Kenneth Gardner
A SPRAIN is one of the most common and disabling injuries for exercise buffs. It is a joint twist that results in stretching or totally tearing the connective tissues that stabilise the joints.
When our joints are involved in movements which are beyond their normal limits, microscopic as well as gross tissue damage may occur. When there is injury, the sudden outpouring of blood and synovial fluid into the joint cavity produces swelling, pain, tenderness and skin discoloration. The most vulnerable joints are the ankles, knees and shoulders. Sprains and strains are stretch injuries so it is sometimes difficult to differentiate between them.
Sprains are graded as first, second or third degree.
A first degree sprain is a mild twist of the joint resulting in a sudden, sharp pain. There is also a minimal amount of haemorrhaging.
A second degree sprain is a moderate twisting of the joint which results in pain and the loss of joint function for several minutes. Tenderness and swelling develop, especially if proper treatment is not given urgently.
A third degree sprain is associated with severe twisting of the joint which results in extreme pain, loss of function over a long period, tenderness and spontaneous swelling. There may also be skin discoloration.
A first degree sprain should be treated by the immediate application of a cold compress (ice) and pressure. The injured area can also be taped or wrapped to provide pressure. Warm heat treatment can be applied the following day and the area above and below the injury massaged. The joint can then be moved gently to retain its range of movement.
In the case of a second degree sprain, the initial treatment should be the application of a cold compress, pressure and the elevation of the body part. The joint can also be taped or wrapped to apply pressure to the injured area. The application of weight should be avoided, especially if the injury is in the knee or ankle.
By the second day a warm compress can be applied and the wrapping continued to apply pressure. The massaging of the area above and below the injury can also be continued. Movement of the joint should be initiated to retain its range of movement. By the third or fourth day, the heat treatment should be made warmer and massaging of the area is included. Analgesic balm can also be applied to help reduce the discomfort, especially during movement. Weight-bearing activities can be introduced as well as activities to increase the range of movement.
A cold compress is applied to third degree sprain as soon as possible after the injury occurs. The injured area should be elevated, taped or wrapped, and pressure and stabilisation applied. Within 48 hours after the injury the application of warm heat can be introduced and the area below and above the injury massaged. Taping or wrapping the injury is still necessary to maintain pressure and support.
Weight-bearing activities should be avoided, however, the injured area should be moved through the range of motion within its limitations. Within 96 hours or the fourth to the fifth day, a warmer heat application is indicated. Weight-bearing activity can now be done within the pain threshold. Increased movement of the joint is also necessary to improve the development of the range of movement. The injury can be massaged and the application of analgesic balm will also help to make the injury less irritating.
Kenneth Gardner is an exercise physiologist at the
G.C. Foster College of Physical Education; email: yourhealth@gleanerjm.com.
