Sprain

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Sprain
Classification and external resources

A sprained ankle with bruising.

ICD-10 T14.3
ICD-9 848.9
MeSH D013180

A sprain (from Middle French espraindre - to wring or twist) is an injury to ligaments that
is caused by being stretched beyond their normal capacity and possibly torn. A muscular
tear caused in the same manner is referred to as a strain. In cases where either ligament or
muscle tissue is torn, immobilization and surgical repair may be necessary. Ligaments are
tough, fibrous tissues that connect bone to bone across the joints. Sprains can occur in
any joint but are most common in the ankle. [1]Contents [hide]
1 Symptoms
2 Diagnosis
3 Causes
3.1 Joints involved
4 Risk factors
5 Treatment
5.1 Functional rehabilitation
6 References

[edit]
Symptoms
Pain
Swelling
Bruising
Hemarthrosis
Decreased ability to move the joint
If the ligament is ruptured, one may hear a popping sound
Difficulty using the affected extremity
[edit]
Diagnosis

The diagnosis of sprain injury is made by a physical examination. In most cases an x-ray
of the affected joint is obtained to ensure that there are no fractures. If a tear in the
ligament is suspected, then an MRI is obtained. MRI is usually ordered after swelling has
subsided and can readily identify the presence of a ligament injury.[2]
[edit]
Causes

Sprains typically occur when the joint is overextended. This can cause over stretching of
the ligament, tear or rupture the ligament.[3]
[edit]
Joints involved

Although any joint can experience a sprain, some of the more common include:
the ankle. It is the most common, and has been said that sprains such as serious ankle
sprains are more painful and take longer to heal than actually breaking the bones in that
area.[4] See sprained ankle for more details.
the knee. Perhaps one of the more talked about sprains is that to the anterior cruciate
ligament (ACL) of the knee. This is a disabling sprain common to athletes, especially in
football, basketball, pole vaulting, softball, baseball,soccer and judo. See Anterior
cruciate ligament injury.
the fingers.
the wrist.
the toes.
[edit]
Risk factors

There are certain factors which increase risk of sprains. Fatigue of muscles generally
leads to sprains. When one suddenly starts to exercise after a sedentary lifestyle, sprains
are quite common. Not warming-up is the most common cause of sprains in athletes.
Warming-up loosens the joint, increases blood flow and makes the joint more flexible.
Poor conditioning of the body can also lead to sprains.[citation needed]

Diagnosis of sprains is not difficult but in most cases x-rays are obtained to ensure that
there is no fracture. In many cases, if the injury is prolonged, magnetic resonance
imaging (MRI) is performed to look at surrounding soft tissues and the ligament.[5]
[edit]
Treatment

The first modality for a sprain can be remembered using the acronym RICE.[6] The
treatment of sprains depends on the extent of injury and the joint involved. Medications
like non-steroidal anti-inflammatory drugs can relieve pain. Weight bearing should be
gradual and advanced as tolerated.[7]
Rest: The sprain should be rested. No additional force should be applied on site of the
sprain. In case of, for example, a sprained ankle, walking should be kept to a minimum.
[8]
Ice: Ice should be applied immediately to the sprain to minimize swelling and ease pain.
It can be applied for 10-15 minutes at a time (longer application of ice may cause damage
instead of healing), 3-4 times a day. Ice can be combined with a wrapping to minimize
swelling and provide support.[8]
Compression: Dressings, bandages, or ace-wraps should be used to immobilize the sprain
and provide support. When wrapping the injury, more pressure should be applied at the
far end of the injury and decrease in the direction of the heart, the reason for this is that it
causes unnecessary fluid to be flushed back up the blood stream easier in order to be
recycled. Compresion should not cut off the circulation of the limb. [8]
Elevate: Keeping the sprained joint elevated (in relation to the rest of the body) will also
help to minimize swelling.[8]

Ice and compression (cold compression therapy) will not completely stop swelling and
pain, but will help to minimize them as the sprain begins to heal itself. Careful
management of swelling is critical to the healing process as additional fluid may pool in
the sprained area.

The joint should be exercised again fairly soon, in milder cases from 1 to 3 days after
injury.[9] Special exercises are sometimes needed in order to regain strength and help
reduce the risk of ongoing problems. The joint may need to be supported by taping or
bracing, helping protect it from re-injury.[9]
[edit]
Functional rehabilitation

Prolonged immobilization delays the healing of a sprain, as it usually leads to muscle

atrophy and stiff joint. The components of an effective rehabilitation for all sprain
injuries include increasing range of motion and progressive muscle strengthening
exercise.[10]
[edit]
References
^ Sprain Treatment Retrieved on 2010-01-26
^ How To Perform Treatment of a Sprained Ankle About health online portal. Retrieved
on 2010-02-01
^ Sprains and Strains: What's the Difference American academy of orthopaedic surgeons.
Retrieved on 2010-01-26
^ Holes Human Anatomy & Physiology, Shier, David, Jackie Butler, Ricki Lewis, Mc
Graw Hill 2007, Eleventh Ed., p.157,160
^ Strains and sprains information Mayo Clinic. Retrieved on 2010-01-26
^ Mnemonic at medicalmnemonics.com 235
^ Sprain and Strain Symptoms and Treatment About Network. Retrieved on 2010-01-26
^ a b c d "Sprained Ankle". American Orthopaedic Foot and Ankle Society. 2005-03.
Retrieved 2008-04-01.
^ a b Ankle Sprains: Healing and Preventing Injury Written by familydoctor.org editorial
staff. American Academy of Family Physicians. Reviewed/Updated: 08/06. Created:
01/96
^ Sprained ankle American academy of orthopedic surgeons. Retrieved on 2010-01-
26[hide]
v · d · e
Injury: Dislocations/subluxations, sprains and strains (Sx3 where x=0 to 9, 830–848)
Joints and
ligaments Head and neckDislocation of jaw · Whiplash

Shoulder and upper arm GH (Dislocated shoulder) · AC (Separated shoulder) ·

SLAP tear · Bankart lesion

Elbow and forearm Nursemaid's elbow · Gamekeeper's thumb

Hip and thigh Dislocation of hip

Knee and leg Tear of meniscus · Anterior cruciate ligament injury · Unhappy triad ·
Patellar dislocation

Ankle and foot Sprained ankle (High ankle sprain) · Metatarsalphalangeal joint
sprain (Turf toe)

Muscles and
tendons Shoulder and upper arm Rotator cuff tear

Hip and thigh Pulled hamstring

Knee and leg Patellar tendon rupture · Achilles tendon rupture · Shin splints

M: JNT
anat(h/c, u, t, l)/phys
noco(arth/defr/back/soft)/cong, sysi/epon, injr
proc, drug(M01C, M4)

M: MUS, DF+DRCT
anat (h/n, u, t/d, a/p, l)/phys/hist
noco(m, s, c)/cong(d)/tumr, sysi/epon, injr
proc, drug (M1A/3)

Categories: Diseases involving the fasciae | Injuries

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