Sprain originates from French word espriandre which means to wring. A sprain is an injury which occurs to ligaments. Ligaments are structures that join two bones across the joints. For example ankle ligaments connect tibia and fibula bones to the talus and calcaneum across the ankle joint.
Therefore the sprains occur mostly around the joints. Ankle and knee are commonest joints where the sprain is reported to occur.
However, the sprain may occur in any joint. We often have heard the terms sprained ankle, neck sprain or sprained knee etc. Twisted ankle and twsited knee are also the terms used for sprains
Mechanism of Injury
A sprain occurs due to sudden overstretching of ligaments. This may occur when a sudden uncontrolled movement occurs in the joint such as twisting of the ankle or outstretching of the wrist in an effort to protect oneself from fall. The force of injury cause ligaments to stretch beyond their normal limits which result in the 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 fibers.
This kind of sprain is very common and almost everybody has 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 a tear of some but not all fibers of the 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 the degree there might be a 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.
Home Remedies of Sprain
First Aid or Initial Treatment generally involves RICE ( See Below)
Provide adequate rest to the injured part and stop all activity that involves the injured joint. In the case of the 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 the injured area and thus swelling.
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)
In this type, weight-bearing is allowed as tolerated. Splinting or casting is generally not required. After pain becomes tolerable, patient is put on joint mobilization exercises.
This type of injury requires Immobilization with a splint or plaster for two weeks. This is followed by joint motion and strengthening exercises.
This kind of injury was earlier treated by immobilization followed by physiotherapy of longer duration. But surgical reconstruction is preferred treatment now in selected cases as conservative treatment was associated with long-term chronic pain and instability.