Sprains and strains are some of the most common NFL injuries. They’re as common as pick sixes during an Eli Manning vs Matt Schaub matchup. More importantly, all sprains and strains, no matter where on the body, share a lot of common characteristics. Seems like it’s easier for me to spell this all out here than to repeat myself every time I’m breaking an injury down in detail.
A sprain is a ligament injury. Ligaments are tough, flexible tissues that usually hold two bones together. You find them most frequently at joints, where they basically act as a hinge and keep everything aligned properly. A strain, on the other hand, is a muscle injury. I shouldn’t have to tell you this, but muscles are used to move body parts, especially bones. Muscles don’t connect directly to bone though, as that is the job of the tendon, a tough band of connective tissue (not unlike a ligament). The term, “strain,” can be used for an injury to the muscle or the tendon.
But what exactly are strains and sprains? In the simplest sense, they are tears. Both sprains and strains are categorized along the same lines, with three grades. A Grade I sprain/strain is one where a ligament or muscle has been overstretched and has very limited damage. There are small tears present, but these might only be at a microscopic level. Grade I sprains/strains cause pain and swelling, but this is usually very temporary. Players can often play through Grade I sprains/strains. Even if a player cannot play through the injury, conservative (meaning non-surgical) treatment is the norm here.
Grade II sprains/strains are a little more severe. The ligament or muscle has a larger, but not complete tear. While the joint or muscle might still be structurally sound, there is significant pain and swelling that will affect the player’s movement. While Grade II is more severe than Grade II, the treatment is usually similar. Grade II sprains/strains rarely require surgery. The typical rehab consists of plenty or rest, ice, compression, and elevation (RICE, in the biz). Grade II sprains are tough to play through, but these guys still surprise me sometimes.
Grade III sprains/strains are complete tears of the ligament or muscle. With Grade III, we’re almost always talking about season-ending surgery. There are a few ligaments that can heal on their own without surgery, but we’ll cover those later on a case-by-case basis. Simple rule is that if you hear, “Grade III,” you can kiss that player goodbye for the year.
Did you get all that? Did you understand that all three grades involve tearing? If so, than you’re way ahead of a lot of reporters, coaches, and players. Now that you know this, listen for how many times you hear someone say that a player has, “a sprain, but no ligament damage,” or that a player, “strained a muscle, but avoided a tear.” In the media, the term, “tear,” is typically (incorrectly) reserved for Grade III sprains and strains. A sprain, by definition, is a ligament tear. Similarly, a strain is a muscle tear. Make sure to point that out when people use those terms improperly. Doing so has done wonders for my own popularity.
Now I’d like to point out a few things about sprains and strains as they relate to my database. First of all, it can be really difficult to get good data on Grade I sprains and strains. These are often the little injuries that show up on reports with vague, “ankle,” or, “quad,” designations. Players play through them, and you never really know precisely what the injury is. Players and teams don’t tend to waste any time disclosing this sort of thing, so you’ll rarely hear someone admit that they have a, “Grade I ankle sprain.” Instead, they might just dismiss it as a, “tweaked ankle,” at most. With injuries like this, I tend to take the cautious approach and just file them away under the vague designation that the team used (like the, “ankle,” or, “quad,” examples). In order for me to log something as a sprain or strain, I try to find third party verification. Like I say, this doesn’t always work so well. In fact, in many of my sprain and strain return-to-play charts, I have incorrectly low numbers of players who returned without missing any time. This is a limitation of my current injury database logging methods. I admit to this, and even point it out. I’m working on getting more visibility on the low end of those RTP ranges, but for right now, it’s a work in progress and I want to be clear about that.
As for the grade designation of specific injuries, I log that whenever I can find it. Unfortunately, that’s not the norm. In general, my RTP charts will cover all three grades of sprains and strains. I am fiddling with breaking these down better so that, for example, you can compare just Grade II hamstring strains, but I’m not there yet. What my current, non-grade specific, RTP charts do have though is a large sample size, so I think there’s some value there.
