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| Sprain Strain |
What Is the Difference Between a Sprain and a Strain?
A sprain is a stretch and/or tear of a ligament (a band of
fibrous tissue that connects two or more bones at a joint). One
or more ligaments can be injured at the same time. The
severity of the injury will depend on the extent of injury
(whether a tear is partial or complete) and the number of
ligaments involved.
A strain is an injury to either a muscle or a tendon (fibrous
cords of tissue that connect muscle to bone). Depending on
the severity of the injury, a strain may be a simple overstretch
of the muscle or tendon, or it can result from a partial or
complete tear.
What Causes a Sprain?
A sprain can result from a fall, a sudden twist, or a blow to the
body that forces a joint out of its normal position and
stretches or tears the ligament supporting that joint. Typically,
sprains occur when people fall and land on an outstretched
arm, slide into a baseball base, land on the side of their foot, or
twist a knee with the foot planted firmly on the ground.
Where Do Sprains Usually Occur?
Although sprains can occur in both the upper and lower parts
of the body, the most common site is the ankle. More than
25,000 individuals sprain an ankle each day in the United States.
The ankle joint is supported by several lateral (outside)
ligaments and medial (inside) ligaments. Most ankle sprains
happen when the foot turns inward as a person runs, turns,
falls, or lands on the ankle after a jump. This type of sprain is
called an inversion injury. The knee is another common site for
a sprain. A blow to the knee or a fall is often the cause; sudden
twisting can also result in a sprain.
Sprains frequently occur at the wrist, typically when people fall
and land on an outstretched hand. A sprain to the thumb is
common in skiing and other sports. This injury often occurs
when a ligament near the base of the thumb (the ulnar
collateral ligament of the metacarpo-phalangeal joint) is torn.
What Are the Signs and Symptoms of a Sprain?
The usual signs and symptoms include pain, swelling, bruising,
instability, and loss of the ability to move and use the joint
(called functional ability). However, these signs and symptoms
can vary in intensity, depending on the severity of the sprain.
Sometimes people feel a pop or tear when the injury happens.
Doctors closely observe an injured site and ask questions to
obtain information to diagnose the severity of a sprain. In
general, a grade I or mild sprain is caused by overstretching or
slight tearing of the ligaments with no joint instability. A person
with a mild sprain usually experiences minimal pain, swelling,
and little or no loss of functional ability. Bruising is absent or
slight, and the person is usually able to put weight on the
affected joint.
A grade II or moderate sprain is caused by further, but still
incomplete, tearing of the ligament and is characterized by
bruising, moderate pain, and swelling. A person with a
moderate sprain usually has more difficulty putting weight on
the affected joint and experiences some loss of function. An x
ray may be needed to help the health care provider determine if
a fracture is causing the pain and swelling. Magnetic resonance
imaging is occasionally used to help differentiate between a
significant partial injury and a complete tear in a ligament, or
can be recommended to rule out other injuries.
People who sustain a grade III or severe sprain completely tear
or rupture a ligament. Pain, swelling, and bruising are usually
severe, and the patient is unable to put weight on the joint. An
x ray is usually taken to rule out a broken bone. When
diagnosing any sprain, the provider will ask the patient to
explain how the injury happened. He or she will examine the
affected area and check its stability and its ability to move and
bear weight.
What Causes a Strain?
A strain is caused by twisting or pulling a muscle or tendon.
Strains can be acute or chronic. An acute strain is associated
with a recent trauma or injury; it also can occur after
improperly lifting heavy objects or overstressing the muscles.
Chronic strains are usually the result of overuse: prolonged,
repetitive movement of the muscles and tendons.
Where Do Strains Usually Occur?
Two common sites for a strain are the back and the hamstring
muscle (located in the back of the thigh). Contact sports such
as soccer, football, hockey, boxing, and wrestling put people at
risk for strains. Gymnastics, tennis, rowing, golf, and other
sports that require extensive gripping can increase the risk of
hand and forearm strains. Elbow strains sometimes occur in
people who participate in racquet sports, throwing, and contact
sports.
What Are the Signs and Symptoms of a Strain?
Typically, people with a strain experience pain, limited motion,
muscle spasms, and possibly muscle weakness. They can also
have localized swelling, cramping, or inflammation and, with a
minor or moderate strain, usually some loss of muscle function.
Patients typically have pain in the injured area and general
weakness of the muscle when they attempt to move it. Severe
strains that partially or completely tear the muscle or tendon
are often very painful and disabling.
How Are Sprains and Strains Treated?
Reduce Swelling and Pain
Treatments for sprains and strains are similar and can be
thought of as having two stages. The goal during the first
stage is to reduce swelling and pain. At this stage, health care
providers usually advise patients to follow a formula of rest, ice,
compression, and elevation (RICE) for the first 24 to 48 hours
after the injury (see the box below). The provider may also
recommend an over-the-counter or prescription nonsteroidal
anti-inflammatory drug, such as aspirin or ibuprofen, to help
decrease pain and inflammation.
