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A sprain happens when the ligaments, which are strong bands of tissue connecting bones in joints, are stretched or torn. This is different from a strain, which is when a muscle is stretched, pulled or torn where it attaches to a bone. Sprains directly affect the joint involved and can range in severity from a stretched ligament to a partially or completely torn one.
The top three locations for sprains are:
- Ankle sprains: Occur when the foot twists inward during running, turning, or jumping and then lands on the ankle.
- Knee sprains: Typically result from a blow to the knee or a fall, and sudden twisting movements of the knee can also cause a sprain.
- Wrist sprains: Frequently happen when someone falls and lands on their hand with an outstretched arm.
The severity of a sprain depends on the degree of the sprain and how many ligaments are involved. Initial treatment for a sprain includes rest, ice, compression and elevation. Mild sprains can be treated at home successfully, but severe sprains may require surgery to repair torn ligaments.
It is important to distinguish between a sprain and a strain because they require different treatments. While a sprain involves ligament damage, a strain involves damage to the muscle. By identifying the injury correctly, the appropriate treatment can be given to help with the healing process.
Symptoms
The extent of the damage may affect the signs and symptoms. They could consist of:
- Pain
- Swelling or inflammation of the joint
- Bruising
- Limited range of motion in the injured joint
- Instabilities, particularly at weight-bearing joints like the ankle or knee.
- At the time of the injury, hearing or sensing a “pop” in the joint
Home treatment can be used to treat minor sprains. However, the same injury that result in sprains can also result in more severe injuries like fractures. If a patient has discomfort directly over the bones of an injured joint, they are unable to move or bear weight on the injured joint or has numbness in any region of the wounded area, they should consult healthcare provider.
Causes
Direct or indirect injuries (trauma) that misaligns the joint, overextends it, and occasionally tears the supporting ligaments results in a sprain. A sprain can result from various injuries, for instance:
- Activities: Running, walking, sudden change of direction, or working out on a rough surface, coming down suddenly from a jump could affect the ankle or knee.
- Wrist: Landing during a fall on an outstretched hand.
- Thumb: Tennis or other racquet sports injuries from skiing or overextension.
Children are more prone to get a fracture than a sprain because the ligaments around a joint are frequently stronger than these growth plates. Around the ends of their bones, children have soft tissue portions called growth plates. The severity of sprains can be classified as follows:
- Mild sprains: involve only a slight stretching of the ligaments.
- Moderate sprains: result from a combination of stretching and partial tearing of the ligament.
- Severe sprains: occur when the ligament is completely torn.
Risk factors
There is a risk of sprain for everyone, regardless of age or physical activity. Certain factors can increase the likelihood of experiencing a sprain, such as:
- Fatigue: When your muscles are fatigued, they are less capable of providing adequate support for your joints, which increases the risk of joint stress from external forces. Additionally, tiredness can make you more susceptible to such forces.
- Weight: The risk increases if the patient is overweight, or they have poor physical condition.
- Environmental: Uneven or slippery surfaces might increase the risk of injury.
- Poor equipment: The risk of sprains might be increased by wearing improperly fitting or poorly maintained shoes or other athletic gear.
Diagnosis
There are different ways to diagnose a sprain, including:
- Physical examination: The injured limb will be examined by the healthcare provider for swelling, range of motion, stability of the joint, and pain. The source and degree of discomfort can provide information as to the size and type of injury.
- Imaging test: X-rays can be used to help rule out a fracture or other type of bone injury as the problems cause. An X-ray cannot show a ligament, but it might still be useful to examine the joint spacing and rule out fractures. To determine the severity of the injury, magnetic resonance imaging (MRI) may also be utilized.
Treatment
Patient are advised to try R.I.C.E. as an initial treatment at home.
- Rest: It is recommended to avoid any activities that could cause pain, discomfort, or any swelling, however some activities could still be done by the patient. Changes in routine are necessary after an injury like a sprain to allow the injured area to heal.
- Ice: Patient should apply ice pack to the affected area for at least 15-20 minutes and should be repeated every 2 to 3 hours. Use a cold pack, ice bag, or plastic bag with ice inside that is covered in a towel. Applying ice for more than 20 minutes at a time might cause frost bite and other cold-related injuries. Stop icing as soon as you begin to experience numbness or discomfort.
- Compression: Compress the area with an elastic bandage until the swelling subsides to help stop it. Avoid wrapping it too tightly to avoid restricting blood flow. At the end that is furthest from the heart, start wrapping. If the discomfort worsens, the area goes numb, or swelling develops below the wrapped area, remove the bandage.
- Elevation: Particularly at night, elevate the damaged area so that it is above the level of the heart. This will allow gravity to help reduce swelling.
- Medication: Ibuprofen (Advil, Motrin IB, among others) and acetaminophen (Tylenol, among others) are two over-the-counter painkillers that can be therapeutic.
After the initial two days, the patient may gradually resume using the damaged area. The ability of the joint to sustain the patient’s weight or allow them to move painlessly should gradually and steadily improve. Sprain recovery may take a few days to several months.
- Physical therapy: Injured joints or limbs can benefit from increased stability and strength through physical therapy. A brace or splint may be recommended by the healthcare provider to the patient in order to immobilize the area. Surgery may be considered for certain ailments, such as a torn ligament.
To prevent the injured joint from becoming stiff, the therapist will provide the patient with a home exercise program and teach them some exercises. They will gradually increase the intensity of strength and balance exercises until the patient is able to return to their pre-injury level of activity (in cases of ankle and knee sprains). Physical therapy can facilitate a safe return to exercise and sports programs, as well as improve the strength of the injured joint beyond its previous level. Physical therapy is strongly recommended for patients who have repeatedly sprained an ankle or who were immobilized during the recovery period to reduce the risk of future injury.
