Serlyn D. RodulfoBSN 4A

SPRAINS AND STRAINS

A sprain (Middle French espraindre, to squeeze) is an injury to the ligaments around a joint, caused by the ligament being stretched beyond its capacity. Ligaments are tough, fibrous tissues that connect bones to other bones. Sprains can occur in any joint but are most common in the ankle and wrist.

SPRAINS

PainSwellingBruisingDecreased ability to move the limbDifficulty using the affected extremity.instability of the injured joint. There may also be a numb or tingling sensation after the injury. Serious sprains often make a popping or snapping sound at the time of injury, and there may be the sensation of something tearing inside the joint.

SYMPTOMS

First degree sprain - is a tear of only a few fibers of the ligament.Second degree sprain - is a tear of part of a ligament, from a third to almost all its fibers.Third degree of sprain - is a complete tear of the ligament.

CLASSIFICATION

Sprains are classified into three different grades based on how badly damaged the ligament is.

Grade 1 sprains – This is mild damage to ligaments that will probably not cause the affected joint to become unstable or affect movement.Grade 2 sprains – This is a partial tear to the ligament. It tyipically causes bleeding underneath the skin, and one feel pain in the joint, especially when it’s being used.Grade 3 sprains – The ligament becomes mostly or completely torn and is likely to be immobilized.

GRADES OF SPRAINS

The diagnosis of a 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 or arthroscopy is obtained. MRI is usually ordered after swelling has subsided and can readily identify the presence of a ligament injury.

In many cases, if the injury is prolonged, MRI is performed to look at surrounding soft tissues and the ligament.

DIAGNOSIS

Sprains typically occur when the joint is overextended. This can cause over stretching of the joints, tear or slipping of the ligament.

CAUSES

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.

This is a very common injury that occurs when ligaments in the ankle are forced to overstretch. It occurs mostly during sports when one’s lands on an uneven surface, or as the result of a misstep. It may also occur during everyday activities if the foot experiences a twisting or a sudden sideways movement. There are three types of ankle sprains they include the following:

TYPES OF SPRAIN (JOINTS

INVOLVED)ANKLE SPRAIN

Inversion sprain – The most common type of ankle sprain, this occurs when the foot inverts falling inwards (the sole of the foot points toward the other foot) causing the lateral (outer) ligaments to overstretch.

Eversion sprain – This is also known as an eversion injury. It occurs when the foot twists outward causing the inner ligament (also called deltoid ligament) to be overstretched.

High ankle sprain – it occurs after a forceful and sudden outwards twist on the foot causing the large ligaments found above the ankle to be injured. The bones of the lower leg join in a joint as well, which can also be injured despite the fact that it’s not a very mobile joint.

CAUSES OF ANKLE SPRAINSlack of stretching properly and warming uplack of conditioninguneven groundinadequate shoesif you have previously been affected by an ankle sprain

THE SEVERITY OF THE ANKLE SPRAINFirst degree symptoms – a first degree ankle sprain is when the ligaments have been stretched but not torn. Symptoms include:

Mild pain

Some swelling

Some joint instability

Mild joint stiffness

Difficulty jogging or jumping

Second degree symptoms – a second degree ankle sprain is the most common of ankle injuries and is a partial tearing of the ligament. Symptoms include:

Significant swelling

Bruising

Moderate pain

Some loss of motion or use of the ankle

Trouble walking

Third degree symptoms -– a third degree ankle sprain is the most severe of ankle injuries. With this sprain, the ligament has been torn completely. Symptoms include:

Severe swelling

Severe pain

Instability of the joint

Extreme loss of motion

Walking can be quite painful

Occur after the ligaments in the wrists become overstretched. They occur mostly after falling on sidewalks after sliding during icy weather and in ball sports like basketball.

WRIST SPRAIN

FINGER SPRAIN

This sprain is a tear or stretch of the ligaments found in any of the many finger joints. They result from being hit strongly on the finger, for example when you fall on your hand or when a ball hits your finger with too much force.

Occurs when ligaments in the knee become overstretched or torn. They occur as a result of being hit on the knee or movements causing stress on your knee. The frequently publicized ACL and MCL tears that affect professional athletes are examples of extremely serious knee sprains.

KNEE SPRAIN

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. While scientific studies are lacking, it is often thought that not warming-up is a common cause of sprains in athletes. Warming-up is thought to loosen the joint, increases blood flow and makes the joint more flexible.

RISK FACTORS

The first modality for a strain can be remembered using the acronym RICE. The treatment of sprains depends on the extent of injury and the joint involved.

Rest: The sprain should be rested. No additional force should be applied on site of the sprain. Rest for about 24 – 48 hours after the sprain and avoid activities that may cause injury to the joint.

Ice: Ice should be applied immediately to the sprain to reduce swelling and 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.

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 more easily causes unnecessary fluid to be flushed back up the blood stream in order to be recycled. Compression should not cut off the circulation of the limb.

Elevate: Keeping the sprained joint elevated (in relation to the rest of the body) will also help to minimize swelling.

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.

Medications like non-steroidal anti-inflammatory drugs can relieve pain. Weight bearing should be gradual and advanced as tolerated.

TREATMENT

The following steps may lower your risk of a sprain:

Wear protective footwear during activities that place stress on your ankle and other joints.

Make sure that shoes fit your feet properly.

Avoid high-heeled shoes.

Always warm-up and stretch prior to exercise and sports.

Avoid sports and activities for which you have not trained.

Healthy diet - keeps muscles strong.

Fall prevention methods - e.g. clean up obstacles, avoid wet areas, etc.

Protective sports equipment. Use suitable wear for vigorous or contact sport (e.g., high-cube rubber shoes for basketball).

