Welcome to a comprehensive exploration of sprains, where we aim to equip you with the knowledge and guidance necessary to navigate the world of joint injuries. Whether you're seeking insights on prevention, treatment, or recovery, this article will provide you with the essential information to confidently address and overcome sprains, allowing you to regain your mobility and get back to doing what you love.
Sprains are injuries that occur when the ligaments, the tough bands of tissue connecting bones in a joint, are stretched or torn. These injuries typically happen due to sudden twisting or wrenching motions, often during physical activities or accidents. Sprains commonly affect joints like ankles, wrists, and knees, causing pain, swelling, and limited mobility.
Join us as we uncover the types and grades of sprains, the factors that contribute to their occurrence, and the steps you can take to prevent and manage these injuries. By the end of this article, you will be equipped with valuable information to better understand sprains, allowing you to take proactive measures in safeguarding your joints and promoting optimal recovery.
A sprain is defined as an injury to the ligaments, which are resilient bands of fibrous tissue that connect bones together, providing stability to the joints.1 When a joint undergoes excessive force, the ligaments can stretch or tear, resulting in a sprain.2
Sprains commonly occur in weight-bearing joints, with the ankle being particularly susceptible due to its complex structure and involvement in various physical activities. The knee and wrist are also commonly affected by sprains.
Degrees of sprains
Sprains are categorised into three degrees based on their severity.
A mild or first-degree sprain involves minimal stretching or microscopic tearing of the ligament fibres, leading to mild pain, swelling, and tenderness in the affected area. With proper rest and care, first-degree sprains generally heal within a few weeks.
Moderate or second-degree sprains occur when the ligament is partially torn, causing more pronounced pain, swelling, bruising, and joint instability. These sprains often require medical attention and may take several weeks to heal.
Severe or third-degree sprains involve a complete tear of the ligament, resulting in severe pain, extensive swelling, bruising, and significant loss of joint function. Third-degree sprains often require immobilisation and may necessitate surgical intervention for proper healing.3
Causes of sprains
Sprains often arise from sudden twisting or wrenching movements, falls, or direct blows to a joint. Sports activities that involve rapid changes in direction, jumping, or physical contact, such as basketball, football, or gymnastics, pose a higher risk of sprains.
Additionally, overuse injuries caused by repetitive stress on a joint, commonly seen in activities like long-distance running or repetitive overhead motions in sports like tennis or baseball, can lead to sprains.
Environmental factors, such as uneven surfaces or inadequate protective equipment, can also contribute to sprains.4
Signs and symptoms of sprains
The signs and symptoms of a sprain may vary depending on its severity.
In mild sprains, individuals may experience mild pain, swelling, and tenderness in the affected joint.
Moderate sprains often present with more significant pain, swelling, bruising, joint instability, and difficulty bearing weight on the injured limb.
Severe sprains result in severe pain, extensive swelling, bruising, joint instability, and a complete loss of joint function.5 Individuals with severe sprains may have difficulty moving the joint and may hear a popping sound at the time of injury.
Management and treatment for sprains
The initial management of a sprain involves following the RICE protocol:6
- Rest: Resting the injured area and avoiding strenuous activities allows the ligaments to heal
- Ice: Applying ice packs for 15-20 minutes at a time helps reduce swelling and pain by constricting blood vessels and numbing the area
- Compression: Compression with an elastic bandage provides support, reduces swelling, and helps stabilise the joint
- Elevation: Elevating the injured joint above heart level also aids in reducing swelling by facilitating fluid drainage
In cases of moderate to severe sprains, medical intervention may be necessary. An orthopaedic surgeon or a sports medicine specialist may recommend immobilisation with a brace, splint, or cast to protect the joint and facilitate healing.3 Crutches may be provided to alleviate weight-bearing pressure on the affected limb.
Physical therapy is often prescribed to restore strength, flexibility, and stability to the injured joint, as well as to prevent future sprains. Physical therapists can design customised rehabilitation programs that include exercises to improve joint range of motion, strengthen surrounding muscles, and enhance proprioception (the body's awareness of its position in space). Gradual progression of activities and functional training help individuals regain full functionality of the injured joint.
Accurate diagnosis is crucial for determining sprain severity and guiding treatment. Healthcare providers start with a detailed medical history, considering injury circumstances and past sprains. This establishes a comprehensive understanding of the condition.
After the medical history, a thorough physical examination assesses the joint. Swelling, tenderness, bruising, and instability are carefully examined. Specific tests evaluate range of motion, strength, and joint stability. These tests involve moving the joint, applying pressure, and assessing pain levels.
