Injury Basics 2 – Sprains and their treatment
Dealing with a sprain
A sprain is different from a strain. Muscles get strained, ligaments and the tough capsule around a joint get sprained.
Ligaments and joint capsules
Ligaments attach bone to bone. They provide the stability in the body and guide joint movement. Ligaments around the joints prevent the surfaces separating too far. They also stop the joint surfaces touching each other and wearing down. Ligaments have a high volume of the stretchy protein ‘collagen’ in them, combining elasticity with incredible strength.
Joint capsules are made of the same collagen protein. They are normally thinner than ligaments as their primary function is holding the lubricating fluid within the joint. Joint capsules also give nerve feedback to the brain to stop you bending the joint too far.
Joint capsules and ligaments often blend into an indistinguishable thicker support band around parts of the joints that need to be more stable.
What a sprain is
A sprain occurs when the ligament has been stretched beyond its elastic limit. This is similar to stretching an elastic band past the elastic point. When you do this it always ends up a bit floppy compared to the original shape. A ligament or joint capsule will end up with a sprain when a large force stretches it in the wrong direction.
Bending a joint against its normal movement plane will cause a sprain. Bending the joint further than it would normally move will also lead to a sprain.
A sprain from overstretched ligaments or joint capsules will heal with the right treatment but left alone they can lead to early breakdown of a joint.
How to fix it
The classic, easily remembered and correct treatment is to “RICE” the joint or area.
Rest from the activity that caused the problem. Keep moving the joint but without any loading. It hurts, so listen to your body and back off any significant exercise.
Cooling the area reduces inflammation (swelling) and relieves pain. Short applications of ice also stimulate the circulation and clear inflammatory substances away from the injury. I always recommend five to six one-minute applications of ice within a ten minute period. If you have to leave the ice on, make sure you take it off after a maximum of five minutes. Then re-apply again after two minutes. Repeat this at minimum twice a day for the first two to three days. For full instructions, visit the hydrotherapy page.
A sprain can be helped a lot by gently compressing the area. A tubigrip or compression bandage provides support and limits swelling. Make sure it is not too tight! (If your arm or leg turns numb, blue or drops off, you need to loosen the bandage, it isn’t supposed to be a tourniquet!)
Raise the body part above the level of the heart for at least three ten-minute periods in the day. This helps the inflammation drain away from the area and speeds up the healing.
Things to remember
Movement is important because it stimulates healing. So stay as active as you comfortably can. Without forcing it or causing pain, keep the joint moving through a comfortable range of motion. This encourages blood flow and maintains flexibility during healing.
Sometimes painkillers can be useful to control the discomfort but non-steroidal anti-inflammatory medication can actually slow down healing.
Things to remember
If the pain or swelling fails to improve within five days, make an appointment! We can assess the injury, give the correct treatment and provide advice for how to get better as fast as possible.
Get to a qualified doctor or physician if your pain can’t be controlled with paracetamol! If the joint can’t hold your weight or things go numb or “dead” or if the swelling is out of control, you might need to get help from A&E. Telephone 111 for advice.