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Sprains and strains - Symptoms of sprains and strains

NHS Choices Medical Reference

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Symptoms of a sprain or strain depend on how severe the injury is. They often include pain, swelling and tenderness.


Common symptoms of a sprain include:

  • pain around the affected joint
  • being unable to use the joint normally or being unable to put weight on it
  • bruising
  • tenderness
  • swelling
  • inflammation

The swelling from a sprain will often occur soon after the injury. However, the bruising may not show until some time later or it may not show at all. Bruising can sometimes occur some distance from the affected joint, as blood from the damaged tissue seeps along the muscles and around the joint before coming close to the skin.


The symptoms of a muscle strain will depend on how severe the injury is. Symptoms can include:

  • pain in the affected muscle
  • swelling
  • bruising
  • muscle spasms (when the muscles contract tightly and painfully)
  • loss of some, or all, of the function in the affected muscle
  • blood collecting under the skin at the site of the strain - this is known as a haematoma and it looks like a large, dark-red bruise

Grading sprains and strains

There are two grading systems used to assess how serious a sprain or strain is.

The grading system for sprains uses a series of grades from one to three:

  • Grade one sprain - mild stretching of your ligament has taken place.
  • Grade two sprain - there has been a partial rupture (splitting) of your ligament but the joint it is associated with is still stable.
  • Grade three sprain - there has been a complete rupture of the ligament and the joint is unstable.

The grading system for muscle strains uses a series of degrees:

  • First degree strain - mild straining of the muscles fibres where only a few fibres have been stretched or torn. The muscle will be painful and tender, but you should still be able to use it normally.
  • Second degree strain - a greater number of fibres have been stretched or torn. You will experience more severe pain and tenderness and there may also be mild swelling and bruising.
  • Third degree strain - the muscle has been split into two or torn away from its tendon (a band of tissue that connects a muscle to a bone). You will lose all use of the affected muscle.

When to seek medical help

You should visit your GP or another healthcare professional if you have a sprain or strain and:

  • you have severe pain and cannot put any weight on the injured joint or muscle
  • the injured area looks crooked or has lumps or bumps (other than swelling) not usually present
  • you cannot move the injured joint
  • the limb gives way when you try to use the joint
  • you have numbness in any part of the injured area
  • the pain has not improved after four days of self-treatment
Medical Review: May 26, 2012
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