WHEN IS A SPRAIN A STRAIN, AND IS THERE ANYTHING I CAN DO ABOUT IT?

By Chan Yin Keen | Principal Chiropractor
One Spine Chiropractic, D27, 3rd Floor, Centre Point Sabah.

Have you ever noticed these two words being thrown about, and ever wondered whether they’re two words that mean the same thing or whether it is two completely different things? They are often used to describe injuries where you have overstretched or torn soft tissue structures around your joints. The reality is they refer to different types of soft tissue structures being injured, even if the mechanism of injury is the same!

A joint sprain refers to the overstretching or even tearing of ligaments in a joint. Ligaments, are bands of flexible, fibrous connective tissue that holds two bones or cartilage together to form a joint. The most common location you will see a joint sprain is the ankle. Other locations we typically see joint sprains are knees and wrists.

A joint strain refers to the overstretching or tearing of muscles or even tendons.

Tendons are tough, fibrous bands connective tissue that holds your muscles to your bones. The most common location we see joint or muscle strains in our office is definitely the lower back. Other common locations are your hamstrings, your quads, even the biceps.

If a joint sprain and joint strain still sounds the same, it is because tendons are ligaments are actually quite similar. Both are fibrous bands of connective tissue, and both are made of collagen. The only difference is ligaments connect two bones together, while tendons connect muscle to bone.

The commonality does not stop there, as even the symptoms are almost alike. You are going to find in both cases there is pain, swelling, and limited ability to move or flex the joint. You might see some bruising when it is a sprain, or muscle spasms when it comes to a strain.

Some of you may be well acquainted with how one gets a sprain or strain. It is not uncommon, and for those of us who are clumsy, it is a fairly regular occurrence. Activities like running, jogging, futsal, Crossfit, even golf, can lead to a sprain or strain. Slips and falls, even those where you catch yourself before you hit the ground, can be a mildly painful experience. Lifting heavy objects, lifting incorrectly, are common reasons people get back strains.

Understand that while anyone can get a sprain or a strain, there are certain factors that predisposes you to overstretching your joint. Being out of shape and in poor condition leaves your muscles weak and susceptible to injury. Not warming up before any exercise or athletic endeavour is another factor to consider. Warm ups help stretch out your muscles, gets the blood flowing and ensures you have as much range of motion as possible in your joint to prevent injury to yourself.

 

Know when your body is fatigued. Tired muscles lead to bad form, and bad form can lead to injury. Heavy lifting when your muscles are fatigued means they may not be able to provide sufficient support. Fatigue when running might mean a misstep and a rolled ankle. Know when your body is fatigued, exercise caution, and save yourself from potential pain.

Let’s just assume you did yourself in with a mild sprain or mild strain. What now? Let me introduce you to your new best friend. RICE. RICE stands for Rest, Ice, Compression and Elevate.

R.I.C.E:

Rest: Take the weight off the affected joint, avoiding any activities that may cause pain and discomfort. This is to give the joint and soft tissue structures time to heal.

Ice: Ice helps with reduce the swelling and inflammation around the area. It also has a mild numbing
effect, reducing the pain. Always be sure to put a barrier between ice and skin, like clothing or a towel. Leaving it on for 10-20 minutes, then taking it off for 20 minutes, and repeating several more times is a common method of using ice. To clarify, the ice goes on the area that is pain, not anywhere else. Putting the ice on our head when the sprain is in the ankle will not do our ankle any favours sadly.

Compression: Compressing the area affected can help reduce the swelling. Using a bandage or some

compression tape to wrap the joint will keep it from swelling too much as well as reducing movement and the possibility of more damage to the joint. It is important not to wrap too tightly and cut off circulation, as well as to loosen it should pain increase.

Elevate: Elevating the affected joint above the level of your heart is another step in reducing swelling. Fairly easy if the affected joint is your wrist; if it is the knee or ankle, you will need to be lying down on a bed or couch with your leg up to let gravity do its thing.

The RICE protocol will get you through mild sprains and strains, easing the pain and discomfort of the first 48 hours. Once the acute phase is over, rehab based management to maximise stability and strength while reducing the length of time the joint stays injured is paramount, as it can even take months to get over an ankle sprain if not careful.

It is also important to recognize when it’s time to throw in the towel and get professional help. Signs like being unable to stand or walk without significant pain, being unable to move the joint, or if you’re having numbness and tingling at the injured area, indicate a need to see your doctor about that sprain or strain you are having in case it is something a little more serious. Likewise if you are experiencing pain and difficulty moving your joint weeks after your incident, consult your doctor to find out what might be the problem.

Typical mild sprains and strains should ease off enough that you can get back to work or light activity within a few days to a week. It is usually advisable to protect the joint for at least a week or two with tape or a brace so the soft tissue has time to heal. Severe sprains and strains can be to the point where surgery is indicated, should there be a torn ligament or ruptured muscle. Sometimes, an X-ray may be requested to rule out fractures as well.

An interesting fact regarding sprains and strains in young children is that it is rather uncommon to see them with either as they are instead prone to fractures. This is due to the fact that the growth plates (areas where bone grows) on their bones are weaker than their muscles or tendons.

Accidents happen. Sometimes an injury can happen even though we are well prepared. Even so, it helps to take preventative measures to reduce the risk of sprains and strains. Stretches to warm up the joints before any strenuous activities, regular exercise to keep the body active and healthy, knowing our limits and not pushing ourselves over the point of pain, all play a part in reducing the risk of sprains and strains to our joints. Lastly if you do end up with an injury, remember to RICE, and if it looks and feels dire, seek professional help immediately.

 

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