Tag: Physical therapy

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Definition:
A sprain (from the French espraindre – to wring) is an injury which occurs to ligaments caused by being stretched beyond their normal capacity and possibly torn. Muscular tears caused in the same manner are referred to as a strain. In cases where either ligament or muscle tissue is torn, immobilization and surgical repair may be necessary.

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Sprain. A sprain is a stretching or tearing of ligaments. Ligaments are tough bands of fibrous tissue that connect one bone to another. Common locations for sprains are your ankles and knees.

Strain. A strain is a stretching or tearing of muscle or tendon. People commonly call strains “pulled” muscles. Hamstring and back injuries are among the most common strains.

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.

Causes:
Sprains and strains occur commonly, and most result in minor injuries.

Sprains. A sprain occurs when you overextend or tear a ligament while severely stressing a joint. Ligaments are tough bands of fibrous tissue that connect one bone to another. They help to stabilize joints, preventing excessive movement. You may sprain your knee or ankle when walking or exercising on an uneven surface. A sprain also may occur when you land awkwardly, either at the end of a jump or while pivoting during an athletic activity.

Strains. A muscle becomes strained or pulled — or may even tear — when it stretches unusually far or abruptly. This type of injury — an acute strain — often occurs when muscles suddenly and powerfully contract. A muscle strain may occur when you slip on ice, run, jump, throw, lift a heavy object or lift in an awkward position. A chronic strain results from prolonged, repetitive movement of a muscle.

Signs & Symptoms:
The typical signs and symptoms associated with a sprain are the cardinal signs of a sprain.

*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.

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*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.

Risk factors:
Factors contributing to sprains and strains include:

*Poor conditioning. Lack of conditioning can leave your muscles weak and more likely to sustain injury.

*Poor technique. The way you land from a jump — for example, when skiing or practicing martial arts — may affect your risk of injury to a ligament in your knee called the anterior cruciate ligament (ACL). Past research has shown that landing with an inward rotation at the knee (“knock-kneed” position) can predispose you to an ACL sprain.

*Fatigue. Tired muscles are less likely to provide good support for your joints. When you’re tired, you’re also more likely to succumb to forces that could stress a joint or overextend a muscle.

*Improper warm-up. Properly warming up before vigorous physical activity loosens your muscles and increases joint range of motion, making the muscles less tight and less prone to trauma and tears.

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.

Click to see :->Sprain: First aid

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.

Lifestyle and home remedies:
For immediate self-care of a sprain or strain, try the P.R.I.C.E. approach — protection, rest, ice, compression, elevation. In most cases beyond a minor strain or sprain, you’ll want your doctor and physical therapist to help you with this process:

*Protection. Immobilize the area to protect it from further injury. Use an elastic wrap, splint or sling to immobilize the area. If your injury is severe, your doctor or therapist may place a cast or brace around the affected area to protect it and instruct you on how to use a cane or crutches to help you get around, if necessary.

*Rest. Avoid activities that cause pain, swelling or discomfort. But don’t avoid all physical activity. Instead, give yourself relative rest. For example, with an ankle sprain you can usually still exercise other muscles to prevent deconditioning. For example, you could use an exercise bicycle, working both your arms and the uninjured leg while resting the injured ankle on a footrest peg. That way you still exercise three limbs and keep up your cardiovascular conditioning.

*Ice. Even if you’re seeking medical help, ice the area immediately. Use an ice pack or slush bath of ice and water for 15 to 20 minutes each time and repeat every two to three hours while you’re awake for the first few days following the injury. Cold reduces pain, swelling and inflammation in injured muscles, joints and connective tissues. It also may slow bleeding if a tear has occurred. If the area turns white, stop treatment immediately. This could indicate frostbite. If you have vascular disease, diabetes or decreased sensation, talk with your doctor before applying ice.

*Compression. To help stop swelling, compress the area with an elastic bandage until the swelling stops. Don’t wrap it too tightly or you may hinder circulation. Begin wrapping at the end farthest from your heart. Loosen the wrap if the pain increases, the area becomes numb or swelling is occurring below the wrapped area.

*Elevation. To reduce swelling, elevate the injured area above the level of your heart, especially at night. Gravity helps reduce swelling by draining excess fluid.

*Continue with P.R.I.C.E. treatment for as long as it helps you recover. Over-the-counter pain medications such as ibuprofen (Advil, Motrin, others) and acetaminophen (Tylenol, others) also can be helpful. If you want to apply heat to the injured area, wait until most of the swelling has subsided.

After the first two days, gently begin to use the injured area. You should see a gradual, progressive improvement in the joint’s ability to support your weight or your ability to move without pain.

Mild and moderate sprains usually heal in three to six weeks. If pain, swelling or instability persists, see your doctor. A physical therapist can help you to maximize stability and strength of the injured joint or limb.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://en.wikipedia.org/wiki/Sprain
MayoClinic.com

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