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Sprains and Strains

Overview

A sprain is  a complete or incomplete tear in the ligaments that support the surrounding joint.  A strain is an acute or chronic injury to a muscle or tendinous attachment.  Sprains and strains are both classified as mild, moderate or severe in acuteness.

Pathyphysiology

Sprains and strains has moderately different pathyphysiologies:

Sprains:

  1. * A ligament in the body tears causing the affected area to bleed
  2. * A hematoma forms
  3. * Inflammatory exudates spills from the torn ligament area
  4. * Granulation tissue develops
  5. * Collagen forms
  6. * The nerves or vessels begin to swell or stretch
  7. * Chronic joint instability and laxity result.

Strains:

  1. * Strains result from the same process as sprains do.
  2. * New muscle will form and eventually become strong enough to withstand normal muscle activity.

Causes and Risk Factors

Causes can include:

  1. * Falling down
  2. * Car or other motor vehicle accidents
  3. * Trauma
  4. * Excessive or new exercise
  5. * Sports injury

Risk factors can include:

  1. * Participating in sports or other moderately to extremely strenuous physical activities.

Common Characteristics of Sprains and Strains:

Sprains:

  1. * Localized pain
  2. * Swelling and warmth in the affected area
  3. * Progressive loss of motion
  4. * Ecchymosis

Strains:

  1. * Pain 
  2. * Inflammation
  3. * Ecchymosis
  4. * Elevated skin temperature in the affected area

Treatment

While surgery may be possibly necessary for some extreme sprains and strains, most can be treated without surgery, and only require general non-medication oriented treatments or some use of medication to alleviate pain, swelling, etc. 

General:

  1. * Using the RICE method (rest, ice, compression, and elevation)
  2. * Rehab and exercise program
  3. * Limited weight bearing activity that could hurt the injured area
  4. * Elevation of affected joint above the level of the heart for 48 to 72 hours
  5. * ROM (range-of-motion) exercises.

Medications:

  1. * Vitamin C supplements
  2. * Nonsteroidal anti-inflammatory drugs
  3. * Analgesics
  4. * Cox-2 inhibitors

Surgery:

  1. * Depends on the extent of the injury

Outcomes

  1. * Better mobility
  2. * Diminishing levels of pain
  3. * Increased comfort
  4. * Identify factors that increase the chance of injury

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