For people with a moderate or severe sprain, particularly of the
ankle, a hard cast may be applied. This often occurs after the
initial swelling has subsided. Severe sprains and strains may
require surgery to repair the torn ligaments, muscle, or
tendons. Surgery is usually performed by an orthopaedic
surgeon.
It is important that moderate and severe sprains and strains be
evaluated by a health care provider to allow prompt,
appropriate treatment to begin. This box lists some signs that
should alert people to consult their provider. However, a person
who has any concerns about the seriousness of a sprain or
strain should always contact a provider for advice.
Begin Rehabilitation
The second stage of treating a sprain or strain is rehabilitation,
whose overall goal is to improve the condition of the injured
area and restore its function. The health care provider will
prescribe an exercise program designed to prevent stiffness,
improve range of motion, and restore the joint's normal
flexibility and strength. Some patients may need physical
therapy during this stage. When the acute pain and swelling
have diminished, the provider will instruct the patient to do a
series of exercises several times a day. These are very
important because they help reduce swelling, prevent stiffness,
and restore normal, pain-free range of motion. The provider
can recommend many different types of exercises, depending
on the injury. A patient with an injured knee or foot will work
on weight-bearing and balancing exercises. The duration of the
program depends on the extent of the injury, but the regimen
commonly lasts for several weeks.
Another goal of rehabilitation is to increase strength and regain
flexibility. Depending on the patient's rate of recovery, this
process begins about the second week after the injury. The
provider will instruct the patient to do a series of exercises
designed to meet these goals. During this phase of
rehabilitation, patients progress to more demanding exercises
as pain decreases and function improves.
The final goal is the return to full daily activities, including
sports when appropriate. Patients must work closely with their
health care provider or physical therapist to determine their
readiness to return to full activity. Sometimes people are
tempted to resume full activity or play sports despite pain or
muscle soreness. Returning to full activity before regaining
normal range of motion, flexibility, and strength increases the
chance of reinjury and may lead to a chronic problem.
The amount of rehabilitation and the time needed for full
recovery after a sprain or strain depend on the severity of the
injury and individual rates of healing. For example, a mild ankle
sprain may require up to 3 to 6 weeks of rehabilitation; a
moderate sprain could require 2 to 3 months. With a severe
sprain, it can take up to 8 to 12 months to return to full
activities. Extra care should be taken to avoid reinjury.
Can Sprains and Strains Be Prevented?
There are many things people can do to help lower their risk of
sprains and strains:
* Avoid exercising or playing sports when tired or in pain.
* Maintain a healthy, well-balanced diet to keep muscles strong.
* Maintain a healthy weight.
* Practice safety measures to help prevent falls (for example,
keep stairways, walkways, yards, and driveways free of clutter;
anchor scatter rugs; and salt or sand icy patches in the winter).
* Wear shoes that fit properly.
* Replace athletic shoes as soon as the tread wears out or the
heel wears down on one side.
* Do stretching exercises daily.
* Be in proper physical condition to play a sport.
* Warm up and stretch before participating in any sports or
exercise.
* Wear protective equipment when playing.
* Run on even surfaces.
Content Source NIAMS NIH GOV 2006
A sprain is a stretch and/or tear of a ligament (a band of
fibrous tissue that connects two or more bones at a joint). One
or more ligaments can be injured at the same time. The
severity of the injury will depend on the extent of injury
(whether a tear is partial or complete) and the number of
ligaments involved.
A strain is an injury to either a muscle or a tendon (fibrous
cords of tissue that connect muscle to bone). Depending on
the severity of the injury, a strain may be a simple overstretch
of the muscle or tendon, or it can result from a partial or
complete tear.
What Causes a Sprain?
A sprain can result from a fall, a sudden twist, or a blow to the
body that forces a joint out of its normal position and
stretches or tears the ligament supporting that joint. Typically,
sprains occur when people fall and land on an outstretched
arm, slide into a baseball base, land on the side of their foot, or
twist a knee with the foot planted firmly on the ground.
Where Do Sprains Usually Occur?
Although sprains can occur in both the upper and lower parts
of the body, the most common site is the ankle. More than
25,000 individuals sprain an ankle each day in the United States.
The ankle joint is supported by several lateral (outside)
ligaments and medial (inside) ligaments. Most ankle sprains
happen when the foot turns inward as a person runs, turns,
falls, or lands on the ankle after a jump. This type of sprain is
called an inversion injury. The knee is another common site for
a sprain. A blow to the knee or a fall is often the cause; sudden
twisting can also result in a sprain.
