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Sprain
Classification and external resources
ICD-10 T14.3
ICD-9 848.9
MeSH D013180

A sprain (from Middle French espraindre - to wring) is an injury to ligaments that is caused by being stretched beyond their normal capacity and possibly torn. A muscular tear caused in the same manner is referred to as a strain. In cases where either ligament or muscle tissue is torn, immobilization and surgical repair may be necessary. Ligaments are tough, fibrous tissues that connect bone to bone across the joints. Sprains can occur in any joint but are most common in the ankle. [1]

Contents

Symptoms

  • Pain
  • Swelling
  • Bruising
  • Decreased ability to move the joint
  • If the ligament is ruptured, one may hear a popping sound
  • Difficulty using the affected extremity

Diagnosis

The diagnosis of sprain injury is made by a physical examination. In most cases an x-ray of the affected joint is obtained to ensure that there are no fractures. If a tear in the ligament is suspected, then an MRI is obtained. MRI is usually ordered after swelling has subsided and can readily identify the presence of a ligament injury. [2]

Causes

Sprains typically occur when the joint is overextended. This can cause over stretching of the ligament, tear or rupture the ligament. [3]

Joints involved

Although any joint can experience a sprain, some of the more common include:

Risk factors

There are certain factors which increase risk of sprains. [5] Fatigue of muscles generally leads to sprains. When one suddenly starts to exercise after a sedentary lifestyle, sprains are quite common. Not warming-up is the most common cause of sprains in athletes. Warming-up loosens the joint, increases blood flow and makes the joint more flexible. Poor conditioning of the body can also lead to sprains.

Diagnosis of sprains is not difficult but in most cases x-rays are obtained to ensure that there is no fracture. In many cases, if the injury is prolonged, magnetic resonance imaging is performed to look at surrounding soft tissues and the ligament [6]

Treatment

The first modality for a sprain can be remembered using the acronym R.I.C.E.[7] The treatment of sprains depends on the extent of injury and the joint involved. Medications like non steroidal anti-inflammatory drugs can relieve pain. Weight bearing should be gradual and advanced as tolerated. [8]

  • Rest: The sprain should be rested. No additional force should be applied on site of the sprain. If, for example, the sprain were an ankle sprain, then walking should be kept to a minimum.[9]
  • Ice: Ice should be applied immediately to the sprain to minimize swelling and ease pain. It can be applied for 20-30 minutes at a time, 3-4 times a day. Ice can be combined with a wrapping to minimize swelling and provide support.[9]
  • Compression: Dressings, bandages, or ace-wraps should be used to immobilize the sprain and provide support.[9]
  • Elevate Keeping the sprained joint elevated above heart level will also help to minimize swelling.[9]

Ice and compression (cold compression therapy) will not completely stop swelling and pain, but will help to minimize them as the sprain begins to heal itself. Careful management of swelling is critical to the healing process as additional fluid may pool in the sprained area.

The joint should be exercised again fairly soon, in milder cases from 1 to 3 days after injury.[10] Special exercises are sometimes needed in order to regain strength and help reduce the risk of ongoing problems. The ankle may need to be supported by taping or bracing, helping protect it from re-injury.[10]

Functional rehabilitation

After any sprain, proper rehabilitation is a must; especially when the injury has been severe. After acute treatment, a rehabilitation program is critical in speeding recovery of the joint. Lack of rehabilitation can often delay return to normal function for months. [11]

The other error most people make is to use prolonged immobilization. This usually leads to muscle atrophy and stiff joint. The components of an effective rehabilitation for all sprain injuries include increasing range of motion and progressive muscle strengthening exercise. [12]

See also

References

  1. ^ Sprain Treatment Retrieved on 2010-01-26
  2. ^ How To Perform Treatment of a Sprained Ankle About health online portal. Retrieved on 2010-02-01
  3. ^ Sprains and Strains: What's the Difference American academy of orthopaedic surgeons. Retrieved on 2010-01-26
  4. ^ Holes Human Anatomy & Physiology, Shier, David, Jackie Butler, Ricki Lewis, Mc Graw Hill 2007, Eleventh Ed., p.157,160
  5. ^ Sprains and Strains About Network. Retrieved on 2010-01-26
  6. ^ Strains and sprains information Mayo Clinic. Retrieved on 2010-01-26
  7. ^ Mnemonic at medicalmnemonics.com 235
  8. ^ Sprain and Strain Symptoms and Treatment About Network. Retrieved on 2010-01-26
  9. ^ a b c d "Sprained Ankle". American Orthopaedic Foot and Ankle Society. 2005-03. http://orthoinfo.aaos.org/topic.cfm?topic=A00150. Retrieved 2008-04-01. 
  10. ^ a b Ankle Sprains: Healing and Preventing Injury Written by familydoctor.org editorial staff. American Academy of Family Physicians. Reviewed/Updated: 08/06. Created: 01/96
  11. ^ Sprain and Strain details Dreddy Clinic. Retrieved on 2010-01-26
  12. ^ Sprained ankle American academy of orthopedic surgeons. Retrieved on 2010-01-26

Simple English

A sprain is a type of injury in which a person hurts the part really bad, but it is not broken. It has common side affects of a broken bone, but it is less serious.

Contents

Degrees

The first degree is only a minor tear or stretch of a ligament.

The second degree is a tear of a ligament, which is usually followed by pain or swelling.

The third degree is a complete rupture.

Signs and symptoms

The typical signs and symptoms associated with a sprain are the main signs of inflammation:

  • localized pain
  • swelling
  • loss of function

Joints involved

Although any joint can experience a sprain, some of the more common include:

Prevention

Sprains can best be prevented by proper use of safety equipment (wrist, ankle guards), warm-ups and cool-downs (including stretching), being aware of your surroundings and maintaining strength and flexibility. Physical conditioning is the best way to avoid or lessen the degree of sprains.

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