Avoid sports/exercise when in pain

Avoid sports/exercise when tired

Avoid running on uneven surfaces

Watch your step when walking on rough ground or near drains.

Maintain a healthy weight. Excessive weight causes too much stress on the joints.

Do regular exercise. This strengthens the ligaments and muscles.

PREVENTION

Damage to a tendon (a tough, fibrous cord of tissue connecting a muscle to a bone) or muscle.Fracture.Joint deformity.Weakened joint, if sprained repeatedly.

COMPLICATION

Although sprains recover completely after a while and care, some very serious sprains could cause prolonged problems. Torn ligaments, particularly in major joints including the elbow or knee, could result in long term injury.

Once you’ve rested long enough, it is essential to exercise the affected joint at the earliest opportunity to restore the strength of the joint. There could possibly be a wrapping around the damaged joint for support, but to get back the natural movement and strength it is essential to exercise the joint after having a sprain according to the advice of your doctor.

HELPING SPRAINS RECOVER

A strain is an injury to a muscle or tendon in which the muscle fibres tear as a result of overstretching. A strain is

also colloquially known as a pulled muscle. The equivalent injury to a ligament is a sprain.

STRAINS

Typical symptoms of a strain include:

localized pain Stiffness Swelling discoloration and bruising

 around the strained muscle.

SYMPTOMS

A strain may be caused by:

Excessive physical activity or effort

Improperly warming up before a physical activity

Poor flexibility

CAUSES

Repetitive strain injuries are mostly caused by making the same movements over and over again as part of the responsibilities and duties of a particular job. It is unbelievable how the overuse of a simple motion can put a toll on particular parts of your body. Here is a compilation of various repetitive strain injuries that can affect your body’s health.

TYPES OF REPETITIVE STRAIN INJURIES (RSI)

Carpal tunnel syndrome (CTS) is one of the most recognized of the RSI types. This syndrome progresses when the median nerve inside of the wrist becomes compressed, usually as a result of strenuous movements or poor posture.

The person suffering from CTS will experience numbness as part of the first symptoms. Genetics, poor working conditions and previous medical problems are often a cause of CTS.

Tendonitis is another common RSI that can affect many different parts of the body. This injury transpires when a tendon becomes inflamed. Common cases of tendonitis occur in the hips, knees, shoulders, wrists, ankles, legs, arms

and elbow. Sport enthusiasts are a common sufferer of tendonitis because of the amount of strain the body goes through. The Achilles tendon is another part of the body that is commonly affected with this syndrome.

Symptoms include pain of the area, stiffness near the tendon, or a burning feeling surrounding the affected joint. There are widely used treatments that one can use to aid their ailments. One can use non-steroidal anti-inflammatory

drugs, braces on the limbs and get some rest to treat their symptoms. Full recovery can be expected within four to six weeks.

Tenosynovitis is a RSI that is similar to tendonitis. Those suffering with tenosynovitis acquire an inflammation of the sheath that surrounds the tendon. The most common cases of tenosynovitis occur within the fingers. Symptoms include a limited range of motion with the fingers and may experience a cracking experience when they try to

straighten their fingers.

De Quervain’s syndrome is a repetitive strain injury of the tunnel that surrounds the two tendons that control the movement of the thumb. These two tendons are of the extensor pollicis brevis and the abductor pollicis longus muscles. These muscles have similar functions and allow for the movement of the thumb away from the hand. The

cause of this syndrome is not known, but some people claim that repetitive use of the thumb is a contributing factor. Symptoms of De Quervain include tenderness, pain and swelling over the side of the wrist where the thumb is

attached to. This syndrome is more common in women.

If you practice repetition in movements in your workplace, look out for these symptoms and pains so you don’t find yourself with these repetitive strain injuries. Practice better posture and consider the use of ergonomic and

stretch or take breaks each hour while working to prevent eye strain, back pain and more serious injuries.

The first-line treatment for a muscular strain in the acute phase include five steps commonly known as P.R.I.C.E.[2][3]

Protection: Apply soft padding to minimize impact with objects.

Rest: Rest is necessary to accelerate healing and reduce the potential for reinjury.

Ice: Apply ice to reduce swelling by reducing blood flow to the injury site. Never ice for more than 20 minutes at a time.

Compression: Wrap the strained area to reduce swelling with an ACE soft-wrapped bandage.

Elevation: Keep the strained area as close to the level of the heart as is conveniently possible to keep blood from pooling in the injured area.

The ice and compression (cold compression therapy) will stop the pain and swelling while the injury starts to heal itself. Controlling the inflammation is critical to the healing process and the icing further restricts fluid leaking into the injured area as well as controlling pain.

Cold compression therapy wraps are a useful way to combine icing and compression to stop swelling and pain.

This immediate treatment is usually accompanied by the use of nonsteroidal anti-inflammatory drugs[4] (e.g., ibuprofen), which both reduce the immediate inflammation and relieve pain. However, NSAIDs, including aspirin and ibuprofen, affect platelat function (this is why they are known as "blood thinners") and should not be taken during the period when tissue is bleeding because they will tend to increase blood flow, inhibit clotting, and thereby bleeding and swelling. After the bleeding has stopped, NSAIDs can be used with some effectiveness to reduce inflammation and pain.

It is recommended[5] that the person injured should consult a medical provider if the injury is accompanied by severe pain, if the limb cannot be used, or if there is noticeable tenderness over an isolated spot. These can be signs of a broken or fractured bone, a sprain, or a complete muscle tear.

Therapeutic ultrasound can be used to break down poorly healed muscle strains and permit them to heal properly.

TREATMENT

The following tips may help you reduce your risk of a strain:

Warm-up properly before exercise and sports.

Keep your muscles strong and flexible.

PREVENTION