Sprains frequently occur at the wrist, typically when people fall
and land on an outstretched hand. A sprain to the thumb is
common in skiing and other sports. This injury often occurs
when a ligament near the base of the thumb (the ulnar
collateral ligament of the metacarpo-phalangeal joint) is torn.
What Are the Signs and Symptoms of a Sprain?
The usual signs and symptoms include pain, swelling, bruising,
instability, and loss of the ability to move and use the joint
(called functional ability). However, these signs and symptoms
can vary in intensity, depending on the severity of the sprain.
Sometimes people feel a pop or tear when the injury happens.
Doctors closely observe an injured site and ask questions to
obtain information to diagnose the severity of a sprain. In
general, a grade I or mild sprain is caused by overstretching or
slight tearing of the ligaments with no joint instability. A person
with a mild sprain usually experiences minimal pain, swelling,
and little or no loss of functional ability. Bruising is absent or
slight, and the person is usually able to put weight on the
affected joint.
A grade II or moderate sprain is caused by further, but still
incomplete, tearing of the ligament and is characterized by
bruising, moderate pain, and swelling. A person with a
moderate sprain usually has more difficulty putting weight on
the affected joint and experiences some loss of function. An x
ray may be needed to help the health care provider determine if
a fracture is causing the pain and swelling. Magnetic resonance
imaging is occasionally used to help differentiate between a
significant partial injury and a complete tear in a ligament, or
can be recommended to rule out other injuries.
People who sustain a grade III or severe sprain completely tear
or rupture a ligament. Pain, swelling, and bruising are usually
severe, and the patient is unable to put weight on the joint. An
x ray is usually taken to rule out a broken bone. When
diagnosing any sprain, the provider will ask the patient to
explain how the injury happened. He or she will examine the
affected area and check its stability and its ability to move and
bear weight.
What Causes a Strain?
A strain is caused by twisting or pulling a muscle or tendon.
Strains can be acute or chronic. An acute strain is associated
with a recent trauma or injury; it also can occur after
improperly lifting heavy objects or overstressing the muscles.
Chronic strains are usually the result of overuse: prolonged,
repetitive movement of the muscles and tendons.
Where Do Strains Usually Occur?
Two common sites for a strain are the back and the hamstring
muscle (located in the back of the thigh). Contact sports such
as soccer, football, hockey, boxing, and wrestling put people at
risk for strains. Gymnastics, tennis, rowing, golf, and other
sports that require extensive gripping can increase the risk of
hand and forearm strains. Elbow strains sometimes occur in
people who participate in racquet sports, throwing, and contact
sports.
What Are the Signs and Symptoms of a Strain?
Typically, people with a strain experience pain, limited motion,
muscle spasms, and possibly muscle weakness. They can also
have localized swelling, cramping, or inflammation and, with a
minor or moderate strain, usually some loss of muscle function.
Patients typically have pain in the injured area and general
weakness of the muscle when they attempt to move it. Severe
strains that partially or completely tear the muscle or tendon
are often very painful and disabling.
How Are Sprains and Strains Treated?
Reduce Swelling and Pain
Treatments for sprains and strains are similar and can be
thought of as having two stages. The goal during the first
stage is to reduce swelling and pain. At this stage, health care
providers usually advise patients to follow a formula of rest, ice,
compression, and elevation (RICE) for the first 24 to 48 hours
after the injury (see the box below). The provider may also
recommend an over-the-counter or prescription nonsteroidal
anti-inflammatory drug, such as aspirin or ibuprofen, to help
decrease pain and inflammation.
For people with a moderate or severe sprain, particularly of the
ankle, a hard cast may be applied. This often occurs after the
initial swelling has subsided. Severe sprains and strains may
require surgery to repair the torn ligaments, muscle, or
tendons. Surgery is usually performed by an orthopaedic
surgeon.
It is important that moderate and severe sprains and strains be
evaluated by a health care provider to allow prompt,
appropriate treatment to begin. This box lists some signs that
should alert people to consult their provider. However, a person
who has any concerns about the seriousness of a sprain or
strain should always contact a provider for advice.
Begin Rehabilitation
The second stage of treating a sprain or strain is rehabilitation,
whose overall goal is to improve the condition of the injured
area and restore its function. The health care provider will
prescribe an exercise program designed to prevent stiffness,
improve range of motion, and restore the joint's normal
flexibility and strength. Some patients may need physical
therapy during this stage. When the acute pain and swelling
have diminished, the provider will instruct the patient to do a
series of exercises several times a day. These are very
important because they help reduce swelling, prevent stiffness,
and restore normal, pain-free range of motion. The provider
can recommend many different types of exercises, depending
on the injury. A patient with an injured knee or foot will work
on weight-bearing and balancing exercises. The duration of the
program depends on the extent of the injury, but the regimen
commonly lasts for several weeks.
