Sprains and Strains

Saturday, June 3, 2006 | 0

By Jomar Almeda, MD (faculty, WorkCompSchool)

Sprains and strains are terms we commonly hear or use and yet, poorly understood. Is a sprain a strain? Is a strain a sprain? In what way is one different from the other? Sprains and strains are soft-tissue injuries frequently associated with sports, but also account for a great majority of work-related injuries. Although each can occur as an isolated injury, they can also occur together.

A SPRAIN is an injury to a ligament. Ligaments are the strong and flexible fibers that connect bones together keeping the joints in place. The type of injury may vary from overstretching or tearing of one or more ligaments, and severity depends on the extent of injury. It can be caused by twisting injuries, falls, or direct trauma which displaces a joint out of its anatomic position.

SPRAINS can occur anywhere in the body, the most common site being the ankle. Early signs and symptoms include pain and swelling, bruising, and in more severe cases, loss of normal joint motion and function. A Grade I or mild sprain is caused by overstretching or slight tearing of the ligaments. Symptoms are usually minimal, with little or no loss of function of the affected joint. In Grade II or moderate sprain, there is more extensive, but still partial tear of the ligaments. This is characterized by moderate pain and swelling, with some loss of joint function. In Grade III or severe sprain, there is complete tearing or rupture of the ligament. Symptoms are generally severe, and is associated with joint instability.

A STRAIN is an injury to a muscle or tendon. Tendons are the tough but flexible tissues that connect muscles to bone. Muscles are responsible for the body's movement. When it contracts, it shortens, and produces a pulling action on the tendons attached to bone to effect movement. Strains are caused by twisting or pulling injuries that could occur acutely or over time (chronic). Overstretching or tears in muscles and tendons can result from performance of daily activities, sports, or work.

The back and muscles in the posterior compartment of the thigh are often strained in people engaged in activities which involves heavy lifting, bending, twisting, and awkward body positioning. The arms and legs may also be strained in industries or sports where they are used a lot.

Severity of symptoms depend on the extent of injury, and includes pain and swelling, bruising, and difficulty or loss of motion.

TREATMENT WITH R.I.C.E.:

Initial treatment for sprains and strains are the same.

* Rest the injured area. Avoid those activities that were known to have caused the injury or those that produce pain. Occasionally, temporary immobilization may be necessary to protect the damaged ligament, muscle, or tendon. To prevent deconditioning, physicians will usually recommend exercises for the uninvolved extremity.

* Ice the affected area. Application of ice and cold packs limit the swelling and reduce pain after an injury (15 - 20 minutes every hour in the initial phase).

* Compress the area with an elastic bandage or compressive wraps. Application should be snug, but not tight. Compressive wraps and bandages offer added support and also help minimize the swelling.

* Elevate the injured extremity to control and prevent further swelling.

It is important to see a doctor following an injury, so that optimum treatment can be given. Most patients recover strength, stability, and function completely without major complications following appropriate medical care. Severe injuries however may weaken the ligaments, muscles, and tendons, making the individual more at risk of re-injury. The physician may then decide to recommend surgery to reconstruct the torn ligaments or muscles. This is often followed by a program of physical therapy and rehabilitation.

PREVENTION:

* Risk of injury can be minimized by maintaining good physical conditioning with daily stretching and regular exercises.

* Eat a well-balanced diet and keep weight within the ideal.

* Wear shoes and protective gears, or equipments that fit properly.

"If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." - Hippocrates

(Note: The above information is not intended to substitute professional medical evaluation and treatment).

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Prior to his involvement with Workers' Compensation, Jomar Almeda, M.D., a graduate of the U.E.R.M. College of Medicine, has over 12 years of active orthopaedic practice in Manila, Philippines. He was Arthroscopy Journal's Traveling Fellow in 2000, and later become an International Member of the Arthroscopy Association of North America in the same year. Jomar also received extensive training at the Nobuhara Orthopaedic Hospital and Institute of Biomechanics in Japan, at the National University Hospital in Singapore, and at Warwick Valley Orthopaedic Surgery, PC in New York.

Jomar is also certified in Occupational and Industrial Medicine and had served as a medical consultant for various multi-national companies in his native country. He is currently with the Workers' Compensation Department of Integrative Industrial and Family Practice Medical Clinics.

Jomar, a graduate of a comprehensive WorkCompSchool program, is now sharing his professional expertise in WorkCompSchool's faculty, with a premier online course currently in the production stages. He can be reached at jomar@lamedcenter.com.

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