Sprain & Strains

Sprains are injuries to joints where the supporting ligaments are stretched or partially torn (fibrous bands that connect bones in a joint). Most occur at the wrist, ankle, knee and thumb joints.

Strains are stretching or tearing of muscle mass or tendon usually during strenuous exertion. Usually seen in the back, calf or thigh (hamstring muscles). Strains may be associated with bleeding into the muscle (hematoma).

Sometimes these injuries can be confused with fractures. If severe pain or localized point tenderness may suggest a broken bone, treat as fracture. Do not move the individual. Call 911.

Symptoms and Signs of Sprains & Strains: 

Causes:

• 1. Sprains - Ligament is stretched or torn

     1. 1. Ankle: walking on uneven surface

        2. Knee: pivoting during athletic activity

        3. Wrist: landing with outstretched hands during fall

        4. Thumb: Skiing or racquet sports, etc.

  2. Strains - Acute: Muscle is pulled even torn abruptly

• • • 1. Slipping on ice

      2. Running, jumping or throwing

      3. Heavy Lifting, etc.

• 3. Strains- Chronic: Prolonged repetitive movement

• • • 1. Tennis

      2. Rowing

      3. golf

      4. cycling

Risk Factors:

• 1. Poor conditioning: Leaves muscles weak and more likely to sustain injury.

  2. Fatigue: Tired muscles are less likely to give support.

  3. Improper warm up: Proper warm up loosen muscles and increase joint mobility.

TREATMENT:

• 1. Consult a health care provider if any of the following are noted:

     1. Severe pain

     2. Unable to walk more than 4 steps without pain

     3. Can't move an affect joint

     4. Numbness

  2. Home treatment for MILD sprains and strains (RICER)1:

     2. • R: Rest. Stop whatever you're doing.

        • I: Ice area for 15 minutes every 2 hours for the first 24 hours, then 15 minutes every 4 hour next 24 hrs (some suggest ice for 15 minutes, wait 1 hour, repeat for up to 24 hours).

        • C: Wrap with compression dressing firmly, BUT not tightly2.

        • E: Elevate to reduce swelling.

        • R: Refer to your health care provider if symptoms worsen or do not begin to resolve.

1Do not rub or message affected area which may increase inflammation and swelling.

2Start below affected area working your way upward and overlapping the dressing or Ace bandage.

Remember, These cases may be difficult to distinguish from fractures, in which case, do not move the patient and call 911. The patient may well need an xray of the involved area and treatment by a medical specialist.

Addendum for those trained in First Aid:

The following tests can determine severity where symptoms are not overwhelming and fractures are not a concern:

• • "Weight Bearing": Have the individual apply steady force along the long bone; ask them to stand. For wrists, have them make a fist with each hand and place on their chest. Ask them to push the fists together. Stop if pain occurs and treat as possible fracture.

  • "Passive Movement": Do this only if weight bearing is possible. Test full range of motion. A sprain will have pain in one direction only. Pain in two directions suggest possible fracture; then treat as such.

Achilles Tendon Injury:

• Thompson's Test For Achilles Tendon Tear   a test used by phycians in the ER, demo from Fitness On The Run

• PCHS Sports Medicine Achilles Tendon Tape Job   From PCHSSprtsmed1234

• A Taping Technique for use in Achilles Tendon Injuries   From sportsinjuryclinic.net

• Achilles Tendon rupture ,tear, tendonitis - Everything You Need To Know   From Nabil A. Ebraheim, M.D., Univerity of Toledo Medical Center.

References:

• 1. Sprains and strains   from the Mayo Clinic

  2. Sprains and Strains   National Institute of Arthritis and Musculoskeletal and Skin Diseases

  3. Sprains and Strains Treatment   from WebMD

  4. Sprains and Strains Treatment   National Health Services, UK

  5. Blogspot   from 2GSIM MARTA MOYA