Sprains and strains

Sprain refers to damage or tearing of ligaments or a joint. Strain refers todamage or tearing of a muscle.

When too much force is applied to a joint, the ligaments that hold the bonestogether may be torn or damaged. This causes a sprain, and its seriousness depends on how badly the ligaments are torn. Any joint can be sprained, but themost frequently injured joints are the ankle, knee, and finger.

Strains are tears in the muscle. Sometimes called "pulled muscles," they usually occur because of overexertion or improper lifting techniques.

Children under age 8 are less likely to have sprains than are older people because their ligaments are tighter and their bones are more apt to break before a ligament tears. People who are active in sports suffer more strains and sprains than less active people. Repeated sprains in the same joint make the joint less stable and more prone to future sprains.

There are three types of sprains: Grade I sprains are mild injuries with no tearing of the ligament and no joint function is lost, although there may be tenderness and slight swelling.

Grade II sprains are caused by a partial tear in the ligament. These sprainshave obvious swelling, extensive bruising, pain, problems bearing weight andin joint function.

Grade III sprains are caused by complete tearing of the ligament with severepain, loss of joint function, widespread swelling and bruising, and the inability to bear weight. These symptoms are similar to those of bone fractures.

Strains can range from mild muscle stiffness to great soreness. Strains are caused by overusing or improperly using muscles, or by compensating for pain in another part of the body by changing the way it moves.

Patients don't need a doctor to diagnose Grade I sprains and mild strains, but Grade II and III sprains are often seen by a doctor to tell the differencebetween a sprain and a fracture.

Grade I sprains and mild strains can be treated at home. Basic first aid forsprains consists of RICE: Rest, Ice for 48 hours, Compression (wrapping in anelastic bandage), and Elevation of the sprain above the level of the heart.Over-the-counter pain medication such as acetaminophen (Tylenol) or ibuprofen(Motrin) will help.

In addition to RICE, people with grade II and grade III sprains in the ankleor knee usually need to use crutches until the sprains have healed enough tobear weight. Sometimes, physical therapy or home exercise is needed to restore the strength and flexibility of the joint.

Grade III sprains are usually immobilized in a cast for several weeks to seeif the sprain heals. Pain medication is prescribed. Surgery may be necessaryto relieve pain and restore function. Athletic people under age 40 are the most likely candidates for surgery, especially with grade III knee sprains. Forcomplete healing, physical therapy usually will follow surgery.

Alternative practitioners endorse RICE and conventional treatments. In addition, nutritional therapists recommend vitamin C to supplement a diet high in whole grains, fresh fruits, and vegetables. If surgery is needed, alternativepractitioners can recommend pre- and post-surgical therapies to enhance healing.

Moderate sprains heal within two to four weeks, but it can take months to recover from severe ligament tears. Until recently, tearing the ligaments of theknee meant the end to an athlete's career. Improved surgical and rehabilitation techniques now offer the possibility of complete recovery. However, oncea joint has been sprained, it will never be as strong as it was before.

Sprains and strains can be prevented by warming up before exercising, using proper lifting techniques, wearing well-fit shoes, and taping or bracing the joint.

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