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Sprains and Strain Rehabilitation and Sports Injury Treatment in Toronto

Sprains usually involve joints and the ligaments surrounding them. Strains involve muscles and connective tissues. They are often confused because both are considered soft tissues of the musculoskeletal system and both present themselves with similar symptoms. Common conditions and injuries that we treat include:

Iliotibial band friction syndrome

woman holding her calf

Ligaments are like strong cloth or leather, tough, but when pulled to their limit they can tear. Muscle fibres are pliable like elastics. They are resilient but, when overexerted or overstretched, can tear. Depending on the tear’s severity, a sprain or strain can be mild, medium or severe, often referred to as level 1, 2 or 3. The accumulation of fluids after an injury gives rise to the characteristic symptoms of pain, swelling and bruising and makes it difficult to differentiate one from the other. Physiotherapists specialize in their differentiation during the initial assessment. If the injury resulted from trauma while playing sports, the physiotherapist might find evidence of both types of soft tissue injury, and therapy may overlap considerably. Acute injury treatment follows the RICE formula: Rest, Ice, Compress, Elevate. The goal of treatment for all soft tissue injuries is to restore function as soon as possible. By seeking prompt diagnosis and treatment, including physiotherapy, you can be back to your usual activities in the shortest time possible.

If you have a sprain or strain revolving around a sports-related incident, contact us today to schedule an appointment and begin your individualized treatment plan.

Tennis/Golfer’s Elbow

You’ve most likely heard of both of these conditions but may be a little confused about which you may be suffering from. Both conditions are similar in nature but are caused by different wrist and elbow activities. Basically, if you have pain on the top (outside) of your elbow, it’s tennis elbow; if it is on the underside (near the “funny bone”), it's the golfer's elbow.

Tennis elbow is caused by stress and eventual microscopic tearing and inflammation of muscle and tendon where your wrist extensors, the muscles which bend your wrist back, attach to the outside of your elbow. Activities that can aggravate this condition include a weak tennis backhand, prolonged hammering, working at a computer keyboard, activities involving holding the wrist back and using the fingers to grip to perform small movements like spraying a hairspray bottle or lifting a carton of milk.

Golfer’s elbow involves the same microscopic trauma but involves the muscles which flex or bend your wrist toward your forearm. Activities that aggravate this condition can include striking the ball during your golf swing (the elbow of the dominant, shooting side will feel the stress). Also, included are activities that involve gripping with the fingers or gripping and turning the wrist, like using a wrench or carrying groceries.


What Can You Do to Heal or Prevent These Injuries?


When performing repetitive activities such as typing, hammering and carrying, make sure your wrist is well supported in a neutral position (the midway point between flexion and extension). This can be accomplished by consciously maintaining this position or with the help of various external supports or splints.

If you do a job or like to play a sport that might make you prone to developing either of these conditions, be sure to keep the muscles of your forearm strong, particularly your wrist extensor muscles. You can do wrist curls and wrist extension exercises with small weights at the gym, at work on your break or at home.

Make sure your tennis racquet, golf clubs and tools have a proper grip or handle sizes.

If you do end up having symptoms of either of these conditions, be sure to modify the aggravating activity immediately. Also, seek the advice of a physiotherapist, who will help you identify the cause, help to reduce the inflammation and show you stretching and strengthening exercises that will prevent the condition from becoming chronic. Furthermore, a physiotherapist will advise you if bracing is necessary, and if so, the type of brace that would be available these days. But it is important to have the brace type and size suit you and your condition for the most effective relief of symptoms.

What is a Sprain? What is a Strain?

Both sprains and strains involve injuries to muscle fibres or ligaments. Ligaments are strong and pliable, like leather or thick rope. They are very resilient but when overstretched they can tear. Depending on the injury, the tear can be microscopic and limited to a few fibres or it can be severe and rip the ligament apart. As a result, ligament sprains can be mild, medium, or severe and are usually graded in corresponding levels of 1, 2, or 3.


Muscle fibres are pliable, more like an elastic. They too can tear after an overexertion injury or the accumulation of repetitive, strong muscle contractions. Like sprains,they too can be graded level 1, 2, or 3 depending on the injury. We usually refer to a muscular injury as a strain.

What Are the Symptoms of a Sprain or Strain and What Can I Do?

Usually, there is an immediate onset of localized pain and swelling after a sprain injury. Bruising follows shortly thereafter. Skin in the area will most likely feel hotter than normal.


