Ronald W. Smith, M.D.

Sprains

sprain3I.      Definition:  The most common athletic injury is the ankle sprain of the anterior talofibular ligament.   A sprain is a condition in which a ligament is stretched or torn.  Ligaments are the fibers that hold the joints in place.  Sprains are characterized by pain, tenderness, swelling, discoloration, and joint instability of the affected area.  When a sprain occurs, you may feel a pop or tear, followed immediately by severe pain.

II.      Cause:   A sprain is caused by trauma that pulls the joint out of position, thereby overextending, stretching, or tearing the supporting ligaments.  Many sprains occur while participating in sports, for example when landing on the side of a foot after a jump, abruptly changing directions, or running on an uneven surface.

III.      Treatment and Prevention:  Steps can be taken to lower the risk of a sprain injury.

•    Keep a regular fitness program to maintain and build muscle strength.
•    Do daily stretching exercises.
•    Always wear properly fitted footwear.
•    Always warm up before sports activities.
•    Use appropriate athletic equipment for each activity.

Most sprains can be treated conservatively to decrease the pain and swelling of the injury.  Ibuprofen, acetaminophen, and other over the counter medications are usually effective in providing relief.  The RICE treatment method should also be followed.

•    Rest – Allow the ligaments to heal by avoiding activities that put pressure on the affected area.
•    Ice – Ice should be applied immediately when a sprain occurs.  Apply ice for 15-20 minutes every 2-3 hours to keep pain and swelling down.
•    Compression – Compress the area with a bandage to keep swelling down.  When an ankle sprain occurs, the shoe can be used as a compress.  Loosen, but do not remove the shoe.
•    Elevation – Elevate the sprained area above the level of the heart to minimize swelling.

If you experienced a “pop” sound or sensation at the time of injury or if your ankle turns black and blue, you may be suffering from an acute sprain and should seek treatment from an orthopaedic specialist.  Mild to moderate sprains usually take 4-6 weeks to heal.  Casts may be worn for the first 3 weeks to allow the ligaments to heal in an optimal position.  Severe sprains take longer and may eventually require surgery to tighten a stretched ligament and re-establish support of the joint if there is late instability.  Braces or supports are sometimes used after the sprain has healed to prevent re-injury.

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