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  • Writer's pictureDr Josh Bonine DC


We will have a whole series of posts about muscle strain and tendon sprain, this will give you the basics and also let you know what you don't know.....LOL. Diagnosis codes are great and all, and a huge part of a patient's care and attorney's case, but it also has it's limitations. Look no further than "strain / sprain". Do you remember that show called "Married With Children" with Al Bundy and his wife Peggy? Remember the theme song when it says in the first verse, and I quote from the late great Frank Sinatra:

"Love and marriage, love and marriage

They go together like a horse and carriage

This I tell you brother

You can't have one without the other"

It's true when it comes to sprain / strain also. They go together like a horse and carriage. You can't have one...without the other.

STRAIN / SPRAIN & PERMANENCY: Strain/sprains can be permanent. There are 3 grades of sprain/strain:

Grade 1: Overstretching of the ligament that is a transient condition that resolves.

Grade 2: Partial tearing of the ligament that does not heal, it wound repairs, with internal scar tissue called adhesions. This is a permanent change in tissue structure and leaves the joint unstable.

Image Compliments of Medical Legal Art via The Doe Report ( Copyright © 2010 Medical Legal Art, All rights reserved. Grade 3: This is a complete tear of the ligament and can require surgery. This leaves the joint very unstable, that over time will fill in with adhesions (scar tissue). This, too, is a permanent scenario.

Doctors are not given the choice of choosing which type of strain/sprain in their diagnosis, as the coding guidelines only gives the doctor 1 choice. When confronted with a diagnosis from a doctor with strain/sprain, do not assume that it is a grade 1. Ask the doctor to clarify which grade you or your client have to determine if it is a permanent condition or not. These can happen in any joint of the body including the spine and all extremities.


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