Another goal of rehabilitation is to increase strength and regain
flexibility. Depending on the patient's rate of recovery, this
process begins about the second week after the injury. The
provider will instruct the patient to do a series of exercises
designed to meet these goals. During this phase of
rehabilitation, patients progress to more demanding exercises
as pain decreases and function improves.
The final goal is the return to full daily activities, including
sports when appropriate. Patients must work closely with their
health care provider or physical therapist to determine their
readiness to return to full activity. Sometimes people are
tempted to resume full activity or play sports despite pain or
muscle soreness. Returning to full activity before regaining
normal range of motion, flexibility, and strength increases the
chance of reinjury and may lead to a chronic problem.
The amount of rehabilitation and the time needed for full
recovery after a sprain or strain depend on the severity of the
injury and individual rates of healing. For example, a mild ankle
sprain may require up to 3 to 6 weeks of rehabilitation; a
moderate sprain could require 2 to 3 months. With a severe
sprain, it can take up to 8 to 12 months to return to full
activities. Extra care should be taken to avoid reinjury.
Can Sprains and Strains Be Prevented?
There are many things people can do to help lower their risk of
sprains and strains:
* Avoid exercising or playing sports when tired or in pain.
* Maintain a healthy, well-balanced diet to keep muscles strong.
* Maintain a healthy weight.
* Practice safety measures to help prevent falls (for example,
keep stairways, walkways, yards, and driveways free of clutter;
anchor scatter rugs; and salt or sand icy patches in the winter).
* Wear shoes that fit properly.
* Replace athletic shoes as soon as the tread wears out or the
heel wears down on one side.
* Do stretching exercises daily.
* Be in proper physical condition to play a sport.
* Warm up and stretch before participating in any sports or
exercise.
* Wear protective equipment when playing.
* Run on even surfaces.
Content Source NIAMS NIH GOV 2006
| MEDICAL NOTES |
| RICE Therapy Rest Reduce regular exercise or activities of daily living as needed. Your health care provider may advise you to put no weight on an injured area for 48 hours. If you cannot put weight on an ankle or knee, crutches may help. If you use a cane or one crutch for an ankle injury, use it on the uninjured side to help you lean away and relieve weight on the injured ankle. Ice Apply an ice pack to the injured area for 20 minutes at a time, 4 to 8 times a day. A cold pack, ice bag, or plastic bag filled with crushed ice and wrapped in a towel can be used. To avoid cold injury and frostbite, do not apply the ice for more than 20 minutes. Compression Compression of an injured ankle, knee, or wrist may help reduce swelling. Examples of compression bandages are elastic wraps, special boots, air casts, and splints. Ask your provider for advice on which one to use, and how tight to safely apply the bandage. Elevation If possible, keep the injured ankle, knee, elbow, or wrist elevated on a pillow, above the level of the heart, to help decrease swelling. |
DISEASES AND
CONDITIONS
Acidosis
Acne
Acromegaly
Addison's Disease
Adrenal Crisis
Age. macular degn
Alzheimer's disease
Autoimmune
Hepatitis
Barrett's Esophagus
Cancer
Constipation
Colon Polyps
Crohns Disease
Cushing's Syndrm.
Diabetes
Erectile Dysfunction
Fecal Incontinence
Gallstones
Gastritis
Gastroenteritis
Gastroesophageal
Reflux (GERD)
Growth Hormone
Def.
Heartburn
Hemochromatosis
Hemorrhoids
Hyperparathyroidism
Hypertension
Inflam. Bowel Dis.
Kidney Stone
Liver Cirrhosis
Migraines
Multiple Sclerosis
Obesity
Osteorithritis
Osteoporosis
Pancreatitis
Parkinson's Disease
Peyronies' Disease
Prolactinoma
Psoriasis
Sprain and Strain
Stroke
Ulcerative Colitis
Urin. Incontinence
Vitiligo
CONDITIONS
Acidosis
Acne
Acromegaly
Addison's Disease
Adrenal Crisis
Age. macular degn
Alzheimer's disease
Autoimmune
Hepatitis
Barrett's Esophagus
Cancer
Constipation
Colon Polyps
Crohns Disease
Cushing's Syndrm.
Diabetes
Erectile Dysfunction
Fecal Incontinence
Gallstones
Gastritis
Gastroenteritis
Gastroesophageal
Reflux (GERD)
Growth Hormone
Def.
Heartburn
Hemochromatosis
Hemorrhoids
Hyperparathyroidism
Hypertension
Inflam. Bowel Dis.
Kidney Stone
Liver Cirrhosis
Migraines
Multiple Sclerosis
Obesity
Osteorithritis
Osteoporosis
Pancreatitis
Parkinson's Disease
Peyronies' Disease
Prolactinoma
Psoriasis
Sprain and Strain
Stroke
Ulcerative Colitis
Urin. Incontinence
Vitiligo