Sprains and Strains

Sprains and Strains

 

Definition

Sprain refers to damage or tearing of ligaments or a joint capsule. Strain refers to damage or tearing of a muscle.

Description

When excessive force is applied to a joint, the ligaments that hold the bones together may be torn or damaged. This results in a sprain, and its seriousness depends on how badly the ligaments are torn. Any joint can be sprained, but the most frequently injured joints are the ankle, knee, and finger.
Strains are tears in the muscle. Sometimes called pulled muscles, they usually occur because of overexertion or improper lifting techniques. Sprains and strains are common. Anyone can have them.
Children under age eight are less likely to have sprains than are older people. Childrens' ligaments are tighter, and their bones are more apt to break before a ligament tears. People who are active in sports suffer more strains and sprains than less active people. Repeated sprains in the same joint make the joint less stable and more prone to future sprains.

Causes and symptoms

There are three grades of sprains. Grade I sprains are mild injuries where there is no tearing of the ligament, and no joint function is lost, although there may be tenderness and slight swelling.
Grade II sprains are caused by a partial tear in the ligament. These sprains are characterized by obvious swelling, extensive bruising, pain, difficulty bearing weight, and reduced function of the joint.
Grade III, or third degree, sprains are caused by complete tearing of the ligament where there is severe pain, loss of joint function, widespread swelling and bruising, and the inability to bear weight. These symptoms are similar to those of bone fractures.
Strains can range from mild muscle stiffness to great soreness. Strains result from overuse of muscles, improper use of the muscles, or as the result of injury in another part of the body when the body compensates for pain by altering the way it moves.

Diagnosis

Grade I sprains and mild strains are usually self-diagnosed. Grade II and III sprains are often seen by a physician, who x rays the area to differentiate between a sprain and a fracture.

Treatment

Grade I sprains and mild strains can be treated at home. Basic first aid for sprains consists of RICE: Rest, Ice for 48 hours, Compression (wrapping in an elastic bandage), and Elevation of the sprain above the level of the heart. Over-the-counter pain medication such as acetaminophen (Tylenol) or ibuprofen (Motrin) can be taken for pain.
In addition to RICE, people with grade II and grade III sprains in the ankle or knee usually need to use crutches until the sprains have healed enough to bear weight. Sometimes, physical therapy or home exercises are needed to restore the strength and flexibility of the joint.
Grade III sprains are usually immobilized in a cast for several weeks to see if the sprain heals. Pain medication is prescribed. Surgery may be necessary to relieve pain and restore function. Athletic people under age 40 are the most likely candidates for surgery, especially with grade III knee sprains. For complete healing, physical therapy usually will follow surgery.

Alternative treatment

Alternative practitioners endorse RICE and conventional treatments. In addition, nutritional therapists recommend vitamin C and bioflavonoids to supplement a diet high in whole grains, fresh fruits, and vegetables. Anti-inflammatories, such as bromelain (a proteolytic enzyme from pineapples) and tumeric (Curcuma longa), may also be helpful. The homeopathic remedy arnica (Arnica montana) may be used initially for a few days, followed by ruta (Ruta graveolens) for joint-related injuries or Rhus toxicodendron for muscle-related injuries. If surgery is needed, alternative practitioners can recommend pre- and post-surgical therapies that will enhance healing.

Prognosis

Moderate sprains heal within two to four weeks, but it can take months to recover from severe ligament tears. Until recently, tearing the ligaments of the knee meant the end to an athlete's career. Improved surgical and rehabilitative techniques now offer the possibility of complete recovery. However, once a joint has been sprained, it will never be as strong as it was before.

Prevention

Sprains and strains can be prevented by warming-up before exercising, using proper lifting techniques, wearing properly fitting shoes, and taping or bracing the joint.

Resources

Periodicals

Wexler, Randall K. "The Injured Ankle." American Family Physician 57 (February 1, 1998): 474.

Key terms

Ligament — Tough, fibrous connective tissue that holds bones together at joints.
References in periodicals archive ?
Really, there isn't much known about sprains and strains among dogs," said Dr.
Sprains and strains are often linked with sporting activities as they are caused by sudden tearing or overstretching of soft tissues around bones and joints, which can cause pain or discomfort.
THE recent cold and frosty weather has seen many people contacting their local pharmacy for advice on sprains and strains and what they should do to treat the injury and the associated pain.
Sprains and strains was the leading nature of injury and illness in every major industry sector in 2005.
The authors suggest ways to evict the little critters with several over-the-counter products and also include suggestions for treating aches and pains, constipation, sprains and strains, and even doggy flatulence.
More than 4 out of 10 injuries and illnesses resulting in time away from work were for sprains and strains, most often involving the back.
A new Insurance Research Council (IRC) report entitled Sprains and Strains Resulting From Auto Accidents: An Analysis of Auto Insurance Claims, revealed that auto accident claimants with low injury severity who were represented by attorneys demonstrated greater use of medical treatment compared to nonrepresented claimants with similar injuries.
Sprains and strains, not major accidents, were driving up costs.
In nearly 80% of all cases where these types of injuries occurred, they resulted from sprains and strains, and inflammation and irritation of joints and elbows.
today announced it received 510(k) clearance from the FDA to market its PremIR818(TM) Infrared Therapy device for the temporary relief/reduction of minor pain or discomfort associated with muscles including neck and back pain caused by muscle tension, joints, arthritis, sprains and strains.
Laborers and material movers, and heavy and tractor-trailer truck drivers often suffered sprains and strains to the trunk or lower extremities, stemming from overexertion or contacts with objects or equipment.