sprain

(sprān)

1. A painful wrenching or laceration of the ligaments of a joint.
2. The condition resulting from a sprain.

[Origin unknown.]

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An injury caused when a joint is moved beyond its normal range of movement, but is not partly or wholly dislocated. Sprains usually arise from a sudden forceful movement that damages a joint capsule and the ligaments that tie together the bones in the joint. Damage to the joint tissue results in pain, swelling, and some loss of function.

Sprains range from small tears to serious ruptures. The severity is graded by degree: with a first degree sprain, there is little damage; with a second degree sprain, partial tearing of the ligament occurs; and with a third degree sprain, there is complete disruption of the ligament.

The primary treatment for a sprain is rest, indirect application of ice, compression with a bandage, and elevation of the damaged joint (see RICE). Secondary treatment may include administration of non-steroidal anti-inflammatory drugs (e.g. aspirin or ibuprofen), physical therapy (e.g. ultrasound or heat treatment), and stretching exercises specific for each type of sprain. Sometimes supportive braces or other devices are useful and, in extreme cases (such as a third degree sprain of the anterior cruciate ligament in the knee) surgery may be necessary. Individuals with excessive flexibility are more prone to sprains because the connective tissue surrounding the joint has been stretched and does not contribute so effectively to joint stability. Exercise addicts are also susceptible because they tend to overtrain. They are also reluctant to stop training when injured and do not give the sprain a chance to heal. It is unwise to continue training with a sprain, even with taping or bandaging, because there is a high risk of the sprain growing worse and becoming more resistant to treatment.

A term used loosely for an injury involving joints and muscles: a ‘soft tissue injury’ which does not damage bone. Since a ‘sprain’ is characterized chiefly by subjective symptoms (though there may be swelling) and reveals no abnormality on X-ray, the precise site and nature of damage can only be guessed from the description of the type and direction of the strain suffered and the location of pain and tenderness. Sprains are probably mainly due to small tears in ligaments or muscles.

— Stuart Judge

verb

To injure a (bodily part) by twisting: turn, wrench. See health/sickness.

An acute injury to a ligament owing to excessive mechanical stress. Sprains are usually caused by a sudden, forceful movement taking a joint beyond its normal physiological range of movement without dislocation of subluxation. Sprains are classified according to the degree of injury. In a first-degree sprain, few ligamentous fibres are damaged. Symptoms include mild tenderness, slight swelling, but no or very little loss of joint range of motion and no joint instability. In a second-degree sprain, more fibres are damaged, there is swelling, bruising, localized tenderness, moderate pain, and some loss of joint mobility, but little to no joint instability. In a third degree sprain, ligamentous fibres are turn or ruptured. This causes swelling and a variable amount of pain, but disability is severe and there is extreme joint instability. The cornerstone of the primary treatment for sprains is rest, ice, compression, and elevation (see RICE). Compare strain.

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Wrenching or twisting of a joint, with partial rupture of its ligaments. There may also be damage to the associated blood vessels, muscles, tendons and nerves.
A sprain is more serious than a strain, which is simply the overstretching of a muscle, without swelling. Severe sprains are so painful that the joint cannot be used. There is much swelling owing to hemorrhage from ruptured blood vessels.

An injury to a joint, with possible rupture of some of the ligaments or tendons but without dislocation or fracture. See also strain.

• Injuries and Accidents - sprain: excessive overstretching of ligament

It has been suggested that Sprained ankle be merged into this article or section. (Discuss) Proposed since February 2010.

This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (February 2010)

Sprain
Classification and external resources
A sprained ankle with bruising.
ICD-10	T14.3
ICD-9	848.9
MeSH	D013180

A sprain (possibly from Middle French espraindre, to squeeze) is an injury in a joint, caused by the ligament being stretched beyond its capacity. A muscular tear caused in the same manner is referred to as a strain. In cases where either ligament or muscle tissue is torn, immobilization and surgical repair may be necessary. Ligaments are tough, fibrous tissues that connect bones to other bones. Sprains can occur in any joint but are most common in the ankle and wrist.^[1]

Contents 1 Symptoms 2 Diagnosis 3 Causes 3.1 Joints involved 4 Risk factors 5 Treatment 5.1 Functional rehabilitation 6 References

Symptoms

• Pain
• Swelling
• Bruising
• Decreased ability to move the limb
• If the ligament is ruptured, one may hear a popping sound
• Difficulty using the affected extremity

Diagnosis

The diagnosis of sprain injury is made by a physical examination. In most cases an x-ray of the affected joint is obtained to ensure that there are no fractures. If a tear in the ligament is suspected, then an MRI is obtained. MRI is usually ordered after swelling has subsided and can readily identify the presence of a ligament injury.^[2]

Causes

Sprains typically occur when the joint is overextended. This can cause over stretching of the joints, tear or slipping of the ligament.^[3]

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.^[4] 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 American football, football (soccer), basketball, pole vaulting, softball, baseball and judo. See Anterior cruciate ligament injury.
• The fingers.
• The wrist.
• The toes.

Risk factors

There are certain factors which increase risk of sprains. Fatigue of muscles generally leads to sprains. When one suddenly starts to exercise after a sedentary lifestyle, sprains are quite common. While scientific studies are lacking, it is often thought that not warming-up is a common cause of sprains in athletes. Warming-up is thought to loosen the joint, increases blood flow and makes the joint more flexible.

