What is sprain/ strain?
Sprains and strains occur when the body is put under physical stress. In these situations, muscles and joints are forced to perform movements for which they are not prepared or designed. An injury can occur from a single stressful incident, or it may gradually arise after many repetitions of a motion.
Usually, the mechanism of injury involves placing the muscle tendon unit or the ligament under excessive stretching, causing damage to the muscle, tendon, or ligament fibers.
The ankle is one of the most common joints that is sprained.
Usually, the mechanism of injury is a rapid "rolling" or "twisting" of the ankle and turning it inward so that the sole of the foot starts to point upward (supination). This causes stretching and damage to the ligaments on the outside or lateral part of the ankle that hold the joint stable.
Knee sprains are common football injuries and often make headlines because of their potential for ending professional athletes' playing careers. There are four ligaments of the knee that allow it to act as a hinge joint, flexing (bending) or extending (straightening).
The medial and lateral collateral ligaments and the anterior and posterior cruciate ligaments keep the knee in alignment and are assisted by the quadriceps and hamstring muscles. As an example of characterisation of an injury, when a player completely tears the anterior cruciate ligament (ACL) in the knee, it is described as a grade 3 injury of that cruciate ligament.
Neck injuries are common, for example, after a car accident. While whiplash is a non-medical term, it accurately describes the head and neck movement when violently flexed forward and backward as the car abruptly stops. While the rest of the body is held in place with a seat belt and/or air bag, the head is like a bobble head and can continue moving.
Both muscles and ligaments hold the neck bones (cervical vertebrae) in place and the stresses placed on those structures can cause pain and damage. Sometimes, the vertebrae are not damaged but the ligaments that support and stabilise the bones are torn, causing significant pain and swelling.
On occasion, these injuries can cause the neck to become unstable and put the spinal cord at risk for injury.
Wrist injuries are common because we use our hands to perform many tasks. Usually, the wrist is damaged because of a fall, but repetitive tasks and a single aggressive move can cause pain. Some sports are more prone to wrist injuries because of the forces that are asked to be placed on the joint. These include throwing sports like baseball and football, bowling, skateboarding, snowboarding, and tennis.
The thumb and fingers can also be injured. Skier's or gamekeeper's thumb describes a sprain at the base of the thumb where a ligament attached to hold the thumb stable when grasping. It is most often injured in a fall where the thumb is forced away from the palm of the hand, like when a skier falls and the ski pole pushes the thumb in an awkward direction.
Muscles strains may involve any body area that is required to perform work. Lower back pain and spasm is a common result of repetitive lifting injuries, but it only takes one twist or turn at the wrong time or in the wrong position to cause muscle fibers in the back to tear and go into spasm. Low back strain is the most common work-related injury.
Muscles of the legs can be damaged from overuse or imbalance. For example, the quadriceps muscle in the front of the thigh extends the knee and is balanced by the hamstring muscles of the back of the thigh, which flex the knee. Excess bending or straightening can cause the muscle fibers to tear.
Muscles that move and stabilize the hip are prone to injury. Groin injuries or groin pulls are strains of the hip muscles that normally the thigh inward (medically termed adduction). When the leg is pulled away from the body like doing the splits, the adductors are stretched and potentially damaged.
We use our arms and hands for a variety of activities and the arm muscles (biceps and triceps muscles) and the forearm can be strained because of lifting, pushing, pulling grabbing, twisting, and any other activity that you can imagine the arm and hand trying to accomplish.
Chest wall muscles can be pulled because of activities as aggressive as lifting or as seemingly harmless as sneezing or coughing. Strains of the large muscles on the outside of the chest (pectoralis muscles) or the muscles between the ribs (intercostal muscles) can cause significant pain and can mimic the pain of a broken rib.
The core muscles of the torso of the body, including the abdominal wall muscles and those of the back, lend stability to the trunk and are often the source of power for the arms and legs to lift and push. These muscles can be strained from many different activities that require the torso to bend, stretch, or twist.
Usually pain, though there may be a delay in onset of the symptom and the person who is injured may not recall the specific event that caused the injury. For example, a person who paints a room may develop shoulder pain the day after the repetitive effort of brushing overhead.
This is because inflammation, swelling, and spasm can take time (from minutes to hours) to develop.
Pain is always a symptom that indicates that there is something wrong with the body. It is the message to the brain that warns that a muscle or joint should be protected from further harm. In work, exercise, or sport, the pain may come on after a specific incident, or it may gradually progress after many repetitions of a motion.
Swelling almost always occurs with injury, but it may take from minutes to hours to be noticed. Anytime fibers of a ligament, muscle, or tendon are damaged, some bleeding occurs. The bleeding (such as bruising on the surface of the skin) may take time to be noticed.
Because of pain and swelling, the body starts to favour the injured part. This may cause the muscles that surround the injured area to go into spasm. Hard knots of muscle might be felt near the site of the injury.
The combination of pain, swelling, and spasm causes the body to further protect the injured part, which results in difficulty with use. Limping is an example of the body trying to protect an injured leg.
Suggestions for treating sprain/strain
Muscle, tendon, and ligament heal themselves naturally by repairing the fibers or filling in the damaged area with scar tissue. Full muscle and joint mobility may take time to return and gradual stretching may be required to return the injured area to normal.
Additionally, depending upon the area of the body that is injured, the damage sustained, and the amount of loss of function, osteopathy may be suggested. A variety of treatment modalities may be considered, including remedial massage, to encourage healing and preserve range of motion and function.
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