SPRAINS VS STRAINS Flashcards
SPRAINS & STRAINS ARE CAUSED BY
excessive reaching, bending, lifting, gripping, squatting, or twisting of hands, shoulders or body
Any work performed with high force, with many
repetitions, or in an awkward position
a stretch or tear of a ligament stretched too far from normal position
SPRAIN
One or more ligaments may be injured at the same time
MOST COMMON SPRAIN
ANKLE
an injury to a muscle or tendon (thick, tough fibrous cord of tissue that connects a muscle to a bone)
STRAIN
Can be as simple as overstretching a muscle or tendon, or it can be a partial or complete tear
MOST COMMON STRAIN
BACK
types of sprains & strains
Back injuries, including pulled back muscles and
ruptured discs
Compressed nerves causing severe pain, such as
carpal tunnel in wrist or sciatic leg pain from back
Ligament sprains in the upper body
Shoulder muscle sprains and dislocations
Abdominal hernias
Tendon injuries to the hands, forearms and elbows
(tennis elbow)
Ankle sprains and strains
where do sprains usually occur?
MC location = ankle
other common locations = wrist
sprain to the thumb common in skiing and other sports
apart from the ankle, sprains also often occur at the
wrist
sprain to the ________ is common during skiing & other sports
thumb
most common ligament sprained in sprained ankle
ATFL
anterior talofibular ligament
then the calceofibular ligmanet
then the posterior talofibular ligament
ankle sprain grades
⦁ Grade I = ligament stretched or slightly torn
⦁ Grade II = ligament partially torn
⦁ Grade III = ligament completely torn
FUNCTIONAL LOSS
- grade I = minimal
- grade II = moderate
- grade III = maximum
INSTABILITY
- grade I = none
- grade II = moderate
- grade III = marked
Injury to either a muscle or a tendon as a result of suddenly pulling them too far
May be a simple overstretch of muscle or tendon, or a result of a partial or complete tear
STRAIN
2 COMMON SITES OF STRAINS
- back
- hamstring muscle
other locations:
- hand
- forearm
- elbow
- adductor muscles (groin pull)
- gastroc
most common sites of strains = back & hamstring muscles
other common locations =
- hand
- forearm
- elbow
- adductor muscles (groin pull)
- gastroc
how do sprains & strains occur
⦁ Carrying, holding, or restraining items, people or animals
⦁ Lifting, pushing, holding or pulling loads
⦁ Working in a fixed position with the back bent, sitting or standing continuously, or driving vehicles for long periods
⦁ Repetitive tasks such as reaching to lift or lower objects, or to grip tools continuously
⦁ Working in awkward positions involving bending or twisting your body to reach items
⦁ Vibrations through the body like driving a truck or using a powered hand tool
what occupations do strains/sprains occur often in
- Construction
- Agriculture
- Trucking / transportation
- Food services
- Delivery services
- Custodial services
SIGNS/SYMPTOMS OF SPRAIN (injury/tear of ligament)
⦁ pain
⦁ swelling
⦁ bruising
⦁ not being able to move the joint**
SIGNS/SYMPTOMS OF STRAIN (injury/tear to muscle or tendon)
⦁ pain ⦁ muscle spasms*** ⦁ muscle weakness*** ⦁ swelling ⦁ cramping ⦁ difficulty moving the muscle***
difference = muscle spasms / muscle weakness
also have difficulty moving the muscle, whereas with sprains = not able to move joint
SPRAIN TREATMENT - 1st stage
RICE
- rest
- ice
- compress
- elevate
REST the injured area (reduce regular exercise or activities as needed)
ICE the injured area, 20 minutes at a time, four to eight times a day (cold pack, ice bag, or plastic bag filled with crushed ice and wrapped in a towel can be used)
COMPRESS the injured area, using bandages, casts, boots, elastic wraps or splints to help reduce swelling
ELEVATE the injured area, above the level of the heart, to help decrease swelling while you are lying or sitting down
SPLINTS fall under which RICE treatment for sprains
compression
using bandages, casts, boots, elastic wraps or splints to help reduce swelling
posterior splint vs stirrup splint
similar to posterior splint, but less inversion / eversion, and less plantar flexion compared to posterior splint
- great for ankle sprains
- 12-15 layers of 4-6 inch plaster
leave on for 10 days; f/u as needed
for moderate & severe sprains
o Moderate sprain
- may require the use of mobility aids: cane, crutches, walker or wheelchair
o Severe sprain
- may need surgery to repair torn ligaments, muscles or tendons
- short course of narcotic analgesic may be necessary if grade III sprain with severe pain
still use
- NSAIDS
- RICE
- weight bearing as tolerated
WHEN TO XRAY ANKLE SPRAINS = OTTAWA RULES
- ankle X-ray only required if there is any pain in the malleolar zone, and any one of the following:
⦁ bone tenderness along the distal 6 cm of the posterior edge of the tibia or tip of medial malleolus
⦁ Bone tenderness along the distal 6 cm of the posterior edge of the fibula or tip of the lateral malleolus
⦁ An inability to bear weight both immediately and in the emergency department for four steps
SPRAIN TREATMENT - 2ND STAGE
o REHAB
⦁ Physical Therapy / exercise program: designed to help reduce swelling, prevent stiffness and restore normal, pain-free range of motion - during 1st week after injury
⦁ Increase strength & flexibility - usually do more demanding exercises to improve function - during 2nd week after injury
⦁ Return to full daily activities, including sports if appropriate; must work closely with PT to avoid re-injury
TREATMENT OF STRAINS (much simpler)
- Rest
- Alternate Ice / Heat
- NSAIDS
- Muscle relaxers if accompanied by spasm
- Advance to stretching / ROM exercises
- Refer to PT if indicated
TIME NEEDED FOR FULL RECOVERY
HEALING TIME FOR STRAINS / SPRAINS
⦁ mild sprain / strain = 3-6 weeks
⦁ moderate sprain / strain = 2-3 months
⦁ severe sprain / strain = 8-12 months
