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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Sprains and Strains

What is it?

A sprain refers to an injury to a ligament—one of the tough, fibrous cords that act as tethers to hold the bones together at the joint. Sprains occur at the joints when the adjacent bones are twisted or pushed too far. The ligaments can stretch and even tear, causing pain and loss of function. The most common joints to experience sprains are the knee, ankle, shoulder, and those in the fingers. A strain refers to a muscle injury. As such, strains usually occur away from the joint, in the muscle tissue. The most commonly injured muscles are the hamstring at the back of the thigh and the gastrocnemius, or calf muscle. Athletes commonly suffer both sprains and strains.

What Causes It?

  • Sprains occur as a result of an injury, when the joint is subjected to more physical force than it can withstand.
  • Strains occur when a muscle is overstretched or overexerted, often from running or lifting a weight.
  • Previous sprains may weaken the ligaments; recurrence is possible with only minor pressure.
  • Strains increase with obesity and poor muscular conditioning.

Prevention

  • Perform warm-up exercises before undertaking any strenuous physical activity.
  • Engage in regular, moderate exercise to keep muscles and joints strong and flexible.

Diagnosis

  • Patient history and physical examination are needed.
  • X-rays of the affected joint to rule out a bone fracture or other underlying problem.

How to Treat It

First-aid measures for a sprain or strain can be easily remembered with the acronym RICE, short for rest, ice, compression, and elevation: * Rest the injured area. Try not to move or put pressure on the affected joint. A sling or splint may be recommended to immobilize the joint and allow damaged ligaments or muscles to heal. * Ice the affected area to reduce swelling. Apply ice daily (but for no longer than 20 minutes at one time) until the pain and swelling have resolved, and full motion and function have returned. * Compress the joint by wrapping it in an elasticized bandage to help reduce swelling and pain. * Elevate the joint to reduce swelling. * In addition, take over-the-counter pain relievers to treat minor pain. Your doctor may prescribe stronger analgesics for more severe pain. * Surgery may be required in severe cases to repair torn ligaments. * After the pain has subsided, gently exercise the joint to regain strength and mobility. A physician or physical therapist may help devise an exercise program to aid in rehabilitation.

When to Call a Doctor

  • Call a doctor if symptoms do not respond to selfcare treatments.
  • Contact a doctor if you feel a joint shift, especially if it is accompanied by extreme pain, swelling, or loss of motion, or if the area turns black and blue.