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 May 11, 2005
Sprains and Strains
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Although the terms sprain and strain are used loosely and have no precise clinical definition, a sprain generally refers to an injury to a ligament - one of the tough, fibrous cords within a joint that connects the bones together, and a strain refers to muscle injury. Sprains and strains often occur together in or near a joint, since joints absorb the stress of movement and are vulnerable to be being twisted or wrenched. The ankle and the knee are the most common sites of such injuries. In mild cases, the force of the injury tears a few fibers of the ligament or muscle, causing mild to moderate pain and swelling, which usually subside within a few days. A more violent injury may completely tear a ligament or muscle and involve bone damage such as a dislocation or fracture. With proper care, most sprains and strains heal completely without complication. The ankles are among the most vulnerable elements of the body. These complex hinges of bone, ligament, tendon and muscle support the entire body weight and may transmit a force of impact equal to three times your weight. Thus, ankle injuries, usually the tearing or straining of a ligament, are the most common of all joint injuries. The great majority of sprains are inversion sprains. This happens when the sole of the foot turns inward, injuring the ligaments on the outside of the ankle. Eversion injuries occur when the foot turns outward, affecting ligaments on the inner side. Some sprains are minor and can be successfully treated at home, but many need medical attention. Any ankle sprain can put you at risk for another, since when the injury heals, it leaves the tendon weakened and less flexible - and thus more susceptible to injury.


Sprains and strains occur as a result of an injury, when the joint is subjected to more physical force that it can withstand. Athletes, dancers, and those who perform manual labor commonly suffer such injuries. Previous sprains may so weaken the ligaments that recurrence is possible with only minor pressure. The risk of sprains and strains increases with obesity and poor muscular conditioning.


Symptoms include mild-to-severe pain in the affected joint that worsens with movement or application of pressure; swelling, redness, or bruising around the affected joint; and, in severe cases, loss of mobility in the affected joint.


First aid measures for a sprain or strain can best be remembered by the acronym RICE - Rest, Ice, Compression, and Elevation.

    Restthe injured area. Try not to move or put pressure on the affected joint. A sling or splint may be recommended to immobilize the joint and allow damaged ligaments or muscles to heal. Icethe affected area to reduce swelling. After 24 hours, either ice or heat may be applied to reduce pain. Compressthe joint by wrapping it in an Ace bandage to help reduce swelling and pain. Elevatethe joint to reduce swelling.
Take over-the-counter pain relievers to treat minor pain. Your doctor may prescribe stronger analgesics for more severe pain. After the pain has subsided, gently exercise the joint to regain strength and mobility. A physician or physical therapist may help to devise an exercise program to aid in rehabilitation. Surgery may be required in severe cases to repair torn ligaments or muscles.


Perform warm-up exercises before undertaking any strenuous activity. Wear a brace or elastic support, or tape or wrap joints before engaging in vigorous physical activity. Engage in regular, moderate exercise to keep muscles and joints strong and flexible.


How much muscle or ligament damage has been done? What is the probable cause? Is the RICE procedure recommended? Will you prescribe painkillers? Will there be a full recovery? How can this be avoided in the future?

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