Health Topics for Bones, Joints and Muscles

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Department of Orthopaedics

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Rheumatology Clinic

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UI Spine Center

Sprains

A sprain is an injury to a ligament. Ligaments connect one bone to another and support the joints of the body. A sprain is a tear or stretching of a ligament when a joint is moved past its normal range. This may be from a fall or sudden twist. A blow to the body that forces a joint out of its normal position may also cause a sprain. Sprains are most common in the ankle, knee, and wrist. Sprains of the wrist can happen when some one puts their hand out to catch themselves when they fall.

Sprains are graded by the severity of injury. A first degree or mild sprain is the stretching of the ligament or there may be a mild tear of a few fibers of the ligament. There is not much swelling. The area may be tender to touch with a small amount of pain when moving the joint. Weight can be put on the joint.

A moderate or second-degree sprain is a partial tear of the fibers of the ligament. The joint will be tender and hard to move. There will be pain, swelling, and a slight bruise. The joint may feel unsteady when trying to stand on it.

A severe or third degree sprain is a complete tear of the ligament. With this injury, there is severe pain, swelling, and bruising. The joint will feel like it is going to give way. Sometimes there will a pop or tear with this injury.

A healthcare provider needs to be seen for joint injuries to determine the severity of the injury. The provider will need to take an x-ray to see if there is a broken bone. The provider will want to know how the injury happened, and when it occurred. The joint will be examined for swelling, tenderness, and mobility.

The first part of the treatment for a sprain of any grade is to lessen the pain and keep the joint from swelling. This is usually done with rest, ice, compression, and elevation for 48 to 72 hours. Rest means not using or putting weight on the injured part. A cloth-covered ice pack can be put on the injured area for no more than 20 minutes 4 to 8 times a day. Sometimes, a provider will suggest applying an elastic bandage to the area. It must not be wrapped too tightly. To help reduce swelling, the injured part should be elevated so it is 12 inches above the heart.

For any of these injuries, the provider may suggest non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen. NSAIDs should be taken with food or milk to prevent stomach upset. NSAIDs should be avoided by anyone who has been diagnosed with asthma, ulcer disease, or a bleeding disorder. Taking NSAIDs increases the risk of bleeding with trauma, dental work, surgery, or if taking blood thinners (anticoagulants).

The second part of treatment is rehabilitation. When most of the pain and swelling is gone, the healthcare provider will give the person a series of exercises to do several times a day. The suggested exercises will help prevent stiffness, improve range of motion, and get the joint back to its normal flexibility and strength.

Moderate and severe sprains may need a cast. Severe sprains often need surgery. Physical therapy is usually needed after the surgery.

For a moderate sprain, a person may need 3 to 6 weeks of exercises before they can return to their normal activities. A severe sprain may take 8 to 12 months of exercises before the ligament is healed.

Some things can be done to avoid a sprain. Keep the muscles strong by eating a nutritious diet and keeping a healthy weight. Safety measures around the home help prevent falls. Wear shoes that fit right. Athletic shoes should be replaced when the tread starts to wear or the heel wears down on one side. Keep in good physical condition to play sports. This includes doing stretching exercises daily and warming up and stretching before any sports or exercise. Do not exercise when tired or in pain and always run on even surfaces.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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