Sprains

Answer 1

Definition

A sprain is an injury to the ligaments around a joint. Ligaments are strong, flexible fibers that hold bones together. When a ligament is stretched too far or tears, the joint will become painful and swell.

Alternative Names

Joint sprain

Causes

Sprains are caused when a joint is forced to move into an unnatural position. For example, "twisting" one's ankle causes a sprain to the ligaments around the ankle.

Symptoms

• Joint pain or muscle pain
• Swelling
• Joint stiffness
• Discoloration of the skin, especially bruising

First Aid

1. Apply ice immediately to help reduce swelling. Wrap the ice in cloth -- DO NOT place ice directly on the skin.
2. Try NOT to move the affected area. To help you do this, bandage the affected area firmly, but not tightly. ACE bandages work well. Use a splint if necessary.
3. Keep the swollen joint elevated above the level of the heart, even while sleeping.
4. Rest the affected joint for several days.

Aspirin, ibuprofen, or other pain relievers can help. DO NOT give aspirin to children.

Keep pressure off the injured area until the pain subsides (usually 7-10 days for mild sprains and 3-5 weeks for severe sprains). You may require crutches when walking. Rehabilitation to regain the motion and strength of the joint should begin within one week.

Call immediately for emergency medical assistance if

Go to the hospital right away or call 911 if:

• You suspect a broken bone
• The joint appears to be deformed
• You have a serious injury or the pain is severe
• There is an audible popping sound and immediate difficulty using the joint

Call your doctor if:

• Swelling does not go down within 2 days
• You have symptoms of infection -- the area becomes redder, more painful, or warm, or you have a fever over 100F
• The pain does not go away after several weeks

Prevention

• Wear protective footwear for activities that place stress on your ankle and other joints.
• Make sure that shoes fit your feet properly.
• Avoid high-heeled shoes.
• Always warm-up and stretch prior to exercise and sports.
• Avoid sports and activities for which you are not conditioned.

References

Mercier LR. Sports medicine. In: Mercier LR, ed. Practical Orthopedics. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 15.

Krabak BJ, Baima J. Ankle sprain. In: Frontera, WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 75.

Geiderman JM. General principles of orthopedic injuries. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. St Philadelphia, Pa: Mosby Elsevier; 2006:chap 46.

Answer 2

Definition

A sprain is an injury to the ligaments around a joint. Ligaments are strong, flexible fibers that hold bones together. When a ligament is stretched too far or tears, the joint will become painful and swell.

Alternative Names

Joint sprain

Causes

Sprains are caused when a joint is forced to move into an unnatural position. For example, "twisting" one's ankle causes a sprain to the ligaments around the ankle.

Symptoms

Symptoms of a sprain include:

• Joint pain or muscle pain
• Swelling
• Joint stiffness
• Discoloration of the skin, especially bruising

First Aid

• Apply ice immediately to reduce swelling. Wrap the ice in cloth . Do not place ice directly on the skin.
• Wrap a bandage around the affected area firmly, but not tightly, to limit movement. Use a splint if necessary.
• Keep the swollen joint raised about your heart, even while sleeping.
• Rest the affected joint for several days.

Aspirin, ibuprofen, or other pain relievers can help. DO NOT give aspirin to children.

Keep pressure off the injured area until the pain goes away. This usually takes 7-10 days for mild sprains and several weeks for severe ones. Your doctor may recommend crutches. Physical therapy will help you regain motion and strength of the injured area.

Call immediately for emergency medical assistance if

Go to the hospital right away or call 911 if:

• You think you have a broken bone
• The joint appears out of position
• You have a serious injury or severe pain
• You hear a popping sound and have immediate difficulty using the joint

Call your doctor for an appointment if:

• Swelling does not start to go away within 2 days
• You have symptoms of infection, including red, warm, painful skin or a fever over 100°F
• The pain does not go away after several weeks

PreventionThe following steps may lower your risk of a sprain:

• Wear protective footwear during activities that place stress on your ankle and other joints.
• Make sure that shoes fit your feet properly.
• Avoid high-heeled shoes.
• Always warm-up and stretch prior to exercise and sports.
• Avoid sports and activities for which you have not trained.

References

Brinker MR, O'Connor DP, Almekinders LC, et al. Physiology of Injury to Musculoskeletal Structures: 1. Muscle and Tendon Injury. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 1, section A.

Reviewed By

Review Date: 05/01/2011

Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.