Sprains and Strains Injuries

A sprain is an injury to a ligament. A ligament is a thick, tough, fibrous tissue that connects bones together. Commonly injured ligaments are in the ankle, knee, and wrist. The ligaments can be injured by being stretched too far from their normal position. The purpose of having ligaments is to hold your skeleton together in a normal alignment — ligaments prevent abnormal movements. However, when too much force is applied to a ligament, such as in a fall, the ligaments can be stretched or torn; this injury is called a sprain.

A strain is an injury to a muscle or tendon. Muscles move your skeleton in an amazing variety of ways. When a muscle contracts, it pulls on a tendon, which is in turn connected to your bone. Muscles are made to stretch, but if stretched too far, or if stretched while contracting, an injury called a strain my result. A strain can either be a stretching or tear of the muscle or tendon.

Young man with an injury
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Causes of Sprains and Strains

A sprain is caused by a ligament being stretched too far. Ligaments are very strong and can allow a joint to move, but they do not have much elasticity. That means that when the ligament is stretched too far, tears can occur. A ligament tear can be partial or complete. Typically, physicians will indicate the severity of the injury by grading the ligament damage. Grade 1 and grade 2 injuries are usually partial injuries to the ligament, whereas a grade 3 injury is often a complete tear.

Strains are injuries to muscles or the tendons that attach the muscles to your bones. By pulling too far on a muscle, or by pulling a muscle in one direction while it is contracting (called an 'eccentric contraction') in the other direction can cause injuries within the muscle or tendon. Strains can also be caused by chronic activities that develop an overstretching of the muscle fibers.

Many sports place participants at risk for sprains and strains; these include football, basketball, gymnastics, volleyball, and many others. These injuries also often occur in normal everyday activities such as slipping on ice, falling on your wrist, or jamming a finger. Repetitive activities may also cause a sprain or strain.

Signs of Sprains and Strains

The most common symptoms of a sprain or strain include:

  • Pain at the location of the injury
  • Swelling and bruising of the injured area
  • Difficulty bending an injured joint
  • Spasm of an injured muscle

Symptoms will vary with the intensity of the injury. If you are unsure of the injury or of the severity of the condition, you should seek professional help from an athletic trainer, physical therapist, or medical professional.

When to Get Help

Knowing when to get help is important. Many sprains and strains can be managed with simple steps on your own, but you should be sure something more serious is not causing your pain. Here are some signs that you may need help with your condition:

  • You have severe pain and cannot put any weight on the injured extremity
  • The injured area looks deformed when compared to the opposite side
  • You cannot move the injured area
  • You cannot walk because of pain
  • Your limb buckles or gives way when you try to move
  • You've injured this part before
  • You have severe swelling or swelling that doesn't improve with rest and elevation

Treatment Steps

Treatment of sprains and strains is often accomplished with the "RICE" method. If you are unsure of the severity of your sprain or strain, talk to your doctor before beginning any treatment or rehab. The following is an explanation of the RICE method of treatment for sprains and strains:

  • Rest:
  • The first 24-48 hours after the injury is considered a critical treatment period and activities need to be curtailed. Gradually use the injured extremity as much as tolerated, by try to avoid any activities that cause pain. Often using a splint, sling, or crutches is necessary to adequately rest the injured body part.
  • Ice:
  • For the first 48 hours post-injury, ice the sprain or strain 20 minutes at a time every 3-4 hours. The ice pack can be a bag of frozen food, allowing you to be able to re-use the bag. Another popular treatment method is to fill paper cups with water then freeze the cup. Use the frozen cube like an ice cream cone, peeling away the paper as the ice melts. Do NOT ice a sprain or strain for more than 20 minutes at a time!! You will not be helping heal the injury any faster, and you can cause damage to the body.
  • Compression:
  • Use compression when elevating a sprain or strain in early treatment. Using an Ace bandage, wrap the area overlapping the elastic wrap by one-half of the width of the wrap. The wrap should be snug, but not cutting off circulation to the extremity. So, if your fingers or toes become cold, blue, or tingle, re-wrap!
  • Elevate:
  • Keep your sprain or strain as best possible — try to get it higher than your heart if possible. Elevate at night by placing pillows under your arm or leg.
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  1. American Academy of Orthopaedic Surgeons. Sprains, strains and other soft-tissue injuries. Updated June 2020.