Sprain vs. Strain vs. Tendinopathy

What’s the Difference (and Why You Should Care)

If you've ever hobbled into physical therapy with pain and a lot of questions, you’re not alone. One of the first things we help patients figure out is what exactly is injured – and trust us, it’s not always the obvious answer.

Three of the most common culprits? Sprains, strains, and tendinopathies. These are different types of injuries, even though they may feel similar. Understanding which one you're dealing with helps us (and you) build the right game plan to get you moving again.

Sprains: When You Overstretch or Tear a Ligament

A sprain happens when you overstretch or tear a ligament, the tough bands of tissue that hold your joints together. Think: rolling your ankle during a run or landing awkwardly on your foot during a workout.

What it feels like:

• Sharp pain right at the joint

• Swelling, maybe some bruising

• A feeling like the joint is “loose” or unstable (especially in more severe sprains)

How we treat it:

PTs will initially protect the injured ligament through brace, tape, or modified activities to minimize further damage. Whether you're training for a marathon, chasing a ball down the courts, or even misstepping along a curb, we’ve all experienced swelling. Learning how to rebuild balance, control, and strength all while managing a sprain allows for quicker recovery. Most importantly, you’ll learn how to trust your body again.

Strains: When a Muscle or Tendon Gets Pulled or Torn

A strain is an injury to a muscle or the tendon that connects it to bone. This can happen suddenly (like sprinting or lifting something heavy) or over time from repetitive stress.

What it feels like:

• Pain right in the muscle belly or at the muscle-tendon junction

• Tenderness, especially when the muscle contracts or stretches

• Sometimes bruising, weakness, or a visible dent in more serious cases

How we treat it:

At first, we ease into movement to avoid stiffness and help the tissue heal. Then we gradually load the muscle with strength work (like isometrics and controlled lifting) to restore power and prevent future injury. Returning to sport or workouts too soon can set you back, so we focus on building durability.

Tendinopathy: When a Tendon Just Won’t Calm Down

Tendinopathy is a more chronic, nagging issue with a tendon. Unlike sprains or strains, this usually builds up over time. It’s common in runners, lifters, and active folks who train consistently, but may not give their bodies enough time to recover between sessions.

What it feels like:

• Pain that shows up during or after activity (and can hang around into the next day)

• Stiffness first thing in the morning or after sitting for a while

• A thick, ropey feel in the tendon (like at the Achilles or patellar tendon)

• Pain with specific loading—like going downstairs, jumping, or pushing off

How we treat it:

The key is not rest—but smart loading. We use heavy, slow strength work to help the tendon remodel and get stronger. It’s a process, and it takes time, but it works. We also zoom out and look at how you move, train, and recover, so we can address the root cause—not just the pain.

Why Does It Matter?

The treatment plan is totally different depending on what’s hurt. A sore Achilles could be a tendon issue, a calf strain, or even referred pain from the low back. Knowing what you’re dealing with helps your PT make smart decisions about when to push, when to pull back, and how to get you feeling better, faster.

Quick Comparison:

	Sprain (Ligament)	Strain (Muscle/Tendon)	Tendinopathy (Tendon)
How it starts	Sudden trauma (like a twist)	Sudden overload or gradual overuse	Gradual buildup over time
Common signs	Joint swelling, instability	Muscle pain, weakness	Pain with activity, morning stiffness
Healing time	Weeks to months	Days to months	Long-term process, needs ongoing loading
PT focus	Stability, balance, joint control	Strength, flexibility	Smart loading, tendon strength

You don’t need to memorize every detail (that's on us, as your PT!) — but knowing the difference between these injuries can help you understand your recovery process and stay patient with your progress.

Whether you're rehabbing a sprain, rebuilding a strained muscle, or dealing with a stubborn tendon, the right care makes all the difference. At Finish Line PT, we’re here to guide you every step of the way—and make sure you come back stronger, smarter, and more confident in your body.