DESCRIPTION
A strain is a stretched or torn muscle. A sprain is a stretched or torn ligament. Sprains occur most often in the ankles, knees or fingers, although any joint can be sprained. Sprained joints can function, but only with pain.

FREQUENT SIGNS AND SYMPTOMS

• Pain or tenderness in the area of injury (severity varies with the extent of injury)
• Swelling of the affected joint
• Redness or bruising in the area of injury, either immediately or several days after injury
• Loss of normal mobility in the injured joint

• Obesity
• Trauma
• Excessive exercise
• Poor conditioning
• Poor fitting shoes and high heeled shoes
• High risk activities: skateboarding, contact sports, ice and roller skating

• Permanent weakness if the sprain is severe or if a joint is sprained repeatedly
• Arthritis

Strains usually are associated with overuse injuries. Sprains usually occur due to trauma (fall, twisting injury or automobile accident). The ankle is injured most often because of its anatomical weakness, its exposed position and the stress it sustains in athletic and recreational activities. It is difficult to differentiate sprains from strains.

PREVENTIVE MEASURES

• Maintain a good level of fitness and try to avoid injury
• Wrap weak joints with support bandages before strenuous activity
• Stretch muscles before and after exercise
• Strengthen weak muscles with rehabilitative exercises to prevent a recurrence
• Accident-proof your home

EXPECTED OUTCOME
With appropriate treatment, expect six to eight weeks for recovery. It may take longer depending on the severity of the injury.

ACTIVITY

• Allow the joint to rest one or two days.
• After resting, begin exercising the joint gently, without putting weight on it.
• Physical therapy may be recommended to regain strength and normal use of the joint

• Apply ice to the injured joint during the first 24 hours. Place ice in a plastic bag and separate it from the skin with a thin towel. Hold it against the joint for up to two hours at a time, either constantly or intermittently, depending on your ability to tolerate the cold. Continue the ice treatment at two-hour intervals for 24 hours while awake.
• After 24 hours, you may switch to heat.
• To use heat either soak the joint in warm water or apply heat for 15 minutes every two hours or whenever possible. Do not apply heat during the first 24 hours. It may increase bleeding and swelling and may prolong the healing time.
• Compress with an elastic (Ace®) bandage.
• Whenever possible, elevate the joint (especially while sleeping) so fluid can drain and decrease swelling

MEDICATION
You may use nonprescription pain relievers such as acetaminophen or ibuprofen. Avoid aspirin because it may increase the tendency to bleed.

CONSIDER NOTIFYING YOUR PHYSICIAN IF ANY OF THE FOLLOWING OCCUR:

• You or a family member has a sprained joint that will not bear weight or move normally
• Pain becomes intolerable
• Swelling or bruising increases, despite treatment.