If you've ever taken a fall or twisted an ankle, chances are you've experienced a sprain or a strain. Sprains and strains are common injuries, and though these terms are often used interchangeably, their causes are different.
A strain is an injury that involves stretching, tearing or twisting of a muscle or tendon. A tendon attaches a muscle to a bone, and strains commonly occur at the seam of this attachment. A strain generally occurs when a muscle suddenly contracts after being stretched out, such as with running or jumping. This scenario is often seen in runners who strain their hamstrings. This type of injury will often occur in the middle of an athletic event, when the athlete is at full speed. Strains can be qualified as either acute, resulting from a sudden injury, or chronic, which result from repetitive or excessive use and build up over time. Symptoms of a strain include pain, weakness and loss of function.
The word "sprain" comes from the French "espraindre," meaning "to press out." A sprain is an injury that affects the ligaments, which are thick bands of cartilage connecting bone to bone. A sprain occurs when a ligament has been excessively stretched or torn. A sudden, excessive and compressive force, such as a fall, generally is behind a sprain. Sprains commonly occur in the ankle as a result of sudden sideways or twisting motion of the foot. The most frequently sprained ligament in the ankle is the anterior talo-fibula ligament, which attaches the ankle bone (talus) to the outer portion of the lower leg (fibula). Sprains are classified according to severity and can range from mild stretching and tenderness to severe tearing and pain. If a ligament or muscle is injured sufficiently, instability of the entire joint can ensue, as the joint becomes displaced from its normal alignment. Symptoms of a sprain include swelling, discoloration and loss of range of motion.
Certain areas of the body are more vulnerable than others to strains and sprains. However, no area of the body is invincible. Neck and back strains are common findings not only in athletes but also in individuals who impose excessive demands on their spine as a result of inappropriate posture or poor ergonomics in the workplace. Shoulders and knees are frequently sprained not only when participating in competitive sports but also when performing everyday activities such as gardening, stepping out of your truck or even walking the dog.
Treatment of sprains and strains is generally separated into immediate care and long-term rehabilitation. Of course, the key to complete recovery is early intervention and thorough evaluation. If you feel you have a strain or a sprain, remember this mnemonic: DR ICE.
Diagnosis: Though with most strains and sprains we have an innate sense of what has occurred, it is prudent to see your health care professional to rule out any aggressive condition such as fracture or avulsion.
Rest: This is essential not only for recovery but also to arrest the progression of injury.
Ice: This treatment is effective in reducing swelling and alleviating pain. Though commonly used for acute injuries, ice packs and wraps are also effective in treating chronic conditions, such as overuse injuries. Remember to ice the area after activity, not before. This keeps inflammation in abeyance. It should be mentioned that heat is also an effective modality. However, it should be used with chronic conditions to help stimulate blood flow and relax tissue. Check with your doctor as to duration and intensity.
Compression: This refers to taping or wrapping the injured or weakened area. Compression wraps such as an elastic or ACE bandage can help decrease swelling, which will enable you to heal more quickly. This will also immobilize the injured area and serve as protection against further injury. It should be noted that prolonged immobilization can potentially result in atrophy of the muscle, so avoid bracing for prolonged periods of time.
Elevation: It is important to elevate the injured area above the level of the heart. This ensures that fluids will not collect throughout the injured area and intensify swelling.
Determining the severity of a sprain or strain, and differentiating these from more severe conditions, can be challenging, so occasionally imaging such as MRIs or X-rays may be indicated. Inability to bear weight or associated numbness or tingling should raise concerns.
If you believe you have experienced a strain or sprain of any kind, remember DR ICE. Understand the cause of your symptoms and what they mean for you, and enjoy a pain-free summer.
Patricia Holl graduated with a doctor of chiropractic degree from Los Angeles College of Chiropractic and is part of the staff at Yellowstone Naturopathic Clinic. She can be reached at 259-5096. Send naturopathic health questions to firstname.lastname@example.org.