SPEAKER_01 1:04

Yeah. So I'll just be quick with this initial response. So in terms of like healing process, it's the same as any healing process in the body, right? It's just there's going to be essentially an inflammatory phase. And then we need to have, you know, like some tissue regeneration phase, right? To to some extent. So even if it's just like a scab on your arm, you know, you have like that initial, you bleed, it gets a little red, and then you get a scab, and then the scab, you know, protects it, and you get some skin that forms, and eventually it softs off and you have healed wounds, right? Um, it's it's kind of no different for generally speaking, for any area in the body that has an injury, right? Where there's been some tissue damage. Um, that's kind of the general means of it. But in terms of expediting it or slowing it down via exacerbations or in you know, uh worsening the original symptoms. So there's definitely uh things we can do about that.

Sprain Versus Strain Definitions

SPEAKER_01 1:58

So, first things first is what is a sprain and what is a strain, right? People often get these mismatched, right? Even professionals get them mismatched because I'll get a diagnosis from somebody and I'm like, that's not right. But anyway, I'm also a little OCD, I guess. But um, so a sprain is defined as a ligament injury, right? That is where it's kind of been stretched a little bit. And what is a ligament? A ligament connects bones to bone, generally speaking, right? Um, that is its job. So it's kind of like a passive structure. So if we want to test ligaments, we want to test that joint in a passive range of motion. So that means like I would be moving the patient's finger to test a ligament rather than them moving the finger, right? Because that's gonna tell me if I'm moving it, that's active, that's muscles, right? If I'm moving it for them, that's ligaments, because now it's passive, right? So that's that's a ligament for you, um, connects bones to bones, and it's uh it's integral in uh in the integrity of stability in joints, right? Um, especially if we're talking about like joint capsules and stuff, but that's a story for another day. Um in terms of strains, um, strains are either muscle tissue or tendon injury, right? So um, and what is a tendon, right? So a tendon is what connects the muscle to the bone, right? It's that it's that junction, right? Because the muscle doesn't just directly attach to the bone. There's a there's a bridge, the gap, there's a there's something that gaps the bridge or whatever, you know what I mean. So that's that's essentially what's going on there. It's called the musculotendinous junction, right? So a strain can occur anywhere in there. In fact, they're generally going to be around that area, right? Um, so in terms of uh rehabbing these injuries, I would say there's definitely a lot of overlap and there's definitely some differences,

Sprain Rehab And Proprioception

SPEAKER_01 3:48

right? So I'll start off with uh with sprains. So sprains, we kind of we want to focus on strengthening the surrounding tissues of that joint to help with the um call it the lost integrity of that ligament because obviously it's there's gonna be some uh you know, there's gonna that that ligament is slightly compromised in terms of its duty, right? And so we want to so we want to strengthen the surrounding tissues in that injured area to uh to essentially assist that ligament in its job, right? Because now, you know, that ligament is not as capable as it once was. We want to go ahead and give it as much help as we possibly can, and while also maintaining normal uh, you know, ranges of motion and and essentially preventing compensatory patterns from developing because that can just lead to uh you know more injuries down the road, which obviously we don't want to happen, right? Um, the second thing with ligament rehab that's that's essential, and this is essential for any rehab process, but especially ligaments because it's an integral part of their duty, is something called proprioception, right? So I know it's a big fancy word, but essentially all it means is uh your body's position sense in space, right? So uh a very common one, and and this is uh kind of my own little story. So I was a basketball player, I've rolled my ankles like you know, like all basketball players do a lot, right? Or most of them do. And um I my body basically, like instead of, you know, I instead of rolling my ankle, right, it started to snap back whenever I'd go, whenever I'd do this motion, it would start to go back, right? And that's like my body essentially learning to activate muscles to prevent uh that motion that causes the injury, right? So it's like it would start to motion and then the muscles would activate to bring it back out of that uh call it danger uh range of motion, right? So that's kind of like a proprioceptive feedback mechanism, right? And the goal again with that is um and anytime you have an injury to these areas, proprioception is going to be impacted, your body's position, sense, and space. And and essentially, um yeah, I mean, that's that's like one of the biggest things with that is when you're going and doing a function of movement, when you're walking, when you're jumping, doing a squat, uh, certain muscles should be activating, right? And ligaments even should be getting a little bit more taut to some extent. Obviously, they're not they're more passive structures, but nonetheless, they're gonna have some job in dynamic stability, right? To give or take. Um, more passive stability structures, to be fair, or static stability. But um, you need to rehab it just to make sure that you maximize therapeutic outcomes with the recovery of that ligament, essentially, right? Um, sorry for getting off the beaten path a little bit there. But yeah, so just uh yeah, so we we want to basically strengthen the surrounding tissues. We want to increase that uh that body position sense of the ligaments to help with stability, right? And then um the other thing that's really good for uh sprains,

