Sprains and Strains
Sprains and Strains
Sprain refers to damage or tearing of ligaments or a joint capsule. Strain refers to damage or tearing of a muscle.
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.
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.
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 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.
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.
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.
Wexler, Randall K. "The Injured Ankle." American Family Physician 57 (February 1, 1998): 474.
Ligament — Tough, fibrous connective tissue that holds bones together at joints.