Sprain originates from French word espriandre which means to wring. Sprain is an injury which occurs to ligaments. Ligaments are structures that join two bones across the joints. Therefore the sprains occurs mostly around the joints. Ankle and knee are commonest joints where the sprain is reported to occur.
However, sprain may occur in any joint.
Mechanism of Injury
Sprain occurs due to sudden over stretching of ligaments. This may occur when a sudden uncontrolled movement occurs in the joint such as twisting of ankle or outstretching of wrist in an effort to protect oneself from fall. The force of injury cause ligaments to stretch beyond their normal limits which results in tear of the ligaments.
Degrees of sprain
Degrees of sprain varies from minor stretching to complete tear depending upon the degree of insult.
Sprains are graded in three degrees
The first degree is only a minor tear or stretch of a ligament. There is microscopic tearing of some fibres.
This kind of sprain is very common and almost everybody haas felt it at some time. This injury results in minimal tenderness & swelling and is associated with minimal impairment of function.
The second degree is an incomplete tear of a ligament. This means there is tear of some but not all fibers of ligament. This results in moderate tenderness & swelling and is associated with decreased motion(Usually)
The third degree is a complete rupture of the ligaments. This type is most severe, and actually breaks the ligament, along with some small bones if severe enough. This kind of injury results in gross instability of the joint involved.
The strain can occur in any of the joints but ankle, wrist, knee and finger joints are most commonly involved.
Signs and Symptoms
Acute pain followed by swelling is the commonest symptoms. Depending on degree there might be loss of function.
It is not easy to differentiate between the degrees on clinical examination but a gross idea can be made.
After examination first investigation to be done is an Xray to rule out any bony injury. MRI( Magnetic Resonance Imaging) is done to confirm third degree strains.
First Aid or Initial Treatment: This involves RICE ( See Below)
Provide adequate rest to the injured part and stop all activity that involves the injured joint. In case of lower limb it is walking or standing.
Ice application would reduce the imminent swelling. Ice causes cooling at the injured area and reduces bleeding by causing constrictions in the vessels.
This involves wrapping of injured part to cause its compression and reduce swelling.
Keep the affected part elevated so as to keep it at heart level or higher. This helps in reducing blood flow to injured area and thus swelling.
AS SOON AS POSSIBLE VISIT A DOCTOR.
Your doctor would put you on one of the following treatments depending upon your injury and your demands ( e.g.Athletes have a higher demand from their body)
Weight bearing as tolerated. Splinting or casting is generally not required. Physiotherapy as per tolerance of pain
Immobilization with a splint or plaster for two weeks followed by physiotherapy.
Immobilization followed by physiotherapy of longer duration was general treatment for a long time, but now surgical reconstruction is preferred treatment in selected cases as conservative treatment was associated with long term chronic pain and instability
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