An overview of Sprain

A sprain happens when a ligament is stretched or torn. A ligament is a strong, fibrous band of rope-like tissue that connects two or more bones at a joint. When you have a sprain, you may have injured one or more ligaments. A sprain is different from a strain, even though sometimes the terms can get used interchangeably.

Ankle sprain: This type of sprain typically happens when the foot turns inward as you run, turn or land on the ankle after a jump.

Knee sprain: Typically, this occurs after a blow to the knee or a fall. Sudden twisting of the knee may result in a sprain.

Wrist sprain: This sprain often happens when you fall and land on an outstretched hand.

A sprain occurs when you overextend or tear a ligament while severely stressing a joint. Sprains often occur in the following circumstances:

Rolling your ankle — either while running, changing direction or landing from a jump.

Falling or slipping on a wet surface or uneven ground.

Taking a blow to the body, including contact sports that cause a direct hit or a shift in balance and falls.

Signs and symptoms will vary, depending on the severity of the injury, and may include:

1. Pain.

2. Bruising.

3. Limited ability to move the affected joint.

4. Swelling.

5. Hearing or feeling a "pop" in your joint at the time of injury.

The following steps may lower your risk for a sprain:

1. Wear protective footwear during activities that place stress on your ankle and other joints.

2. Make sure that shoes fit your feet properly.

3. Avoid high-heeled shoes.

4. Always warm-up and stretch before doing exercise and sports.

5. Avoid sports and activities for which you have not trained.

A sprain can be diagnosed in several ways, including:

1. Through your doctor: Your doctor will take a history and do a physical exam to see if the history and exam are consistent with an injury to the joint which could have injured one or more ligaments. They will check for swelling, range of motion and stability of the joint.

2. Through imaging tests: Orthopaedic or Sports Medicine specialists will start with an X-ray to make sure that there is not a broken bone. Although a ligament cannot be seen on an X-ray, it can be important to look at the spacing of the joint and to rule out a fracture. Depending on their exam or your response to initial treatment, higher imaging like an ultrasound or MRI may be required to further evaluate your injury.

Your healthcare provider will advise you to follow the PRICE method for the first 24 to 48 hours after the injury. PRICE stands for:

1. Protection: Try to immobilize an area of concern or stay off a weight bearing joint to prevent further motion and restore alignment. You may be advised to use a brace/splint or crutches to stay off the injured area.

2. Rest: Cut back your regular exercises and activities of daily living. An injury like a sprain requires a change in your normal routine to let the area heal.

3. Ice: Apply an ice pack to the injured area for 10 minutes. Do this four to eight times a day. You can use a cold pack, ice bag or plastic bag filled with ice wrapped in a towel. An even better way to ice the area of concern is to use an ice massage method — you can use an ice cube held in a washcloth or put water in a Dixie® cup into the freezer. After the cup is frozen, peel back the top of the cup so it is like a frozen push pop. Use a circular motion or back and forth motion over the area of concern. You only need three to five minutes to ice this because it will penetrate deeply into the area of concern. To avoid frost bite and cold injury, do not apply the ice for longer than 20 minutes at a time. Once you start to feel numb or uncomfortable — you should stop icing.

4. Compression: Compression (continuous pressure) of the injured area my help reduce swelling. Using an ACE bandage, you can wrap the affected area always from fingers towards the shoulder (on the upper body) or from your toes to your groin (lower body). This prevents swelling distal (away from the middle of your body) to where the injury is wrapped. A bandage should feel snug, but not so tight it is uncomfortable or cuts off your circulation. You can adjust as needed. An easier way to apply compression from your knee down is with compression stockings. These can be easily purchased online or over-the-counter.

5. Elevation: In order to help decrease swelling, keep the injured area elevated on a pillow. You should try to keep the injury above the level of your heart.

1. Fusion: Two or more bones are permanently fused together. Fusion immobilizes a joint and reduces pain caused by movement.

2. Joint replacement: A damaged, arthritic joint gets replaced with an artificial joint. Joint replacement preserves joint function and movement. Examples include ankle replacement, hip replacement, knee replacement and shoulder replacement.

Factors contributing to sprains include:

1. Environmental conditions. Slippery or uneven surfaces can make you more prone to injury.

2. Fatigue. Tired muscles are less likely to provide good support for your joints. When you're tired, you're also more likely to succumb to forces that could stress a joint.

3. Poor equipment. Ill-fitting or poorly maintained footwear or other sporting equipment can contribute to your risk of a sprain.