Introduction to sprain and strains
Sprain refers to the over stretching or tearing of the tissues known as ligaments that connect the bones at the joints while strain is the overstretching or tearing of a muscle or tendon (tissue that connects the muscle to a bone). This is a common condition that may be associated with day-to-day activities, sports or certain incidents like jumping, falling or sudden movements of the muscles or joints. Sprains or strains may be noticed in the neck, hands, wrists, hips, legs, knees and ankle. Sprains and strains may either be mild in nature resulting in minor restriction of movements or may be severe enough to cause immobility for several days or weeks.1, 4, 5
Signs and Symptoms of sprain and strains
Sprains and strains are characterized by pain of varying severity based on the severity of the muscle or tendon injury. Swelling or redness over the affected area that may at times be painful to touch may also be noticed soon after. The ability to bend or extend the muscle or the associated joint may be reduced due to the pain and the swelling.
Causes of sprain and strains
Sprains or strains of the muscles or tendons may occur due to factors such as abnormal positioning of the head and neck while watching television, working on a computer for long durations, reading books in an awkward position, bending over the desk while working, sleeping in an awkward position and sudden twisting of the body while performing exercises.
Overuse of the muscles may be noticed in most of the individuals that makes them vulnerable to be strained or sprained. Repeated overuse of the knees and ankles as in walking, running or squatting is a common example. Overuse of the knees and ankles is more frequently observed in case of athletes such as gymnasts, runners or cyclists. Trauma to the joint ligaments while running, jumping or sudden twisting also results in significant pain in these joints. 1, 2, 5
Risk Factors for sprain and strains
Awkward positioning of the body while performing day-to-day activities is the most common risk factor associated with an increased incidence of sprains and strains. Athletics or other sports are prone to overuse of the muscles and joints along with an increased risk of falls or awkward twisting of the muscles.
Diagnosis of sprain and strains
The diagnosis of sprains and strains is based on the history of the fall, awkward positioning of the body or sports injuries and the symptoms or signs associated with it. In severe cases, an examination by a doctor is required.
The doctor may perform certain physical tests such as bending or extending the legs and hands, applying pressure on the joints, moving or rotating the ankles in order to check for any underlying injuries and the extent of movements possible. These procedures are carried out to verify the stiffness in the muscles or ligaments and assess the severity of the condition. Radiographs of the affected joint along with MRI and CT scan may be advised in certain cases to rule out the presence of other abnormalities.
Treatment of sprain and strains
Pain related to overuse at home or due to physical activities generally respond to certain simple steps such as rest. Weight-bearing exercises or lifting heavy objects must be avoided till the pain is reduced. Applying ice packs for about 15 min once in an hour initially and 3–4 times in a day after that also helps in reducing the pain and swelling. After 48 h of the injury, application of heat packs may be helpful in reliving the symptoms. Gentle massage in the area of stiffness (not to be performed if it is painful) usually improves blood circulation and relaxes the stiff muscles. Whenever possible, the affected portion must be rested at an elevated position while sitting or lying down. Crepe bandages or elastic sleeves, which are available as over-the-counter products may be applied on the knees, arms, wrists, elbows or ankles to reduce the swelling. Common painkillers such as acetaminophen or ibuprofen that are also available over-the-counter are helpful in reducing the pain.
A doctor should always be consulted when:
- The pain is severe
- Symptoms do not improve after 2–3 days of home treatment
- The fall was from a significant height
- Major injury during sports
- Visible deformation of the joint is present
- There is a clicking or popping sound heard when the joint is bent or flexed
Depending on the severity of the sprain or strain, the doctor may advise stronger pain killing medications or apply a crepe bandage or plaster to immobilize the affected joint. Surgical correction of the muscle or ligament tear may be required at times following which the individual may be required to rest for a few weeks to months. 2, 3, 5– 7
Alternative therapies for sprain and strains
Other alterative therapies that help in relieving the pain include massage, physiotherapy and acupuncture.
Prevention of sprain and strains
Warming up exercises and stretching before sports is always advised. Wearing proper footwear prevents injuries that occur due to slipping or twisting. Simple steps such as sitting straight, adjusting the computer monitor to a comfortable height, using a comfortable pillow while sitting or sleeping and not cradling the phone on the shoulders while speaking, go a long way in better health of the muscles. Staying fit with proper exercises is helpful in toning the muscles to prevent stiffness.
Complications for sprain and strains
In the absence of any underlying conditions, there are no complications associated with sprains and strains other than temporary restriction of movements.
Living with Sprains and Strains
The pain may either persist for a few days to weeks while at times it may persist for a few months with associated immobility. The recovery depends on the severity of sprain or strain and complete recovery is usually noted.
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