Sprains

By Mayo Clinic Staff

A sprain happens when a ligament is stretched or torn. Ligaments are tough bands of tissue that connect bones at a joint. The ankle is the most common place for a sprain.

The first steps in treating a sprain are protection, rest, ice, compression and elevation. This is called the P.R.I.C.E. method. Most mild sprains can heal at home. More serious sprains may need surgery to repair torn ligaments.

The difference between a sprain and a strain is that a sprain affects ligaments, the tissues that connect bones. A strain affects muscles or tendons. Tendons connect muscles to bones.

Sprain symptoms depend on how serious the injury is. They may include:

• Pain.
• Swelling.
• Bruising.
• Trouble moving the joint.
• A popping sound or feeling at the time of injury.

Although many sprains can be treated at home, the same type of injury can sometimes cause a fracture or other serious damage. See a healthcare professional if you:

• Can't move or bear weight on the joint.
• Have pain directly over the bone of an injured joint.
• Have numbness in the injured area.

A sprain happens when a ligament is stretched too far or torn because of too much stress on a joint. Common examples of how this happens include:

• Ankle. Walking or running on uneven ground or landing awkwardly after a jump.
• Knee. Twisting or pivoting quickly during sports or exercise.
• Wrist. Falling and catching yourself with an outstretched hand.
• Thumb. Overstretching the thumb in sports such as skiing or tennis.

Children's bones have softer areas called growth plates near the ends of the bones. Because ligaments are often stronger than growth plates, young children are more likely to injure a growth plate than sprain a ligament.

Factors contributing to sprains include:

• Slippery or uneven surfaces. These increase your chance of twisting a joint.
• Fatigue. Tired muscles don’t support your joints as well and make you more prone to injury.
• Poor equipment. Shoes or sports gear that don’t fit properly or are worn out can increase your risk of sprains.

You can lower your chances of sprains by:

• Doing regular stretching and strengthening exercises for your sport, fitness routine or job.
• Staying in shape before playing your sport instead of using the sport to get in shape.
• Following a conditioning plan to protect your joints if your job is physically demanding or you regularly take part in sports. A conditioning plan is a regular plan of exercise designed to improve balance and the strength, flexibility and endurance of your muscles and joints.
• Strengthening muscles around joints you have injured in the past. Your muscles act as a natural brace to support your joints.
• Wearing supportive, well-fitting shoes or gear.
• Asking your healthcare professional about stability and conditioning exercises that fit your needs.

During an exam, your healthcare professional asks about how the injury happened. The exam includes looking for swelling and checking for tender spots by pressing on the injured area. The exact location and level of pain help show how serious the injury is.

X-rays may be used to check for broken bones. MRI scans may be ordered to see how badly the ligaments or soft tissue are injured.

For immediate self-care of a sprain, follow the P.R.I.C.E. approach — protection, rest, ice, compression, elevation. Do this even if you are seeking medical help.

• Protect. Protect the injured area. Use crutches or a cane to keep weight off an injured foot. Your healthcare professional may recommend a brace or splint, depending on your sprain.
• Rest. Avoid activities that make the pain or swelling worse, but don't stop moving completely.
• Ice. Apply an ice pack or a bag of ice and water to the injured area. Put a thin towel between the ice and your skin. Do this for 15 to 20 minutes at a time every 2 to 3 hours while awake. Continue to ice the area for the first few days.
• Compression. Wrap the area with an elastic bandage to reduce swelling. Start wrapping at the point farthest from your heart. Don't wrap too tightly. Loosen the wrap if you feel numbness, more pain or swelling below the wrap.
• Elevation. Raise the injured area above the level of your heart, especially at night, to help reduce swelling.

Pain medicines you can buy without a prescription, such as ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others), also can help manage pain and swelling.

If you sprain an ankle, you may need support with a walking boot or a splint for the first 2 to 3 days. If your sprain is serious, you'll likely need crutches to keep weight off the ankle while it heals.

Sometimes a brace or splint is used to protect the joint while it heals. In serious cases, such as a torn ligament, surgery may be needed. After your symptoms improve, a physical therapist can teach you exercises to restore strength and stability to your joint.

If you are treating a mild sprain at home, after the first two days gently start moving the injured area. If you seek medical care, follow the instructions your healthcare professional gives you. Healing time varies. Your recovery can take anywhere from a few days to several months, depending on your injury. But you should notice steady, gradual improvement in your ability to move or bear weight without pain.

You typically first see your primary healthcare professional. You may be referred to a sports medicine doctor or a doctor who specializes in bones, joints and muscles, called an orthopedic surgeon.

Bring a written list that includes:

• A clear description of your symptoms.
• Any past medical issues you've had.
• Information about health issues of your parents or siblings.
• All medicines, vitamins and dietary supplements you take.
• Questions you want to ask.

Your healthcare professional may ask questions such as:

• What were you doing when the injury occurred?
• Did you hear or feel a pop or snap?
• When did the injury happen?
• What home treatments have you tried?
• Have you ever injured this part of your body before? If so, how?