Sprains And Strains

From orthopedics.about.com and firstaid.about.com

What is the difference between a sprain and a strain?

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.

What causes a sprain?

As said earlier, a sprain is caused by a ligament being stretched too far. A common sprain is an injury we often call a 'twisted ankle.' This injury often occurs in activities such as running, hiking, and basketball. People will fall or step on an uneven surface (in basketball this is often another player's foot) and roll their foot to the inside. This stretches the ligaments on the outside of the ankle, called the talofibular and calcaenofibular ligaments.

Sprains are commonly graded according to the extent of the injury. Grade I and Grade II ankle sprains can usually be treated conservatively with treatments such as icing and physical therapy. Grade III ankle sprains can place individuals at higher risk for permanent ankle instability, and an operation may be a necessary part of treatment.

What causes a strain?

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.

What activities are common causes of these injuries?

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 a slip on ice, a fall on your wrist, or jamming a finger. Repetitive activities may also cause a sprain or strain.

While not all sprains and strains can be prevented, a few helpful tips can help you avoid this nuisance of an injury:

  • Stretch before you workout
  • Wear proper footwear for the activity
  • Warm up properly before activities
  • Do not run on icy or uneven surfaces

What are the symptoms of strain or sprain?

The symptoms of a sprain are typically pain, swelling, and bruising of the affected joint. Symptoms will vary with the intensity of the injury; more significant ligament tears (Grade III injuries) cause an inability to use the affected joint and may lead to joint instability. Less serious injuries (Grade I injuries) may only cause pain with movement.

Treatment

Treatment of a 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 vegetables (peas or corn), 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 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 tissues! Learn how to ice an injury here…

  • 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.

You should seek a doctor's care if

  • there is severe pain
  • victim unable to put any weight on it
  • it looks different than uninjured joint (swelling doesn't count)
  • victim can't move it
  • victim can't walk more than four steps on it
  • there is numbness in any part of it
  • redness or red streaks spread out from the injury.
  • it has been sprained several times before
  • there is pain, swelling, or redness over a bony part of your foot
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