Shockwave Therapy And Scar Tissue

SPEAKER_01 6:49

right? So I'm gonna talk about this with both sprains and strains, is uh uh shockwave therapy, right? So that is what I utilize for those types of things. And the reason I like it a lot is because when we talk about a sprain, what's actually happening is you know, you have a ligament and it gets sprained, it gets a little stretched, right? And that causes that stability to be impacted because now instead of having that tight rope connect these two structures, now it's a little looser, right? And that's why we have to strengthen up the surrounding tissues to help support that uh rope, so to speak, right? Um, so shockwave can actually help to promote because ligaments are generally what we call avascular, right? They don't get a lot of blood flow, they don't get a lot of love, so to speak, right? So shockwave helps to go in there and kind of promote new blood flow to be, you know, uh in that area, right? So angiogenesis is the fancy term, but essentially it just means new blood vessels are are uh stimulated to grow there, and also collagen production to help kind of rebuild and re, you know, uh get that ligament healthy again, and also prevent scar tissue from forming because scar tissue is gonna make that ligament unhappy as well, right? Um everybody you know talks about scar tissue, nobody really explains what it is. All scar tissue is is the body's exhausted effort at healing an injured area, right? And when it gets exhausted, it kind of starts to quit, right? And what ends up happening is instead of having neat organized tissue, right, it starts to get all mangled and unorganized, right? And so that's what scar tissue is. It's just uh unorganized connective tissue, right? Um, so that's my spiel on sprains. Any questions on that?

Ice Heat And Contrast Therapy

SPEAKER_02 8:28

When should somebody use ice heat or a combination thereof?

SPEAKER_01 8:32

I'm a big fan of contrast therapy. Um if I had a so I would say in terms of ice, the the initial 24 to 48 hours after an acute injury, right? So we're talking the core signs of inflammation, which are gonna be it's gonna be heat, so you know, temperature change, heat, redness, swelling, and pain, right? So pain is kind of like that can go with chronic or acute, but generally speaking, redness, swelling, and uh and heat are gonna be associated with acute inflammation, right? And so in those scenarios, we want to do a rice protocol. We want to rest, ice, uh, compress, and elevate. And I would say compression is one that people neglect. That is very important as well, because we want to drive that into the tissues as much as we can. Also, compression is gonna help to reduce the swelling significantly, right? That's why, you know, people will wear like a compression or you know, think about compression socks for people with uh congestive heart failure, right? It helps to prevent the swelling in the legs, right? So it's no different theoretically with uh compression being added with an ice application, right? Um, and then I would say after that initial phase, you start, you know, you can start to switch to like some contrast. And the reason I love contrast is also the swelling effect, right? Because it's gonna kind of pump the vasculature. It's gonna, it's gonna constrict and dilate blood vessels, right? And so that's just gonna help to drain the area, and not to mention it's gonna help to get old waste products out of the damage, the damaged tissue and get new healing factors into the damaged tissue to help promote healing, right? So huge fan of contrast in terms of heat. I'm a huge fan of heat for chronic pain stuff, right? Uh, because with chronic pain, we want to promote blood flow, right? We don't want to restrict blood flow, right? Um, there's actually ice used to be like the chief thing recommended for a lot of people, and now it started to lean more towards heat, you know, and in within that uh environment, moist heat specifically, right? So heating pads don't really cut it nearly as well as like a moist heat pack you can buy, a CVS or something like that. Um, I even think that the the little you can get these like frozen packs that can either be frozen or heated. And I believe that the heat mechanism of that is is a moist heat because it's like a gel inside there. Um, and that is going to be advantageous compared to a heating pad that's dry heat, right? Um, so and then a homemade thing you can make with heat is also you just take like a tube sock, you throw some rice in it, tie a knot at the top, obviously, so it doesn't leak, throw it in the microwave for 30 seconds at a time to tolerance, and boom, you got a little

Pushing Too Hard And Return To Play

SPEAKER_01 11:02

heat back.

SPEAKER_02 11:02

What's a sign someone's pushing too hard or not hard enough during their recovery?

SPEAKER_01 11:07

Um, pain is definitely one of the main ones. Uh instability, especially with ligamentous injuries, is huge, right? And again, it's just essentially you're working with a practitioner throughout your recovery process until you're released to uh return to play, right? Because um you want to make sure that you know sometimes you want to work through a little pain. You can work through a little instability, you can work through some of these things, but you want to have a practitioner who is educated in this rehab protocol to say, yeah, that's okay. This is not okay, right? So it's just it's important to have guidance, right? Um and and the other thing that's so important is like in terms, especially with athletes. So I had a history with working with NFL players and MLB guys, but mostly NFL athletes. And one of the hugest things with recovery was you want to make sure that their rehab is more intensive as best you can than the actual gameplay they'll be having. Now, sometimes you can't infer what might occur in a game or even in practice, but you want to do your best to prepare that patient to be quote unquote bulletproof before they return to play to make sure that reoccurrence is not even in the book of possibilities, right? Um, it's just that's certainly you want to come back stronger than then you got hurt, right? Because there's a reason you got hurt, assuming it's atraumatic, right? Um so that's my spiel

Strain Rehab And Home Techniques

SPEAKER_01 12:25

on that. I'll talk about strains a little bit real quick, if that's all right.

