Sprains and strains

Introduction

Although Sprain and Strains are considered as the minor injuries of soft tissues like muscles, tendons, and ligaments, but they can be significant due to their symptoms and frequency. Sprain and Strains are most commonly occurring sports injuries, which can cause pain, swelling and functional disability. It can also occur in high impact exercises. Even though, it is difficult to differentiate a strain from a sprain, both the condition starts with an inflammatory response and is treated in the same way.

Sprain injury to the ankle ligament

Sprain:

Usually, a sprain occurs due to the tearing of the ligament within a joint or the joint capsule, caused by sudden and forceful movement. Both the ligament and capsule are responsible for the joint stability. So, any damage to the joint, ligament and capsule can cause joint instability, with the symptoms like pain, swelling, and limitations in the range of motion.

The parts of your body that are more prone to have sprains are your ankles, knees, and wrists. An ankle sprain can occur when the foot turns inward, placing extreme stress on the outer ankle ligaments. A sprained knee can be the result of a sudden turn, and a wrist sprain can occur when falling on an outstretched hand.


Depending on the severity, the sprain is classified as following:

Torn ligament leading to sprain

Grade 1 sprain (mild):

It occurs due to the mild stretching and the damage to the ligament.

Grade 2 sprain (moderate):

In this class, the patient will have the partial tear of the ligament, causing abnormal looseness in the joint, particularly while it moves in a certain direction.

Grade 3 sprain (severe):

In grade 3 sprain, the patient will have the complete ligament tear, which leads to significant instability, making the joint nonfunctional.

Treatment for mild sprains includes rice therapy, and sometimes physical therapy exercises. Moderate sprains can be treated with bracing for some period. More severe sprains may require surgery to repair the torn the ligaments.

RICE means for rest, ice, compression and elevation:

RICE therapy for acute injuries

Rest:

Take a break from the activity that caused the injury. Your doctor may recommend that you use crutches to avoid putting weight on the leg.


Ice:

Use cold compresses for 20 minutes at a time, several times a day. Do not apply ice directly to the skin.

Compression:

To prevent additional swelling and blood loss, by using an elastic compression bandage.

Elevation:

To reduce swelling, elevate the injured part.

Strain

On the other hand, a Strain is caused by overstretching or tearing of a muscle or tendon. The strain is common in running or jumping and is typically seen in the runners when their hamstrings are strained. An acute muscle strain is characterized by the symptoms of a muscle spasm, pain, loss of strength, and disturbed range of motion. The chronic strain occurs gradually, due to the overuse or repetitive stress in the muscle and tendon.

Football, soccer, hockey, boxing, wrestling and other sports players are always at higher risk of strain. Gymnastics, tennis, rowing, golf and other sports that require extensive gripping are likely to have the incidences of strains in their hands. Likewise, elbow strains are frequently seen in the racket sports persons.

The recommended treatment for a strain is same as for a sprain: RICE- rest, ice, compression, and elevation. This should be followed by simple exercises to get relief of the pain, and to restore the mobility. Surgery may be required for a more serious tear.

Injured leg muscle classified as strain

Physiotherapy management for sprain and strains:

Physiotherapy can accelerate the healing process in sprain and strain, ensuring the optimal results and also reduces the likelihood of recurrence.

The physiotherapy treatment may include:

Physiotherapy management for strain and sprain
  • Soft tissue manipulation
  • Joint mobilization
  • Electrotherapy modalities for pain relief (e.g., ultrasound)
  • Anti-inflammatory (NSAIDs) tips
  • Crutches
  • The use of heel wedges
  • Ankle taping
  • Braces
  • Cryotherapy
  • Exercises to improve mobility, strength and balance
  • Hydrotherapy
  • Education
  • Activity modification tips
  • Bio-mechanical correction (posture)
  • Shoe tips
  • Dry needling
  • Prescription orthotics.
  • Prevention of Strain and Sprain:

    Most of the injuries usually occur when people suddenly increase the duration and frequency of their activities. Many soft tissue injuries can be prevented by proper conditioning, training, and equipment. Some of the important preventive measures are mentioned below to avoid the occurrence of Sprain and Strain.

    Change of position:

    Do not sit in one position for a long duration. Always take some breaks to move and change the position. Use a comfortable chair that gives good support to your lower back.

    Lifting Object:

    Lift any object carefully. Keep your back straight and bend your knees while you lift the object. Keep the object close to your body, avoid twisting at the same time.

    Prevent falls:

    Prevent falls by taking some precautions like avoid the slippery floors, hold the rails when climbing the stairs, and keeping your floor uncluttered.

    Proper technique of exercise:

    Regular exercise helps keep the muscles and tendons strong. But at the same time, it is equally important to do so with proper technique to prevent the muscle strain.

    Use the right equipment

    Replace your sports shoes as they wear out. Always wear comfortable shoes which fit properly, and also light enough to release the body heat.

    Balanced fitness

    Practice a balanced fitness program which includes cardio, strength training, and flexibility. Add any new activity or exercise cautiously. Do not try to take on too many activities at one time. It is best not to add more than one or two new training activities at a time.

    Drink water

    Drink enough water to prevent dehydration, heat exhaustion, and heat stroke. Drink 1 liter of water 15 minutes before you start exercising. Have a glass of water every 20 minutes or so while you exercise.

    Calm down

    Minimize or decrease the speed of your movements for at least 10 minutes before you stop the exercise completely.

    Break

    Should give 1 or 2 days of break from the vigorous exercise, and take rest when tired. Try to do at least 30 minutes of moderate physical activity every day. If you cannot manage the time, you can divide it into 10 minutes throughout the day.

    So, the recovery period of the sprain and strain mainly depends on the evaluation done by your physician. Once your injury is confirmed, your doctor will develop the treatment plan accordingly. With a correct treatment and care, one can get rid of the sprain and strain within a short period of time, without any long-term negative effect.