Sprains and Strains: Practice Prevention

Whether you're a weekend warrior with a few extra pounds or an ultra-fit athlete who doesn't skip a workout willingly, you've probably experienced a sprain or a strain from physical activity in your lifetime.

Sprains
The American Academy of Orthopaedic Surgeons (AAOS) defines a sprain as "a stretch and/or tear of a ligament, the fibrous band of connective tissue that joins the end of one bone with another." Sprains often occur in ankles, knees, wrists, and thumbs.

How They Happen
The joint gets knocked out of place by falls, twists, or blows to the body. At that point the supporting ligament either overstretches or snaps.

Signs
Expect some pain, swelling, and bruising with all types of sprains, with intensity increasing with the severity of the sprain. You may hear or feel a pop at the moment of injury.

• Mild: can put weight on it, overstretching with no joint loosening
• Moderate: more difficulty putting weight on it, partial ligament tear with joint loosening
• Severe: cannot put weight on it, complete ligament tear with nonfunctioning joint

Strains
The AAOS defines a strain as "a twist, pull and/or tear of a muscle and/or a tendon" and tendons as "fibrous cords of tissue that attach muscles to bone." Common sites for strains include backs, hamstring muscles in the back of the leg, hands, forearms, and elbows.

How They Happen
Acute strains come from a one-time trauma or shortly after overdoing it. Chronic strains result from overuse (repetitive movements over time).

Signs
Expect pain, muscle spasms, swelling, limited motion, and muscle weakness.

• Mild: muscle/tendon is stretched a bit
• Moderate: muscle/tendon is overstretched and torn a bit
• Severe: muscle/tendon is ruptured all or part of the way

Treatment for Sprains and Strains
See a doctor for all but minor sprains and strains. Your plan of care may include:

• RICE (Rest, Ice, Compression, and Elevation) therapy for the first 24 to 48 hours to reduce pain and swelling
• Immobilization and surgery for severe injuries, followed by months of therapy
• Rehabilitation exercises and activity modification for mild and moderate injuries
• Working with health care providers to determine when you can return to activities -- length of time to return to full activity levels will vary from weeks to a year

Prevention
You can't avoid all risks but you can do the following:

• Stretch daily
• Eat a healthy diet and keep your weight appropriate
• Wear shoes that fit properly and replace them when they begin to wear out
• Condition yourself for the sports you do
• Warm up before and cool down after activities
• Bow out of the game or exercise if you are extremely tired or in pain
• Remove fall hazards at home

On the Road Again
Sprains and strains are common injuries for both amateur and professional athletes.  Ironically, you can also get injured just walking from your car to your front door. But if you follow your doctor's instructions after an injury and practice prevention, maybe you'll find the road a little smoother.