SPEAKER_02 12:27

Yeah.

SPEAKER_01 12:28

All right. So in terms of strains, we're talking about tendons and tendons and muscles. So we already talked about kind of what that is, right? Um, one of the chief things that the literature supports is eccentric uh training. And what that essentially is is you know, if we have uh let's call it, you know, finger flexion, right? So bending is concentric and then lengthening it, right? Having resistance on that lengthening process is eccentric, right? And that that elongation of the tissue, putting resistance there is gonna really help to uh build strength and and uh you know, tolerance essentially to load, load tolerance in that damaged tendon or uh muscle, right? So that's definitely something we want to work on. Is some people call it a negative rep in weightlifting, but um I think that's what they call it at least. But it it in my field it's called an it's eccentric focus training. Also, something called isometrics is really good too. That's kind of what previously held the uh the podium for for uh tendon and muscle injuries. But nowadays it's I would say in the best answer generally in medicine is a is a little bit of both, but I do lean more towards eccentric training for uh for you know optimal recovery. Manual therapy has a great place. So I you I use like active release techniques and stuff like that for especially muscle injuries. For tendons, I tend to focus more on uh again, because tendons along with ligaments are a bit more avascular, they don't get a lot of blood flow. So treatments are gonna be really focused on stimulating blood flow in that tissue to help uh promote healing as fast as possible, right? Um, so something you can do at home is called transverse friction massage. You just kind of like if this is a tendon, you kind of rub it transversely, right? And that helps to irritate it. Um, and that helps to promote inflammation and therefore, you know, some blood flow. Same with scraping, everybody sees people scraping, right? That's kind of like one of the main mechanisms is trying to irritate the tissue to promote blood flow. I think some people overdo that a little. I'm a huge fan of shockwave again, and I didn't clarify this before talking about shockwave, but shockwave is is more it's not electrical. It's like if we throw a rock in the water and that ripple effect you see in the water, that is the impact that the shockwave is having on the tissues. It generates that impact via an acoustic wave. So it's an air impulse, right? It's not electrical, it's it's literally an intense acoustic airwave. They call it a ballistic airwave, right? Um, so that's what it's doing to the tissues, and the effects that it has is it, you know, we talked about this a little bit, but yeah, so collagen production, growth factors, anti-inflammatory, and you know, decreases pain and then promotes new blood vessel growth to promote healing quicker, right? And then uh as always, rehabilitation is key with strains or sprains. Um and you know, depending on the presentation and and the mechanism of injury, that's gonna all kind of drive uh rehabilitation mechanisms. Um and then obviously with sprains and strains, the you know, and you talked about that first question with uh you know when to use ice and heat and that kind of thing. Uh rest is also, we talked about that, rice, right? So rest, ice, compression, elevation of that acute 24 to 48 hours. You definitely want to rest a little bit before you get back to it. Um, so and again, that's all this should all be coordinated with a practitioner, right? Um, because it it is totally case scenario dependent on many, many factors. And practitioners should or will be aware of those factors to be considered uh in terms of that. Because sometimes you can go right back, you can go right into rehab. Sometimes you want to wait two weeks before rehab. Sometimes you want to get surgery, god forbid, you know. So it just really depends on the uh severity of the injury. Um and then, yeah, the general goal, just a kind of an overview of what we already talked about. The general goal with strains and sprains is to promote blood flow, right? Uh, promote which is going to promote tissue healing. And then we want to also strengthen the ceramic tissues, because generally, even with a strain, right, it's because that muscle is being sometimes it's overused, sometimes it's because that muscle is compensating for other weak muscles. And so you need to go ahead and strengthen the weak area, right? That's a very common mechanism as well, especially in athletes that have like, you know, perhaps uh at a groin strain or a hamstring strain, right? That could be due to weakness in either the groin or the hamstring because they tend to do similar roles in uh in the mechanism, you know, with running and stuff like that. Um, and then obviously stability is huge and uh and just ensure that a full recovery is achieved. And and I get back to you want to kind of make as best you can uh the person bulletproof before returning to play.

Closing And How To Book

SPEAKER_02 16:59

Well, Dr. Telfair, thank you for breaking that down so clearly. Understanding how the body heals makes recovery feel a lot less overwhelming. Yeah. Uh and we will see you next time.

SPEAKER_01 17:08

All right, sounds good. Thank you.

SPEAKER_00 17:09

Thanks for listening to the Sarasota Pain Podcast with Telfair Chiropractic. If pain is slowing you down, Dr. Alexander Telfair at Telfair Chiropractic specializes in conservative, comprehensive care designed to keep you active, mobile, and doing what you love without unnecessary procedures or downtime. Because the goal isn't just to feel better, it's to move better, live stronger, and truly optimize your quality of life. For more information or to schedule your visit, go to Telfairchiropractic.com or call 941 685 2415. Until next time, keep moving, keep improving, and remember a well maintained body performs better than a brand new excuse.