by Lawrence R. Schiff, MD, FACEP and Farheen Gaffar RPA-C
Now that the warmer weather is here, no doubt you are gearing up to become more active. Whether its running, biking, tennis or softball, chances are, your weekend plans will include at least one type of sports activity.
Sports injuries should not be taken lightly. In fact, other than the common cold, sport-related injuries are some of the most common reasons people visit the local hospital Emergency Department. Acutely, it is often difficult to determine the full extent of one’s own injury.
A sprain can result from a fall, a sudden twist, or a blow to the body that forces a joint out of its normal position and stretches or tears the ligament(s) supporting that joint. Typically, sprains occur when people fall and land on an outstretched arm, slide into a baseball base, land on the side of their foot, or twist a knee with their foot planted firmly on the ground.
The severity of the injury depends on the extent of injury, whether a tear is partial or complete, and the number of ligaments involved. Mild sprains generally heal rapidly, but if not treated or properly rested, the joint can be re-injured.
Sprain symptoms include pain, swelling, tenderness and bruising. Sprains generally take longer to heal than broken bones. Although sprains can occur in both the upper and lower parts of the body, the most common ligament to be injured is the anterior talo-fibular ligament in the ankle. Most ankle sprains happen when the foot turns inward as a person runs, turns, falls, or lands on the ankle after a jump.
Thumb sprains occur when a ligament near the base of the thumb is torn or over-stretched. The most common ligament to be injured is the ulnar collateral ligament, commonly referred to “skiers thumb.” Sometimes people feel a pop or tear when the injury happens. In this case, an emergency physician or hand specialist will closely observe the injured site to diagnose the severity of your sprain.
Strains are different from sprains and can occur by twisting or pulling a muscle or tendon. Strains can be acute or chronic. An acute strain is associated with a recent injury, lifting heavy objects the wrong way or overstressing the muscles. Chronic strains are often the result of overuse: prolonged, repetitive movement of muscles and tendons.
Common sites for strains include the back or hamstring muscle due to contact sports such as soccer, football, hockey, boxing, and wrestling. Gymnastics, tennis, rowing and golf are sports that require extensive gripping and can increase the risk of hand and forearm strains.
Typically, people with a strain experience pain, limited motion and muscle spasms, in addition to localized swelling, cramping, or inflammation.
First-aid treatment for sprains and strains, known as the RICE regimen, is as follows:
Rest the injured area by keeping weight off the area for 48 hours. If the injury involves an ankle or knee, you may need crutches. 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.
Ice the injured area for 20 minutes of every hour for the first 24 hours to 48 hours. Ice is only effective during this period to decrease pain and swelling. A cold pack, ice bag, or plastic bag filled with crushed ice and wrapped in a towel can be used. Do not put ice directly on the skin.
Compress the injured area to protect and support the injury. Examples of compression bandages are elastic wraps, special boots, air casts, and splints. An emergency physician can advise you on which one to use, and how tight to safely apply the bandage.
Elevate the injured area on a pillow, above the level of the heart, to help decrease swelling.
Sprains can be either moderate or severe depending on whether the tearing of the ligament is partial or complete. An x-ray may be needed to help determine if a fracture is causing the pain and swelling. Magnetic resonance imaging is occasionally used to help differentiate between a significant partial injury and a complete tear in a ligament or tendon. It may also be recommended to rule out other injuries.
Moderate and severe sprains should be properly evaluated by a physician to allow prompt, appropriate treatment to begin. The emergency physician at your local hospital can help determine when the attention of an orthopaedic surgeon is indicated to repair torn ligaments, muscle, or tendons.
Typically, healing time for mild sprains is 2-6 weeks, moderate sprains is 6-8 weeks and severe sprains is 8-10 weeks.
This information is provided by Lawrence R. Schiff, MD, Chairman of Emergency Medicine and Farheen Gaffar RPA-C, Physician’s Assistant at Eastern Long Island Hospital.