Diagnosis of sprains is not difficult but in most cases X-rays are obtained to ensure that there is no fracture. In many cases, if the injury is prolonged, magnetic resonance imaging (MRI) is performed to look at surrounding soft tissues and the ligament.^[5]

Treatment

The first modality for a strain can be remembered using the acronym RICE.^[6] The treatment of sprains depends on the extent of injury and the joint involved. Medications like non-steroidal anti-inflammatory drugs can relieve pain. Weight bearing should be gradual and advanced as tolerated.^[7]

• Rest: The sprain should be rested. No additional force should be applied on site of the sprain. In case of, for example, a sprained ankle, walking should be kept to a minimum.^[8]

• Ice: Ice should be applied immediately to the sprain to reduce swelling and pain. It can be applied for 10-15 minutes at a time (longer application of ice may cause damage instead of healing), 3-4 times a day. Ice can be combined with a wrapping to minimize swelling and provide support.^[8]

• Compression: Dressings, bandages, or ace-wraps should be used to immobilize the sprain and provide support. When wrapping the injury, more pressure should be applied at the far end of the injury and decrease in the direction of the heart, the reason for this is that it causes unnecessary fluid to be flushed back up the blood stream easier in order to be recycled. Compression should not cut off the circulation of the limb.^[8]

• Elevate: Keeping the sprained joint elevated (in relation to the rest of the body) will also help to minimize swelling.^[8]

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.

The joint should be exercised again fairly soon, in milder cases from 1 to 3 days after injury.^[9] Special exercises are sometimes needed in order to regain strength and help reduce the risk of ongoing problems. The joint may need to be supported by taping or bracing, helping protect it from re-injury.^[9]

Functional rehabilitation

Prolonged immobilization delays the healing of a sprain, as it usually leads to muscle atrophy and stiff joint. The components of an effective rehabilitation for all sprain injuries include increasing range of motion and progressive muscle strengthening exercise.^[10]

References

1. ^ [1] Retrieved on 2010-02-16
2. ^ How To Perform Treatment of a Sprained Ankle About health online portal. Retrieved on 2010-02-01
3. ^ Sprains and Strains: What's the Difference American academy of orthopaedic surgeons. Retrieved on 2010-01-26
4. ^ Holes Human Anatomy & Physiology, Shier, David, Jackie Butler, Ricki Lewis, Mc Graw Hill 2007, Eleventh Ed., p.157,160
5. ^ Strains and sprains information Mayo Clinic. Retrieved on 2010-01-26
6. ^ Mnemonic at medicalmnemonics.com 235
7. ^ Sprain and Strain Symptoms and Treatment About Network. Retrieved on 2010-01-26
8. ^ ^{a b c d} "Sprained Ankle". American Orthopaedic Foot and Ankle Society. 2005-03. http://orthoinfo.aaos.org/topic.cfm?topic=A00150. Retrieved 2008-04-01. 
9. ^ ^{a b} Ankle Sprains: Healing and Preventing Injury Written by familydoctor.org editorial staff. American Academy of Family Physicians. Reviewed/Updated: 08/06. Created: 01/96
10. ^ Sprained ankle American academy of orthopedic surgeons. Retrieved on 2010-01-26

v d e Injury: Dislocations/subluxations, sprains and strains (Sx3 where x=0 to 9, 830–848) Joints and ligaments Head and neck Dislocation of jaw Whiplash Shoulder and upper arm GH (Dislocated shoulder) AC (Separated shoulder) SLAP tear Bankart lesion Elbow and forearm Nursemaid's elbow Gamekeeper's thumb Hip and thigh Dislocation of hip Knee and leg Tear of meniscus Anterior cruciate ligament injury Unhappy triad Patellar dislocation Ankle and foot Sprained ankle (High ankle sprain) Metatarsalphalangeal joint sprain (Turf toe) Muscles and tendons Shoulder and upper arm Rotator cuff tear Hip and thigh Pulled hamstring Knee and leg Patellar tendon rupture Achilles tendon rupture Shin splints M: JNT anat(h/c, u, t, l)/phys noco(arth/defr/back/soft)/cong, sysi/epon, injr proc, drug(M01C, M4) M: MUS, DF+DRCT anat (h/n, u, t/d, a/p, l)/phys/devp/hist noco(m, s, c)/cong(d)/tumr, sysi/epon, injr proc, drug (M1A/3)

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Dansk (Danish)
v. tr. - forstuve, forstrække
n. - forstuvning, distorsion

Nederlands (Dutch)
verstuiken, verzwikken, verstuiking

Français (French)
v. tr. - se fouler, se faire une entorse
n. - entorse, foulure

Deutsch (German)
n. - Verstauchung
v. - verstauchen

Ελληνική (Greek)
n. - διάστρεμμα, στραμπούλισμα
v. - εξαρθρώνω, στραμπουλίζω

Italiano (Italian)
slogare, slogarsi, slogatura

Português (Portuguese)
n. - torcedura (f)
v. - torcer

Русский (Russian)
растяжение сустава, дисторзия, растянуть связки

Español (Spanish)
v. tr. - torcer, descoyuntar
n. - torcedura, esguince

Svenska (Swedish)
n. - vrickning, stukning, (för)sträckning
v. - vricka, stuka, (för)sträcka

中文（简体）(Chinese (Simplified))
扭, 扭伤

中文（繁體）(Chinese (Traditional))
v. tr. - 扭, 扭傷
n. - 扭傷

한국어 (Korean)
v. tr. - (발목, 손목 따위를) 삐다, 염좌하다
n. - 삐기, 접질림, 염좌

日本語 (Japanese)
n. - 捻挫
v. - くじく

العربيه (Arabic)
‏(الاسم) رض, التواء المفاصل (فعل) لوى ( المفصل)‏

עברית (Hebrew)
v. tr. - ‮ניקע (מפרק), סובב, נקע‬
n. - ‮סיבוב, תפיחה‬

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