Sprain

Sprain
Specialty	Emergency medicine

A sprain (from the French espraindre - to wring) is an injury which occurs to ligaments caused by a sudden overstretching (for the muscle injury, see strain). Ligaments are usually only stretched, but if it is completely torn, a longer period of immobilization and surgical repair may be necessary.

Degrees

Although some signs and symptoms can be used to assess the severity of a sprain, the most definitive method is with the use of Magnetic Resonance Imaging (MRI). Sprains are graded in four degrees.

• The first degree is only a minor tear or stretch of a ligament.
• The second degree is a tear of a ligament, which is usually followed by pain or swelling.
• The third degree is a complete rupture.
• The fourth degree is the most severe and actually breaks the ligament, along with some small bones if severe enough, and requires surgery to repair.

Signs and symptoms

The typical signs and symptoms associated with a sprain are the cardinal signs of:

• inflammation
• localized pain
• swelling
• loss of function
• loss of normal limb function
• elasticity of ligament decrease

Joints involved

Although any joint can experience a sprain, some of the more common include:

• the ankle. It is the most common, and has been said that sprains such as serious ankle sprains are more painful and take longer to heal than actually breaking the bones in that area. See sprained ankle for more details.
• the knee. Perhaps one of the more talked about sprains is that to the anterior cruciate ligament (ACL) of the knee. This is a disabling sprain common to athletes, especially in basketball, football, and judo. See Anterior cruciate ligament injury.
• the fingers.
• the wrist.
• the toes.

Prevention

Sprains can best be prevented by proper use of safety equipment (wrist, ankle guards), warm-ups and cool-downs (including stretching), being aware of your surroundings and maintaining strength and flexibility. Physical conditioning is the best way to avoid or lessen the degree of sprains.

Treatment

The first modality for a sprain can be remembered using the acronym R.I.C.E.

• Rest: The sprain should be rested. No additional force should be applied on site of the sprain. If, for example, the sprain were an ankle sprain, then walking should be kept to a minimum.

• Ice: Ice should be applied immediately to the sprain to minimize swelling and ease pain. It can be applied for 20-30 minutes at a time, 3-4 times a day. Ice can be combined with a wrapping to minimize swelling and provide support.

• Compression: Dressings, bandages, or ace-wraps should be used to immobilize the sprain and provide support.

• Elevation: Keeping the sprained joint elevated above heart level will also help to minimize swelling.

Ice and compression (cold compression therapy) will not completely stop swelling and pain, but will help to minimize them as the sprain begins to heal itself. Careful management of swelling is critical to the healing process as additional fluid may pool in the sprained area.

External links

• More information and treatment at nhsdirect.nhs.uk