Sprain / Strain

Sprain. A ligament is defined as a fibrous connective tissue attaching bone to bone. Ligaments stabilize mobility by preventing certain range of motions. Ligaments are made up of connective tissue that resist stretching. They have a very poor blood supply to them. Because of this, they heal slowly. Sprains are classified as mild or plus one, meaning that the ligament fibers have been stretched or slightly torn. The ligament fibers, although injured, still are able to function. A moderate, or plus two sprain has some degree of ligament tearing. Also the ligament has been damaged enough as to allow some abnormal motion or elasticity of the joint. Type three sprains are severe with complete or near complete tear of the ligament. Abnormal motion with total elasticity of the joint can occur. Type three frequently required bracing or surgical repair.

Sprains are the result of violent forces that are strong enough to stretch or rip ligaments. Pain, stiffness and inflammation are signs of a sprain. Some sprains may not show up immediately. An example of this is whiplash or hyper-extension/flexion injury. This causes damage to the cervical ligaments.

Symptoms from a sprain are frequently worse the day after the sprain. Common areas for sprains to occur are the shoulder or acromioclavicular ligaments, the knee including the interior cruciate and the medial and collateral ligaments and the ankle with the talofibular and talocalcaneal ligament and fingers. As soon as the injury happens, it is important to make sure that there are no fractures or dislocations. Exam and X-ray may be required. The first thing you want to do for the joint is ice it down. Ice packs, crushed ice, ice cubes in a bag and a bucket of ice water should be adequate to ice any joint. Ice the joint down for twenty-to-thirty minutes. Wait for a period of one-to-two hours between icings and do this at least three times a day. If you can do it more, great! Alternating hot for five minutes and cold for ten minutes up to one hour can also be of benefit.

Stretching and motion has been shown to be extremely important to how well the sprain heals. You want the ligament to heal without any slack and as strong as possible. Studies now show that by stretching the damaged ligament and moving the damaged joint, scar tissue sets up along the lines of stress. This creates a stronger ligament when healing is complete. If the tear is severe, a period of immobilization or bracing takes place. This should be kept to a minimum and motion and strengthening started immediately. Type two and type three sprains need to be monitored by a physician. Stretching and motion, even if it is done very light, should always be started as soon as possible with any type of sprain.

Pharmaceutical drugs and natural remedies including acupuncture and herbs can be given to reduce inflammation, Enzymes have reported good use in musculoskeletal type injuries. Enzymes have reported anti-inflammatory benefits in trauma like sprains and strains. They have the added benefit of promoting wound and tissue healing. Enzymes are thought to speed up the inflammatory process, thereby decreasing would healing time. This can cause a temporary worsening of the symptoms at first. This is not a bad sign but we may need to decease the dosage. Enzymes seem very safe to take. Enzymes can be made up of natural plant enzymes or natural animal enzymes. Some allergic reactions can occur but are rare.

Acupuncture has shown numerous studies in reducing pain. It seems especially useful in musculoskeletal-like pain, like a sprain. Also, elevate the part, if possible. Gravity will help reduce the swelling. Compression around the joint will help prevent inflammation. Make sure you don’t cut off the circulation. Compression with elastic bandage can be worn twenty-four hours a day. Be especially sure not to cut off circulation at night before going to bed.

A range of physical modalities can be applied to sprains. These consist of Ultrasound and Interferential. Both have the ability to decrease pain and increase healing. They are very useful early in an injury. Ice is usually applied simultaneously.

Once the injury happens, the muscles around the joint of the damaged ligament go into a contracture. This is called splinting It is protective mechanism designed to prevent you from moving the injured area. If splinting is allowed to go on to long, the muscles, capsules, tendons and ligaments will shorten and you will loose function. A joint that does not function right is programmed to be painful. Manipulation can help restore normal movement to a damaged joint, preventing Osteoarthritis and dysfunction in the future.

When manipulation starts depends on the joint and the degree of injury. Early manipulation of the severe sprain should not be done. Generally, the milder the sprain, the earlier the manipulations can start. Manipulation of the joint helps the joint heal better. Some joints remain hyper-mobile and should not be manipulated. Therefore, a manipulation of a sprained joint should only be done with a skilled individual schooled in the art of manipulations.

As the pain and inflammation subside, gentle stretching techniques are prescribed. The stretch should be gradually increased as the patient’s pain and inflammation improve. Strengthening should be started once the pain starts to subside and the patient has stretched the joint a couple of days, to a couple of weeks. Strengthening usually starts with very small weights. Start out with two sets a day with a high amount of reps, fifteen to twenty. As this is tolerable, you can start to add more weight and decrease the reps. You may want to ice the joint if the exercises or the stretches seems to be irritating. You can ice the joint ten-to-thirty minutes before and after the stretching or strengthening routines. It is best to be monitored by a physician to do this, especially in Type One or Type Two sprains.

Some sprain joints are left with the joint lax or moving to much. Others may heal with contractures in the joints and muscles. Here, you have a joint that is restricted or lacks mobility. These are opposite situations. Manipulation can prevent the latter. Bracing of the joint in athletic or everyday life may become necessary with a hyper-mobile joint or one that is moving to much. Both of these situations create an increase risk for degeneration, especially in the spine and the knees.

Supplements to support Osteoarthritis including Glucosamine Sulfate are usually prescribed. We suggest looking under the area of Osteoarthritis. These are only recommended for Type Two to Type Three sprains or moderate to severe sprains.

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