How Are Sprains and Strains Treated? (NIAMS)
Reduce Swelling and Pain
Treatments for sprains and strains are similar and can be thought of as having two stages. The goal during the first stage is to reduce swelling and pain. At this stage, health care providers usually advise patients to follow a formula of rest, ice, compression, and elevation (RICE) for the first 24 to 48 hours after the injury
The provider may also recommend an over-the-counter or prescription nonsteroidal anti-inflammatory drug, such as aspirin or ibuprofen, to help decrease pain and inflammation.
For people with a moderate or severe sprain, particularly of the ankle, a hard cast may be applied. This often occurs after the initial swelling has subsided. Severe sprains and strains may require surgery to repair the torn ligaments, muscle, or tendons. Surgery is usually performed by an orthopaedic surgeon.
It is important that moderate and severe sprains and strains be evaluated by a health care provider to allow prompt, appropriate treatment to begin.
Reduce regular exercise or activities of daily living as needed. Your health care provider may advise you to put no weight on an injured area for 48 hours. If you cannot put weight on an ankle or knee, crutches may help. If you use a cane or one crutch for an ankle injury, use it on the uninjured side to help you lean away and relieve weight on the injured ankle.
Apply an ice pack to the injured area for 20 minutes at a time, 4 to 8 times a day. A cold pack, ice bag, or plastic bag filled with crushed ice and wrapped in a towel can be used. To avoid cold injury and frostbite, do not apply the ice for more than 20 minutes.
Compression of an injured ankle, knee, or wrist may help reduce swelling. Examples of compression bandages are elastic wraps, special boots, air casts, and splints. Ask your provider for advice on which one to use, and how tight to safely apply the bandage.
If possible, keep the injured ankle, knee, elbow, or wrist elevated on a pillow, above the level of the heart, to help decrease swelling.
The second stage of treating a sprain or strain is rehabilitation, whose overall goal is to improve the condition of the injured area and restore its function. The health care provider will prescribe an exercise program designed to prevent stiffness, improve range of motion, and restore the joint's normal flexibility and strength. Some patients may need physical therapy during this stage. When the acute pain and swelling have diminished, the provider will instruct the patient to do a series of exercises several times a day. These are very important because they help reduce swelling, prevent stiffness, and restore normal, pain-free range of motion. The provider can recommend many different types of exercises, depending on the injury. A patient with an injured knee or foot will work on weight-bearing and balancing exercises. The duration of the program depends on the extent of the injury, but the regimen commonly lasts for several weeks.
Another goal of rehabilitation is to increase strength and regain flexibility. Depending on the patient's rate of recovery, this process begins about the second week after the injury. The provider will instruct the patient to do a series of exercises designed to meet these goals. During this phase of rehabilitation, patients progress to more demanding exercises as pain decreases and function improves.
The final goal is the return to full daily activities, including sports when appropriate. Patients must work closely with their health care provider or physical therapist to determine their readiness to return to full activity. Sometimes people are tempted to resume full activity or play sports despite pain or muscle soreness. Returning to full activity before regaining normal range of motion, flexibility, and strength increases the chance of reinjury and may lead to a chronic problem.
The amount of rehabilitation and the time needed for full recovery after a sprain or strain depend on the severity of the injury and individual rates of healing. For example, a mild ankle sprain may require up to 3 to 6 weeks of rehabilitation; a moderate sprain could require 2 to 3 months. With a severe sprain, it can take up to 8 to 12 months to return to full activities. Extra care should be taken to avoid reinjury.
Can Sprains and Strains Be Prevented?
There are many things people can do to help lower their risk of sprains and strains:
Avoid exercising or playing sports when tired or in pain.
Maintain a healthy, well-balanced diet to keep muscles strong.
Maintain a healthy weight.
Practice safety measures to help prevent falls (for example, keep stairways, walkways, yards, and driveways free of clutter; anchor scatter rugs; and salt or sand icy patches in the winter).
Wear shoes that fit properly.
Replace athletic shoes as soon as the tread wears out or the heel wears down on one side.
Do stretching exercises daily.
Be in proper physical condition to play a sport.
Warm up and stretch before participating in any sports or exercise.
Wear protective equipment when playing.
Run on even surfaces.
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
877-22-NIAMS (226-4267) (free of charge)
The National Institute of Arthritis and Musculoskeletal and Skin Diseases provides information about bone, muscle, and joint diseases; arthritis and rheumatic diseases; and various forms of skin diseases. It distributes patient and professional education materials and refers people to other sources of information. Additional information and updates can also be found on the NIAMS Web site.
Posted on 07 Dec 2006 by coachgianni