Sprain (Ligament Tear)
What is a sprain?
Ligaments are strong tissues that stabilize a joint by extending from one side of the joint to the other and a sprain is a partial or complete tearing of the ligament(s) associated with a joint. Sprains most commonly occur in the ankle; however, they can occur in any joint. Athletes and physically active individuals are at a higher risk of spraining a joint.
Clinical Presentation
Sprains occur as a result of an acute injury. Symptoms typically include: pain, swelling, and redness around the injured joint. Sprains involving lower extremity joints (ankle. knee, etc.) often lead to difficulty bearing weight on the joint
Physical Examination
Upon physical examination, range of motion of the injured joint will be severely limited because of the pain. Physical exam may also reveal weakness (i.e. of the foot, finger, or hand) and bruising of the skin in the region. The pain intensity during certain motions may be used to determine which ligaments are affected. Patient history may also be used for diagnosis, as a sprain generally occurs from forceful inward or outward twisting of the joint.
Imaging
Diagnosis of a joint sprain is generally made based on the patient’s history and physical examination. However, imaging can be used to rule out other injuries. An X-ray can be used to rule out any fractures or other bone abnormalities. MRI may reveal damage to surrounding soft tissue.
Treatment
Treatment of a sprain initially involves the RICE (Rest, Ice, Compression, and Elevation) technique. The RICE technique is applied immediately following the injury. Joint immobilization is usually also beneficial. Resting promotes healing and helps prevent further injury. Ice and compression reduce the pain and swelling associated with injury and inflammation. Elevating the limb helps limit swelling, particularly if the sprain is in the wrist or ankle. An ankle sprain may be immobilized, using bandages, and ankle brace, or a walker boot, for a period of days depending on the extent of the injury. After a period of rest and immobilization, physical therapy is often recommended. Physical therapy promotes joint stability and decreases the likelihood of future sprains by strengthening the muscle associated with the joint. The severity of the sprain determines the healing time. Mild sprains generally improve within days, while severe sprains may take months to fully heal. In the setting of a severe sprain with complete tearing of the ligament, surgery may be indicated.
Edited March 16th, 2021