Julian E Girod, MD

Sprains and Strains

Introduction
Many people use the term sprain to inaccurately describe many different types of injuries to a joint. Medically, a sprain means that a ligament tissue have been torn. Tearing of a ligament can be partial or complete.
Ligaments are connective tissue that attach to and hold two bones together. It is a tough tissue, but it is not very elastic. Sudden stretching due to excessive bending or twisting can cause an injury to the ligament.
Knees and ankles are the two joints most commonly sprained, but any joint can be affected. Frequently, muscle strain will occur at the same time as a sprain, especially with ankle sprains. Strains and sprains, however, are not the same.
Symptoms of a sprain may include:
bullet1. Pain (mild to severe) at the time of injury
bullet2. A "popping" sound may be heard
bullet3. Rapid discoloration of the skin
bullet4. Intensified pain with pressure or movement of the joint
bullet5. Swelling, often beginning within minutes of the injury
If the joint is out of alignment, a dislocation or fracture may also have occurred.
Prevention of sprains primarily rests on limiting activities that require sudden, unexpected changes in the use of a joint. However, this advice may be too limiting, especially for people who are very physically active or who play different sports.

Wearing shoes that fit well and that provide support to the ankles may help prevent both knee and ankle sprains. Wearing cleated shoes, however, may increase one's chance for injury. The longer the cleats, the greater the risk.

Developing and maintaining good muscle tone and flexibility will not only decrease the risk of sprains but also help prevent muscle strains.

Treatment
Sprains can be very mild, requiring only simple measures for recovery to take place. The main goals of these measures is to prevent further injury and decrease pain. Pain is often caused by swelling.

Self-Help Treatment Measures Sometimes Include:



bullet1. Intermittent application of ice to the areas for the first 24 hours to 48 hours following the injury
bullet2. Keeping the part elevated (above the level of the heart, if possible) to decrease swelling
bullet3. Minimizing use of the joint, if it causes any pain
bullet4. Use of anti-inflammatory medication such as aspirin or ibuprofen (Ask your pharmacist to explain the benefits, risks and costs of this option if you consider using medications.)

Sprains can also be very severe when there has been a lot of tearing or rupture of a ligament. These injuries may require, in addition to the above, immobilization of the joint. Partial immobilization can be accomplished with the use of splints and bandaging. However more complete immobilization may require the use of a cast.

Ligaments have poor blood supply and therefore heal slowly. The healing process continues long after the symptoms of the injury have gone away.

The key to prevention of repeat injury and long-term problems is returning slowly to activities that put extra stress on the involved joint.

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