Strains and Sprains FAQs

Our muscles allow us to move. They do this by contracting which makes joints extend, flex and rotate. Muscles attach to bone on each side of the joint with thick, fibrous bands of tissue called tendons. Our muscles contract which shortens the tendon and allows the joint to go through a range of motion.

These joints are surrounded by ligaments, which are also tough, fibrous bands of connective tissue that allow the joint to move in specific directions. Ligaments connect the end of one bone to another bone and are anchored to bone on each side of the joint.

What Is The Difference Between A Strain And A Sprain?

A Strain is when the muscle tendon unit is stretched or torn. This may be from overuse or stretching of the muscle, or if it was forced to contract too strongly. The severity of the muscle strain is graded as follows:

• First degree strain: mild strain, only a few muscle fibres are torn or stretched. Injury may be tender and painful, but should retain normal strength.
• Second degree strain: a moderate strain with a greater number of injured fibres. Muscle pain may be more severe and tenderness more profound. Symptoms may include mild swelling, some loss of strength and possibly bruising.
• Third degree strain: the muscle tears (ruptures) completely, resulting in a total loss of muscle function.

A Sprain occurs when a ligament is stretched or torn. A ligament can be injured by being stretched during a sudden pull, which can cause swelling, inflammation and bleeding (bruising) around the affected joint and movement of the joint is painful. The severity of the muscle sprain is graded as follows:

• Grade I: Mild stretching of the ligament without joint instability.
• Grade II: Partial rupture (tear) of the ligament but without causing joint instability.
• Grade III: Complete rupture (tear) of the ligament with instability of the joint.

What Causes Strains and Sprains?

These injuries occur when the body is put under stress. They are caused primarily when joints and muscles are forced into performing movements for which they are not prepared or designed to perform. The injury can be caused by one incident or by repeated stress from certain motion.

The first symptom is always pain. It indicates that there is something wrong with the body and sends a message to the brain that a muscle or joint should be protected from further harm.

The next symptoms are swelling and spasms which can take time to develop (from minutes to hours). Swelling almost always occurs with any injury and when fibres of a ligament, muscle or tendon are damaged, bleeding occurs.

Due to the pain and swelling, the body starts to favour the injured part, which can cause surrounding muscles to go into spasm. You may also be able to feel hard knots of muscle near the injured area. This combination of pain, swelling and spasm causes the body to further protect the injured part, resulting in difficulty with use.

How Can I Treat Strains and Sprains At Home?

The pain can increase for the first one to two days as the spasm surrounding the injury sets in. The following home treatment method works by reducing blood flow from local vessels near the injury and decreasing fluid haemorrhaging as a result of cell damage. Always remember to...

...pay the PRICE...

Protection Protect the injured part from further injury.
Rest Pain is a signal to not move an injury, so you should rest the affected joint / muscle for 48-72 hours after the injury.
Ice This will reduce swelling and help with the spasm. It should be applied as soon as possible after the injury for 10-30 minutes; any less than ten minutes will have little effect, but more than 30 minutes is not recommended, as this may damage the skin. You should wrap ice cubes in a plastic bag or towel, as applying ice directly onto the skin may cause 'ice-burn'. The cold from the ice reduces the blood flow to the damaged ligament or muscle, thus reducing swelling.
Compression This helps to rest the joint and limits swelling. You should apply mild compression that is not uncomfortable or so tight as to cut off the blood supply. Remove the compression before going to sleep. Compression can probably be removed after 48 hours, because by this time the bandage may be limiting the movement of the joint which should normally be moving more freely after this time.
Elevation For ankle and knee sprains, keep the foot elevated to at least hip level when you are sitting, but laying down on a sofa may be preferable. Keep your foot rested on a pillow when you are in bed. With hand and wrist sprains, you should keep your arm in a sling with your hand and wrist higher than your elbow.

...and avoid HARM...for 72 hours after the injury.

Heat This includes hot baths, saunas and heat packs. Heat has the opposite effect on the blood flow to ice. It encourages blood flow so you should avoid heat when inflammation is developing. After 72 hours, when the inflammation should have halted, heat can be soothing.
Alcohol Drinking alcohol can increase bleeding and swelling and reduces the injury's ability to heal.
Running Any exercise is likely to cause further damage.
Massage May increase bleeding / swelling. After 72 hours, however, massage may be soothing and help the injury.

Do I Need To See A Doctor?

You should see a doctor if the pain is not controlled or you think the injury may be more serious than first thought. If the swelling is over a large joint, such as a knee, hip, elbow or wrist, you should also consider consulting a GP or doctor, as well as in the following circumstances:

• If you suspect a bone may be broken or a ligament may be ruptured.
• If you have a lot of tenderness over the bone.
• If the pain is severe, you cannot put any weight on the injured joint, or if you cannot walk because of an injury.
• If the bruising is severe.

What products are available?

We have a wide range of products for the treatment of strains and sprains with different methods of administration:

• Analgesics (pain killers): The most commonly used pain killer is paracetamol, which can be used alongside codeine. These make the pain more bearable when you are experiencing a flare-up of symptoms.
• NSAIDs (Non-steroidal anti-inflammatory drugs): The first NSAID was aspirin, but there are now about 20 types. They are formulated to reduce pain and swelling within a few hours, with noted side-effects including indigestion and possible bleeding from the stomach. They are available over the counter and are one of the quickest ways of relieving pain and inflammation
• Topical (rub-on) anti-inflammatories These contain ibuprofen and are available over the counter; topical anti-inflammatories containing other active ingredients need a prescription. The amount of the drug that gets into the bloodstream is much less than tablets, and there is less risk of side-effects.

We also have a full range of anti-inflammatories.