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Strain or Sprain: What The
Heck Is It?
If you have played
sports long enough chances are you have sprained or
“tweaked” or “bunged up” or strained something in
your body. Probably the most common sports injury
is a “sprain” to a joint.
A sprain is an injury to
a ligament such as a tear or an overstretching. A
sprain, often confused with a sprain, is an injury
to either a muscle or a tendon.
The typical scenario for
a sprain to occur is when an athlete “rolls” their
ankle, or falls and lands on an outstretched arm or
twists their knee while the foot is planted. Ankle
sprains are the most common injury and sports injury
and is often a source of missed games, practices and
lengthy rehab.
The usual signs and
symptoms of an ankle sprain or any sprain for that
matter include pain, swelling, bruising and reduced
ability to move the joint.
In general a Grade 1
sprain causes an overstretching of the ligament(s)
with no joint instability. The person will notice
minimal pain, swelling, no bruising or loss of range
of motion.
A Grade 2 or moderate
sprain causes partial tearing of the ligament(s) and
results in bruising, swelling, moderate pain, some
loss of motion and there is some difficulty with
full weight-bearing.
A Grade 3 or severe
sprain completely tears or ruptures the ligament(s).
Pain, swelling, loss of motion and bruising are
severe and the person is unable to put weight on the
joint.
Any sprain should be
assessed by a qualified health care provider,
preferably with musculoskeletal injury experience
(i.e. physician, chiropractor, physiotherapist).
When diagnosing the injury, the health care provider
will rule out other more severe injuries (i.e.
fracture) and ask the athlete how the injury
happened before examining and assessing the injured
site.
Treatment for a sprain
begins immediately after the injury occurs and not
two or three days later at the health care clinic.
Treatment for a sprain has two stages:
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to reduce swelling and pain
rehabilitation. Immediately after the injury
remember R.I.C.E.: Rest (depending on
severity, rest is relative; you may rest for the
next shift in a hockey game or for two weeks while
riding a stationary bike instead of running while
training for a 10 km race), Ice often
(15-20 minutes several times a day), Compression
with a tensor wrap around injury, Elevate
injured site to help decrease swelling. R.I.C.E.
should occur at least until the bruising, swelling
and pain is gone.
The second stage of
sprain treatment is rehabilitation with a goal of
restoring range of motion, function and strength to
pre-injury status. This stage may begin the day of
the injury or anytime after depending on severity.
Rehab should consist of a variety of techniques to
accelerate recovery which may include:
interferential electrotherapy, ultrasound, Active
Release Technique ®, customized
stretching/strengthening/proprioception (balance)
exercises, ice, heat, joint mobilization,
cardiovascular exercises (i.e. swimming/biking) and
patient education.
These modalities are
very important because they help prevent stiffness,
scar tissue and effectively restore normal pain-free
range of motion.
Everyone wants to know
how long recovery will take. The most accurate and
honest answer is “no one knows” but may take days to
months depending on quality of care and patient
compliance. Most sprains recover significantly
enough to return to action within a few weeks.
To wrap up, one should
seek attention to get their sprain looked at if: you
can’t put normal weight on the injured joint, it is
very tender to touch, the area looks different (i.e.
lumps/bumps), unable to move joint, joint/limb
buckles and/or numbness is present.
The key to a quick
recovery is RICE ASAP, proper diagnosis and rehab
(including sport specific exercises) and consistent
therapy.
Good luck and have a
great season!
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