Sprain

(Ligament Sprain)

Definition

Definition

A sprain is an injury that damages a ligament. A ligament is a firm, fibrous band of tissue. It connects 2 bones across a joint. There are ligaments crossing all of the joints in the body.

Sprain: Grade 2

Copyright © Nucleus Medical Media, Inc.

Causes

Causes

A sprain occurs when a force pushes the bones of a joint apart. If the force is intense enough, the ligament holding the joint together has to give.

Risk Factors

Risk Factors

Sprains can occur with everyday activities, but they are more common during sports. Sports with high speeds and risk of collision have an increased risk of sprains. These sports include:

  • Basketball
  • Football
  • Skiing
  • Gymnastics

Factors that may increase your risk of a sprain include:

  • Muscle weakness
  • Lack of flexibility
  • Coordination and balance difficulties
  • Sudden change in direction
  • Impact with object or other person
  • Misstep that causes a sudden strain at a joint

Symptoms

Symptoms

Symptoms of a sprain may include:

  • Pain immediately after the sprain—without treatment, the pain becomes worse over the next 24 hours
  • A popping sound
  • Local swelling, often within minutes
  • Bruising
  • Trouble moving the joint
  • Increased pain when putting pressure on the injured area

The most common joints involved include:

  • Ankle
  • Knee
  • Thumb or finger joints
  • Shoulder

Diagnosis

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Images may be needed of your joint. This will help check for damage to bones or other structures. Images may be taken with:

Sprains are graded according to the amount of injury:

  • Grade 1—Some stretching with micro-tearing of ligaments
  • Grade 2—Partial tearing of ligaments
  • Grade 3—Complete tearing of ligaments

Treatment

Treatment

Treatment will depend on the joint involved and the extent of the injury. Talk with your doctor about the best treatment plan for you. Options include:

Rest

You will need time to heal, but strict rest is rarely necessary. For most, you should continue to move as long as it does not increase pain. Go about your normal activities as much as you can tolerate.

Decrease Swelling

Elevation will help decrease swelling.

Compression of the area with an elastic bandage also helps to control swelling.

Ice and Heat

Ice may help decrease swelling and pain in the first few days after the injury.

After a couple of days, heat may help loosen tight or injured muscles. Wait for swelling to go away before using heat therapy.

Medications

Medication can help to relieve discomfort and swelling. Medications may include:

  • Over-the-counter pain medication, such as aspirin, ibuprofen, or acetaminophen
  • Topical pain medication—creams or patches that are applied to the skin
  • Prescription pain relievers

Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.

Rehabilitation

Rehabilitation exercises may be helpful after the sprain heals. Exercises can help to strengthen muscles and increase range of motion. Medical help is often needed at this stage. It is important to strengthen the muscles involving the joint where the ligament is. Those muscles need protection against further injury.

Prevention

Prevention

It may be difficult to avoid sprains. Joints are at risk during athletic activities. To reduce your chance of getting a sprain:

  • Use proper techniques to help avoid awkward motions and missteps
  • Participate in flexibility, strength, and fitness training

RESOURCES:

American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org

American College of Sports Medicine http://acsm.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association http://www.coa-aco.org

Canadian Orthopaedic Foundation http://www.canorth.org

References:

Ankle sprain. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated April 10, 2015. Accessed June 22, 2015.

Sprained ankle. American Academy of Orthopaedic Surgeons Ortho Info website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00150
Updated September 2012. Accessed September 6, 2013.

Sprains, strains, and tears. American College of Sports Medicine website. Available at:
http://www.acsm.org/docs/brochures/sprains-strains-and-tears.pdf
Published 2011. Accessed June 22, 2015.

Sprains, strains, and other soft tissue injuries. American Academy of Orthopaedic Surgeons Ortho Info website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00304
Updated July 2007. Accessed September 6, 2013.

10/26/2010 DynaMed’s Systematic Literature Surveillance.
http://www.ebscohost.com/dynamed:
Massey T, Derry S, et al. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.

Last reviewed June 2015 by Michael Woods, MD
Last Updated: 9/30/2013

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