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A sprain occurs primarily due to a severe stretch or tear of a ligament, which is the connective tissue that connects bones together at a joint. This type of injury typically results from sudden or excessive force applied to a joint, often leading to a stretching or tearing of the ligament tissue. When a joint is forced beyond its normal range of motion, the ligaments can become overstretched or ruptured, resulting in pain, swelling, and functional instability.

In the context of the other options, prolonged pressure refers to sustained force that is not typically associated with sprains. Mild exertion usually does not exceed the limits of the ligament and is unlikely to cause significant injury. Inadequate warm-up can contribute to injuries, but it specifically relates to overall muscle and joint readiness rather than directly causing a sprain. Therefore, the most accurate identification of the cause of a sprain is a severe stretch or tear.