Sprains and Strains

By Dr. Loretta Lanphier, ND, CN, HHP, CH

The easiest way to sprain an ankle or strain a muscle is to overexert yourself at a sport or physical endeavor that you are not used to doing. Remember that the next time you participate in the family football game after Thanksgiving dinner. But, the fellowship may be worth the risk, because most sprains and strains are relatively harmless, although they may cause you to be out of commission for a few days. Let’s find out what causes them and how to avoid them.

What Are Sprains and Strains?

Sprains and strains are usually minor injuries that result in swelling and pain around a joint or muscle. So what’s the difference between the two?

  • A sprain involves injury to ligaments, which are fibrous tissues that connect bone to bone. Sprains result in a torn or stretched ligament.  They’re kind of like the sway bars on your car. They help to stabilize your body, and prevent excessive movement of the joints. Sprains often occur in the knees, ankles, wrists, and fingers. Sports that involve rapid changes in direction or collisions with other players can easily foster sprains.
  • On the other hand, a strain involves the stretching or tearing of a muscle. This can happen suddenly  (acute strain) or by overusing a muscle over time (chronic strain). Another common name for strains is pulled muscles. They commonly occur in the back and leg muscles, especially the hamstring.

Sprains and strains can happen to any one of any age, but sprains in particular are more likely to affect people over the age of 8 years old. The ligaments in kids under 8 are tighter and less flexible, so they are more likely, unfortunately, to break a bone than to tear a ligament. If you are active in sports, you are more likely to experience these types of injuries. However, the reverse can be true as well. If you are too inactive, and you must make a sudden move when slipping on the ice, for example, you may be susceptible to injury as well. Sprains can also be progressive, in the sense that if you sprain a ligament several times, it may become unstable and more likely to cause future injuries in the same location.

What Are the Symptoms of Sprains and Strains?

Both of these types of injuries are classified by the severity of the incident: mild, moderate, and severe.

Sprains can sometimes, but not always, be a bit more serious than strains. They often lead to fast and painful swelling of the affected area.

Mild sprains involve a significant stretch or minor tear of the ligament. It’s a bit sore, and may hurt more with movement, but there is probably not much swelling and you are able to bear weight on the affected joint.

Moderate sprains result in a torn ligament. There may be quite a bit of swelling and discoloration at the point of injury, and you may have a hard time putting full weight on the joint or walking on it if it is a leg injury.

Severe sprains may completely rupture the ligament with a serious tear. You may have trouble moving the joint at all without intense pain, and putting weight on it is out of the question. Sometimes it is hard to tell if you have a severe sprain, or have actually broken or dislocated the bone. Some severe sprains will require surgery to repair the damage.

Strains are generally less serious, and typically heal much faster than sprains.

  • Mild strains are usually no big deal, and you may have no more than a sore muscle for a couple of days.
  • Moderate strains involve a partial muscle tear, and usually exhibit some swelling and bruising. It may take several weeks to be back to normal.
  • Severe strains completely rip a muscle apart. There is often a significant amount of swelling and bruising. In extreme cases, if the muscle has completely torn away from the bone, you may need surgery.

Sometimes it’s hard to know, especially right after an injury, just how serious it is. Should you just walk it off, or does it need more attention and care? Here are a couple of tips that may help:

  • If you can’t bear weight on an injured area, especially shortly after the injury, it’s a pretty good bet that you have more than a minor sprain or strain on your hands (or feet, as the case may be). It would probably be a good idea to stop your activity and get home as soon as possible and monitor the situation.
  • If you hear a popping sound, it’s a good indicator that you have a pretty serious injury. I would suggest going right to the doctor or emergency room.
  • If you suspect a severe sprain, don’t put off getting prompt medical care. If you do, you could end up with chronic pain or long-term joint damage.
  • Keep an eye on even “minor” injuries. If they get worse or don’t get better in a few days, it may be a worse situation than you first thought.

Are There Factors That Can Affect my Chances of Sprains and Strains?

  • Poor conditioning can be one of your worst enemies when playing a sport. A good saying to remember is: “Get in shape to play your sport, don’t play your sport to get in shape.” Starting out in poor physical condition is a sure invitation to injury.
  • Always warm up first:  Even if you are in excellent shape, and consider yourself to be on top of your game, stretch and warm up slowly before going out on the playing field. Stretching and winding down after the activities is recommended as well. Both of these habits will help prevent many injuries, including sprains and strains.
  • Practice your technique:  Many injuries can be avoided by proper technique. Learn the right way to make the moves that are common in your sport of choice. Not only will you be a better competitor, but you will spend less time on the sidelines due to injuries as well.
  • Braces or ace bandages can help, especially in areas where you have experienced injuries before. But the best brace is actually your own “muscle brace.” By that I mean, when recovering from an injury, build up the strength of the muscles associated with that particular joint. This is the most effective way to prevent future injuries.

How About Some Self-Care Tips?

As I stated above, most sprain and strain injuries are not serious enough to necessitate a visit to the doctor or hospital. Evaluate the situation, and get medical treatment by all means if the situation calls for it. However, if you can care for it yourself, remember the acronym PRICE. It stands for:

  • Protection:  Immobilize the injured area as quickly as possible. Wrap it in a sling or Ace bandage, and try to move it as little as possible. Also attempt to put as little weight on it as possible. Use crutches or have a friend help you if you must move around. Even a cane can be helpful to baby your wound and give it time to heal.
  • Rest:  Give yourself time to heal by resting and avoiding any movement or activity that causes pain. However, this R should have an asterisk next to it because too much rest can make matters worse. Rest the injured area, but don’t eliminate all physical activity as this will only make it a longer healing process, and also tend to let the rest of your body get out of shape during recovery. In most cases, you should begin to gently and gradually use the injured area after a couple of days, providing the situation is getting better and not worse.
  • Ice: Get ice on the wound as soon as possible after the injury, and keep it on for about 20 minutes every two –three hours that you are awake. Continue this pattern for the first 48-72 hours. Make sure you wrap the ice in a cloth to prevent freezer burn or frost bite.
  • Compression:  Wrapping the area with an elastic bandage can help reduce swelling. Always begin to wrap at the farthest point away from your heart, and don’t wrap it too tightly. You don’t want to cut off circulation. Loosen the wrap if the pain increases, or you notice swelling outside of the wrap.
  • Elevation:  Always elevate the injured area above your heart, especially while sleeping. This will help drain off extra fluid and help reduce swelling.

In the event of a more serious injury, typical treatments may include a cast, or even surgery in some cases. Severe sprains are often put in a cast for several weeks and observed to see how the healing process is coming along. If it does not heal on its own, surgery may be called for. The extent of treatments often depends on the age and physical condition of the patient. For example, a professional athlete in his twenties has a lot more at stake than a middle-aged weekend softball player.

For most people, over the counter pain medication is enough to help alleviate the pain during recovery. That combined with PRICE will make most folks comfortable enough that they are not suffering too badly. A little ice, rest and relaxation, and down time is usually all one needs to get back in the swing of every day activities. However, it would probably be a good idea to back off from sports activities for several weeks until you are confident the injury is completely healed. The last thing you want is to get back in the game too soon and suffer another injury.

An active lifestyle is a wonderful habit, so don’t get scared off from physical exercise or sports just because you have had an injury. Learn what you can from the experience about getting in better shape and learning better techniques to avoid future injuries. If one activity is getting to be too much for you as you get older, then switch to another one, but be sure to pick something you really enjoy doing. Sometimes a change of pace and some new challenges can breathe a bit of new life into your daily routine.

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