Sprains and strains are among the most common injuries in sports. A large percentage of musculoskeletal injuries observed in the outpatient setting involve the ankle. Sprains constitute 85% of all ankle injuries. Of these, 85% are inversion sprains. Up to one sixth of participation time lost from sports results from ankle sprains. Proper rehabilitation begins with accurate diagnosis, because up to 40% of patients with untreated or misdiagnosed ankle injuries develop chronic symptoms. Most injuries respond to treatment. Pain reduction is essential, but improvement of any loss of motion, strength, and/or proprioception is equally important. Proper treatment of a sprain or strain is of utmost importance. Without the best treatment, a sprain of a ligament or a strain of a muscle can be a long recovery. Proper treatment of this injury can get you back quickly.
What is Sprain and Strain?
A sprain is a stretch and/or tear of a ligament, the fibrous band of connective tissue that joins the end of one bone with another. Ligaments stabilize and support the body's joints.
A strain is an injury of a muscle and/or tendon. Tendons are fibrous cords of tissue that attach muscles to bone.
What cause Sprain and Strain?
A sprain is caused by direct or indirect trauma (a fall, a blow to the body, etc.) that knocks a joint out of position, and overstretches, and, in severe cases, ruptures the supporting ligaments. Typically, this injury occurs when an individual lands on an outstretched arm; slides into a base; jumps up and lands on the side of the foot; or runs on an uneven surface.
Chronic strains are the result of overuse (prolonged, repetitive movement) of muscles and tendons. Inadequate rest breaks during intensive training precipitates a strain. Acute strains are caused by a direct blow to the body, overstretching, or excessive muscle contraction.
What are the signs of sprain?
While the intensity varies, pain, bruising, swelling, and inflammation are common to all three categories of sprains: mild, moderate, severe. The individual will usually feel a tear or pop in the joint. A severe sprain produces excruciating pain at the moment of injury, as ligaments tear completely, or separate from the bone. This loosening makes the joint nonfunctional. A moderate sprain partially tears the ligament, producing joint instability, and some swelling. A ligament is stretched in a mild sprain, but there is no joint loosening.
What are the signs of a strain?
Typical indications include pain, muscle spasm, muscle weakness, swelling, inflammation, and cramping. In severe strains, the muscle and/or tendon is partially or completely ruptured, often incapacitating the individual. Some muscle function will be lost with a moderate strain, where the muscle/tendon is overstretched and slightly torn. With a mild strain, the muscle/tendon is stretched or pulled, slightly.
Back strain. When the muscles that support the spine are twisted, pulled, or torn, the result is a back strain. Athletes who engage in excessive jumping (during basketball, volleyball, etc.) are vulnerable to this injury.
Hamstring muscle strain. A hamstring muscle strain is a tear or stretch of a major muscle in the back of the thigh. The injury can sideline a person for up to six months. The likely cause is muscle strength imbalance between the hamstrings and the muscles in the front of the thigh, the quadriceps. Kicking a football, running, or leaping to make a basket can pull a hamstring. Hamstring injuries tend to recur.
What is The symptom of sprain?
The symptoms of a sprain are almost exactly the same as that of a broken bone. When in doubt, sprains should be treated the same as broken bones. The most common symptoms are: pain
· swelling
· bruising
· inability to move
· inability to bear weight on the joint
· pain
· swelling
· bruising
· inability to move
· inability to bear weight on the joint
It is not necessary to have all of the symptoms of a sprain in order for the joint to be injured.
Sprain Severity
· Grade I Sprain: A grade I (mild) sprain causes overstretching or slight tearing of the ligaments with no joint instability. A person with a mild sprain usually experiences minimal pain, swelling, and little or no loss of functional ability. Bruising is absent or slight, and the person is usually able to put weight on the affected joint.
· Grade II Sprain: A grade II (moderate) sprain causes partial tearing of the ligament and is characterized by bruising, moderate pain, and swelling. A person with a moderate sprain usually has some difficulty putting weight on the affected joint and experiences some loss of function. An x-ray or MRI may be needed.
· Grade III Sprain: A grade III (severe) sprain results in a complete tear or rupture a ligament. Pain, swelling, and bruising are usually severe, and the patient is unable to put weight on the joint. An x-ray is usually taken to rule out a broken bone. This type of a muscle sprain often requires immobilization and possibly surgery. It can also increase the risk of an athlete having future muscles sprains in that area.
Strain Severity
Strains are categorized in a similar manner to sprains:
· Grade I Strain: This is a mild strain and only some muscle fibers have been damaged. Healing occurs within two to three weeks.
· Grade II Strain: This is a moderate strain with more extensive damage to muscle fibers, but the muscle is not completely ruptured. Healing occurs within three to six weeks.
· Grade III Strain: This is a severe injury with a complete rupture of a muscle. This typically requires a surgical repair of the muscle; the healing period can be up to three months.
First Aid
Use the RICE method to treat the sprain.
1. Rest the sprained joint by not placing weight on it. Use a cane or crutch on the uninjured side to lean away from the injury.
2. Ice the sprain with an ice pack.
3. Compress the sprain with a compression bandage. Ask a healthcare provider to show you how to properly apply a compression bandage.
4. Elevate the sprain above the level of the heart as often as possible during the first 48 hours.
Rest, ice, compression, and elevation usually will help minimize the damage. It is important in all but mild cases for a medical doctor to evaluate the injury and establish a treatment and rehabilitation plan. A severe sprain or strain may require surgery or immobilization followed by months of therapy. Mild sprains and strains may require rehabilitation exercises and activity modification during recovery.
Prevention Tips
No one is immune to sprains and strains, but here are some tips developed by the American Academy of Orthopaedic Surgeons to help reduce your injury risk:
· Participate in a conditioning program to build muscle strength
· Do stretching exercises daily
· Always wear properly fitting shoes
· Nourish your muscles by eating a well-balanced diet
· Warm up before any sports activity, including practice
· Use or wear protective equipment appropriate for that sport
When To See a Doctor for a Sprain or Strain
· You have severe pain and cannot put any weight on the injured joint.
· The area over the injured joint or next to it is very tender when you touch it.
· The injured area looks crooked or has lumps and bumps that you do not see on the uninjured joint.
· You cannot move the injured joint.
· You cannot walk more than four steps without significant pain.
· Your limb buckles or gives way when you try to use the joint.
· You have numbness in any part of the injured area.
· You see redness or red streaks spreading out from the injury.
· You injure an area that has been injured several times before.
· You have pain, swelling, or redness over a bony part of your foot.