Imaging tests, like X-rays, rule out fractures with similar symptoms to sprains. X-rays provide detailed bone views to identify fractures or abnormalities. However, X-rays may not always provide sufficient information about soft tissues, like ligaments. In those cases, MRI scans are recommended. MRI scans generate detailed images of ligaments and tendons, revealing sprain severity and associated injuries.3
Risk factors contribute to an individual's susceptibility to sprains. Engaging in high-impact sports or activities involving sudden movements, frequent changes in direction, or physical contact significantly increases the risk.
Inadequate warm-up and conditioning routines prior to physical activity, along with muscle imbalances and weakness, can compromise joint stability.7 Fatigue and overexertion impair coordination and muscle control, elevating the risk.
Previous sprains indicate ligament weakness or joint instability, making individuals more prone to future sprains. Genetic factors, such as joint laxity or hypermobility, can predispose individuals to sprains.7
Environmental factors, including uneven surfaces and inadequate protective equipment, also contribute to sprain occurrences.
Recognising these risk factors empowers individuals to take preventive measures like regular conditioning, proper warm-up routines, protective gear usage, and practising good form to reduce the likelihood of sprains and maintain musculoskeletal health.
Prevention of sprains
Preventing sprains involves adopting several proactive measures, including:
- Adequate warm-up exercises before engaging in physical activities help prepare the muscles and ligaments for the demands of exercise
- Maintaining overall physical fitness through regular exercise and conditioning strengthens muscles and improves joint stability
- Wearing appropriate footwear that provides proper support and cushioning can help reduce risk of sprains
- Use protective equipment when participating in sports, such as helmets, knee pads, or ankle braces
- Avoiding activities on uneven surfaces and being mindful of environmental conditions, such as wet or slippery surfaces.6
How can I prevent sprains?
To prevent sprains, you can take precautions such as warming up before physical activities, strengthening muscles around the joints, maintaining flexibility through stretching, wearing appropriate footwear, being cautious on uneven surfaces, using protective equipment when needed, and allowing your body sufficient rest and recovery time.
How common are sprains?
Sprains are common injuries that can occur in people of all ages and activity levels. The frequency of sprains varies depending on the population and activities involved. Ankle sprains, for example, are among the most common, especially in sports-related injuries.
When should I see a doctor?
It is advisable to see a doctor if you experience severe pain, inability to bear weight or use the affected joint, significant swelling and bruising, joint instability or recurrent sprains, or limited range of motion. Seeking medical attention helps assess the severity of the injury, determine appropriate treatment, and prevent further complications.
In conclusion, sprains are common injuries that can occur in various joints, particularly during physical activities and sports. Understanding the different degrees of sprains, their causes, signs and symptoms, management and treatment options, diagnosis methods, risk factors, and prevention strategies is crucial for effective prevention, early intervention, and successful recovery.
By implementing proper prevention strategies, engaging in regular conditioning exercises, and seeking timely medical attention, individuals can minimise the risk of sprains and maintain their overall musculoskeletal health.
- Bahr R, Alfredson H, Järvinen M, Järvinen T, Khan K, Kjær M, et al. Types and causes of injuries. In: The IOC Manual of Sports Injuries [Internet]. 1st ed. Wiley; 2012 [cited 2023 Jun 22]. p. 1–24. Available from: https://onlinelibrary.wiley.com/doi/10.1002/9781118467947.ch1
- Kumar S. Theories of musculoskeletal injury causation. Ergonomics [Internet]. 2001 Jan [cited 2023 Jun 22];44(1):17–47. Available from: https://www.tandfonline.com/doi/full/10.1080/00140130120716
- Melanson SW, Shuman VL. Acute ankle sprain. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Jun 22]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK459212/
- Raina S, Nuhmani S. Factors leading to lateral ankle sprain: a review of the literature. J Musculoskelet Res [Internet]. 2014 Dec [cited 2023 Jun 22];17(04):1430001. Available from: https://www.worldscientific.com/doi/abs/10.1142/S0218957714300014
- Carto C, Lezak B, Varacallo M. Anatomy, bony pelvis and lower limb: distal tibiofibular joint(Tibiofibular syndesmosis). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Jun 22]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK547655/
- Vuurberg G, Hoorntje A, Wink LM, van der Doelen BFW, van den Bekerom MP, Dekker R, et al. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med. 2018 Aug;52(15):956. Available from: https://bjsm.bmj.com/content/52/15/956.long
- Kobayashi T, Tanaka M, Shida M. Intrinsic risk factors of lateral ankle sprain: a systematic review and meta-analysis. Sports Health [Internet]. 2016 Mar [cited 2023 Jun 22];8(2):190–3. Available from: http://journals.sagepub.com/doi/10.1177/1941738115623775