Home remedy treatments should follow the RICE formula.

R is for rest; stop using the involved limb. Don’t walk if it’s a knee or foot injury and don’t use the arm if it's a hand or elbow injury.

I is for ice which can be applied to the specific area for 10 minutes on and 10 minutes off several times during the first day or two. Be sure to avoid a skin burn by wrapping the ice in a towel or some material.

C is for compression which is best done by wrapping a tensor bandage around the area.

E is to elevate. To elevate the injured part, it should be higher than your heart. Sitting in a chair with an injured foot on a stool has not elevated it. Lying flat with the foot up on several pillows might do it. Likewise, you may have to lie down and use pillows to elevate an injured hand or elbow.

If you have a sprain or a strain that is not resolving after  24 hours, contact us and one of the physiotherapist’s at Bloor Jane Physiotherapy will assess the severity of the injury and begin your individual treatment plan. 

Ankle Sprains

Ankle injuries are the most common sports injuries seen by athletic therapists. They usually involve one or more of the many ligaments that stabilize the foot and ankle. An injury to any one of them weakens the ankle and compromises the stability of the whole leg. There may have to be a temporary pause from sports while healing takes place. Most injuries will heal on their own, but a cane or crutches may be needed while it heals. You may need a brace or support for a while, especially if you want to return to play. The physiotherapists at Bloor Jane Physiotherapy are primary contact practitioners who can assess the severity of your injury and decide what treatment plan best suits your needs.


Knee Sprain or Meniscus Injuries

There is a medial meniscus and a lateral meniscus in every knee; one on the inner side of the knee and another on the outside. They are made of cartilage tissue. They are shaped like a crescent moon filling the space between the bones that join at the knee, the femur and the tibia. The menisci act as shock absorbers for the knee joint. The stress of certain movements, especially twisting at the knee, is absorbed by them but if these movements are taken to extremes with force, the meniscus can be damaged and torn. A typical meniscal tear usually occurs in a football tackle but is not limited to football. Any contact sports that involve running are prone to having players with meniscal injuries. Not limited to sports, meniscal injuries can happen at the workplace too.


Knee sprains and meniscal injuries can have similar symptoms of pain, bruising, and swelling and it is often difficult to determine if it is a torn meniscus or a ligament sprain. Sometimes, a tell-tale sign is that the knee ‘gives away’ or one of the quadriceps muscles has weakened but these are not definitive signs. An MRI might be required to determine if it is a meniscal tear or ligament sprain. An MRI will tell you the severity and location of that injury, too.


Meniscal tears do not always require surgical repair. Current research has demonstrated that in the past, surgeries were conducted too often on suspected meniscal tears. No matter whether treatment requires arthroscopic surgery, or you choose the non-surgical conservative approach, a period of intense therapy is required to return to full function and to sports. The leg muscles need to be strengthened, especially the quads, the largest group of muscles in the leg. Our physiotherapists at Bloor Jane Physiotherapy can teach you pre-op or post-op exercises that target the quads as well as teach you a home exercise routine.


What Is Plantar Fasciitis and How To Treat It?

The plantar fascia is a thick ligamentous band inside the bottom of the foot and when it is inflamed,  it is called plantar fasciitis. Often not one singular injury, plantar fasciitis results from repeated microtraumas when walking for prolonged periods in improper footwear. There are several other causes but people with low or high arches of the foot or with flat feet are more susceptible to developing plantar fasciitis. An x-ray of the foot will reveal no fracture but may show a heel spur or a tiny outgrowth of bone where the fascia attaches. 


Pain is usually localized to the bottom of the heel where the plantar fascia attaches to the calcaneus. It is usually worse upon taking the first step on waking or after a rest and it can persist with each step you take. There have been many treatment approaches to this condition over the years, but the latest treatment is to apply shock waves directly to the heel where the plantar fascia has developed into a thick scar or bony outgrowth. Only a few shock wave treatments at Bloor Jane Physiotherapy can break down any thickening of the scar and can render the fascia back to pain free. Laser light is another effective treatment mode at Bloor Jane Physiotherapy, especially when applied early in the more acute phase. Low power laser light can stimulate the healing process and can speed up the body’s own natural ability for recovery. Manual manipulation of the fascia and deep muscle tissue work is also an effective treatment that is given by our registered massage therapist.

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