Please help improve this article by expanding it. Further information might be found on the talk page. (January 2007)

A sprain (from Middle French espraindre - to wring) is an injury to ligaments that is caused by being stretched beyond their normal capacity and possibly torn. A muscular tear caused in the same manner is referred to as a strain. In cases where either ligament or muscle tissue is torn, immobilization and surgical repair may be necessary.

[edit] Degrees

Although some signs and symptoms can be used to assess the severity of a sprain, the most definitive method is with the use of Magnetic Resonance Imaging (MRI). Sprains are graded in six degrees.

• The first degree is only a minor tear or stretch of a ligament.
• The second degree is a tear of a ligament, which is usually followed by pain or swelling
• The third degree is a complete rupture.
• The fourth degree breaks the ligament, along with some small bones if severe enough, and requires surgery to repair.
• The fifth degree tears all the ligaments and actually breaks all the surrounding bones; sometimes cannot be repaired and results in amputation.
• The sixth degree breaks the foot, and results in amputation straight away

[edit] Signs and symptoms

A mild second-degree sprained ankle, rotated inwards

The typical signs and symptoms associated with a sprain are the cardinal signs of a sprain.

• inflammation
• localized pain
• swelling
• loss of function
• loss of normal limb function
• elasticity of ligament decrease

[edit] Joints involved

Although any joint can experience a sprain, some of the more common include:

• the ankle. It is the most common, and has been said that sprains such as serious ankle sprains are more painful and take longer to heal than actually breaking the bones in that area. ^[1] See sprained ankle for more details.
• the knee. Perhaps one of the more talked about sprains is that to the anterior cruciate ligament (ACL) of the knee. This is a disabling sprain common to athletes, especially in football, basketball, soccer, pole vaulting, and judo. See Anterior cruciate ligament injury.
• the fingers.
• the wrist.
• the toes.

[edit] Treatment

The first modality for a sprain can be remembered using the acronym R.I.C.E.^[2]

• Rest: The sprain should be rested. No additional force should be applied on site of the sprain. If, for example, the sprain were an ankle sprain, then walking should be kept to a minimum.^[3]

• Ice: Ice should be applied immediately to the sprain to minimize swelling and ease pain. It can be applied for 20-30 minutes at a time, 3-4 times a day. Ice can be combined with a wrapping to minimize swelling and provide support.^[3]

• Compression: Dressings, bandages, or ace-wraps should be used to immobilize the sprain and provide support.^[3]

• Elevate Keeping the sprained joint elevated above heart level will also help to minimize swelling.^[3]

Ice and compression (cold compression therapy) will not completely stop swelling and pain, but will help to minimize them as the sprain begins to heal itself. Careful management of swelling is critical to the healing process as additional fluid may pool in the sprained area.

The joint should be exercised again fairly soon, in milder cases from 1 to 3 days after injury.^[4] Special exercises are sometimes needed in order to regain strength and help reduce the risk of ongoing problems. The ankle may need to be supported by taping or bracing, helping protect it from reinjury.^[4]

[edit] Prevention

Sprains can best be prevented by proper use of safety equipment (wrist, ankle guards; carts vs. lifting), warm-ups and cool-downs (including stretching), being aware of surroundings and maintaining strength and flexibility. Physical conditioning is the best way to avoid or lessen the degree of sprains.

[edit] References

• [1]