What is a sprain?
A sprain is an injury that causes a stretching or a partial tear in a ligament. Ligaments are strong bands of tissue that connect bones at a joint. Sprains may be classified as acute, recurrent, or chronic. Sprains are also graded in severity. In a first-degree sprain, the ligament is not stretched or lengthened but is painful. With a second degree sprain the ligament is stretched but still functions. With a third degree sprain, the ligament is torn and may not function.
How does it occur?
A twisting injury or severe stretching of a joint is the usual cause of a sprain.
What are the symptoms?
Pain, tenderness, and swelling along the injured joint. At the time of injury you may feel or hear a pop or tearing sensation. The skin of the joint may be red at first. In a few hours to days, it may become bruised. You may not be able to move the injured area. Impaired ability to walk, if joint location is the lower extremity. The sensation of giving away or instability is experienced especially in third degree sprain or chronic injuries.
How are sprains diagnosed?
Diagnosis by a health care worker is usually based on history and physical exam of the injury. You may have an x-ray to exclude a fracture or avulsion injury to the joint. Patients with persistent symptoms including instability may benefit from an MRI.
How are sprains treated?
The general guidelines for treating sprains are R-I-C-E:
Rest:
This includes avoiding activities that cause pain. If you have an ankle sprain or knee sprain you may need crutches for ambulation.
Ice: Put a cold compress on the injured area for 20-30 minutes every 3-4 hours. Do this for 2-3 days or until the swelling subsides.
Compression:
Your health care provider may recommend that you wrap the site with an ace wrap, or provide you with their own compression system to help reduce swelling along the injured site.
Elevation:
Keep the injured joint above the level of your heart as much as possible until the swelling subsides. Your health care worker may also:
- Provide you with a supportive device to support the joint including a splint, brace, or sling.
- They may recommend medications such as nonsteroidal anti-inflammatory medications, aspirin and ibuprofen, used to reduce inflammation. Take these as directed by your physician. Contact your physician immediately if any bleeding, stomach upset, or signs of an allergic reaction occur. Other minor pain relievers such as acetaminophen may also be prescribed.
- You may be given a home exercise program to perform that can aid in faster recovery. Or send you to a professional therapist to aid in recovery. Some sprains with complete tearing of the ligaments or chronic instability may require a surgery.
How can I prevent a sprain?
Most sprains occur from accidents that cannot be prevented. However, in physical activity, appropriate warm up and stretching before practice or competition is recommended. Wearing proper shoes for your activities including high top shoes and taping/bracing can add to support. Be weary of uneven surfaces when you are walking or exercising. Maintain appropriate conditioning including: flexibility, muscle strength, endurance, and balance.
Prognosis:
The majority of sprains heal without residual effects if treated properly. However, recurrent sprains or associated symptoms must be managed carefully to avoid a chronic condition. Inadequate activity restriction, immobilization, or rehabilitation can lead to weakness, incomplete healing, recurrent sprains, and ultimately osteoarthritis of the joint in later years.
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