A sprain can occur when ligaments are stretched or torn, and when joints experience excessive force. Sprains differ from strains in so far as the muscle isn’t affected, whereas the ligaments are. If a sprain is severe, it can feel as though the affected area is broken.
- The ankle is the most commonly affected area
- Causes swelling, bleeding and bruising
- Can be treated with rest and painkillers
If you are concerned about sprains, you can speak with one of our clinicians using our online video consultation service, from 9.30am-4.30pm, five days a week.
What causes a sprain?
A sprain is typically caused by putting too much stress on a joint. They often affect the ankle as a consequence of walking on difficult terrain, or jumping and landing in an awkward position.
Less commonly, sprains can occur in the knees, wrists and thumbs. If you turn quickly, ligaments in the knee can be sprained; this is a very common sporting injury. If you fall, your wrists are vulnerable to sprains, as the hands try to soften the blow of the fall. The thumb can also sprain from overextension, usually during racquet sports such as badminton, tennis or squash, although this is rare.
There are several factors that can contribute to sustaining a sprain. For example, if you are a hiker and spend a lot of time walking on uneven surfaces, you can be more prone to them.
If you do not have appropriate footwear or equipment for a particular activity, your risk of developing a sprain is also increased. Running in unsuitable trainers is a common cause of sprain in the plantar fascia.
If you are tired during physical activity, the muscles you use are unlikely to support your joints adequately, which makes the joints more prone to a sprain. Pressure on a joint can also be significant if the body is fatigued.
Diagnosing the cause of a sprain
A doctor will look to establish what the events leading up to a potential sprain were. They will inquire as to how the symptoms developed, and whether the pain, swelling, or bruising has developed soon after a particularly forceful exercise. If a pop or snapping sensation was experienced, this would suggest that a ligament may have ruptured.
A clinician will also perform a physical examination. This will involve looking at the affected area and assessing signs of heat and tenderness from the possible sprain, and establishing whether there is any localised tenderness at the site of the injury.
A doctor may tap the area to see if it makes the pain worse, or if it triggers any further bruising on the skin, as well as assess if functionality has been lost. If the pain has intensified over a few days whilst the swelling has increased, this may indicate a sprain.
If a sprain is suspected, a doctor will use a grading system to see what type of sprain it is.
There are three different grades of sprain:
- Grade 1 - a mild tear where the joint is still mostly stable and a few tissue fibres are torn.
- Grade 2 - A rupture or partial tear where the joint becomes less stable and unable to take as much weight as it could previously.
- Grade 3 - A severe sprain where the ligaments in the joints are completely ruptured and the joint is unstable.
Testing is unlikely if a sprain is suspected. However, an X-ray can distinguish between a fracture and sprain if there’s a possibility that the bone has fractured. An MRI can also be useful to assess the extent of a tear in a ligament.
How is a sprain treated?
Sprains usually heal over time, and you should treat the inflammation whilst the ligament is repairing itself.
The general approach to treating sprains is that if it’s in either a grade 1 or 2 category, the RICE procedure should be followed.
The RICE procedure
The RICE procedure consists of the following:
- Rest - the affected ligament should be stabilised by significantly reducing movement for up to 48 hours.
- Ice - apply a bag of something frozen such as peas to the affected area in 10 minute intervals, to reduce the pain and swelling.
- Compression - applying mild pressure through the use of a bandage can support the affected area and reduce swelling.
- Elevation - elevating the affected area stops too much blood flowing to the site of the swelling, which will help to control it.
The HARM procedure
The second stage is the HARM procedure. You should avoid the following:
- Heat - as it encourages blood flow to the area, which increases swelling
- Alcohol - as it limits the healing process
- Running - Any strenuous activity can have a negative effect.
- Massage - this increases the bleeding and swelling
Having followed these procedures (over 48-72 hours), painkillers can be taken to help reduce recovery time. Ibuprofen is the recommended first-line treatment.
In the event of a grade 3 tear in the ligaments, or if a grade 1 or 2 tear becomes a grade 3, surgery may be necessary (although this is very rare). Athletes will often have surgery on their ligaments with a view to speeding up recovery, but it’s an invasive procedure and comes with the risk of losing functionality altogether.
If you experience a sprain that hasn’t improved having followed basic RICE and HARM procedures, and you’re having difficulties functioning with the affected ligament, you can speak to one of our GPhC-registered clinicians, who can offer advice about your sprain and treatment options, and provide prescriptions and referral to specialists, where suitable.
How long is it normal to have a sprain for?
This depends on the extent of the sprain. A grade 1 sprain will usually take between 1-2 weeks to recover, a grade 2 sprain up to six weeks to recover, whilst a grade 3 sprain can take 12 weeks or more.
Is a sprain serious?
Sprains are not usually serious and tend to heal naturally with sufficient rest. If there are signs of deformity around the swelling or if you are worried that you may have sustained a fracture rather than a sprain, you should contact your GP urgently.
Can I get treatment for a sprain?
Besides taking painkillers to relieve pain and recovery, pharmacological treatment for sprains is not required.
Using the basic recovery methods detailed above will help the ligament to repair.
If a sprain is grade 3, it’s important to see a doctor to discuss if surgery is required.
How can I prevent a sprain?
It’s not always possible to prevent a sprain, but it is possible to reduce your chances of getting one by following some basic principles.
You should try to maintain the strength of your muscles and warm up properly before aerobic exercise. Using proper equipment, and not exercising when the body is tired can also help to prevent sprains.
Can I speak to a doctor about a sprain?
If you sustain a sprain, you can consult one of our GMC-registered clinicians online via the Treated.com video consultation service. They will be able to give you advice on managing the sprain to aid your recovery and help determine if you should be examined in person by a doctor. Our clinicians are available to consult between 9.30am-4.30pm, five days a week.