A sprain is a tearing and stretching of ligaments or an injury to the bands of collagen tissues—hard bands of fibrous tissues that link two or more bones to a joint. The primary function of the ligament is to give passive stabilization of a joint, and it plays a crucial role in proprioceptive function. A sprain is a sudden stress on a joint or joint being forced suddenly outside, and elastic fibers are significantly stretched. The joint sprain occurs in the ankle (uncontrolled inversion of the ankle causes lateral ankle ligaments and anterior talofibular ligaments to fracture). A mild sprain can be treated or cured at home. Initial treatment or first aid is icing, rest, compression, and elevation. More than 2500 people are victims of sprain every day.
Grades of injury
A sprain can range from mild (few fibers rupture) to severe (complete rupture). There are three primary grades of sprain;
1. Grade I: (mild sprain)
Fracture on a microscopic level occurs with little tenderness and without joint fluctuation.
2. Grade II: (moderate sprain)
Limited rupture of ligaments occurs, with noticeable swelling and tenderness, with mild fluctuation.
3. Grade III: (severe sprain)
It is a severe sprain level, complete ligament rupture with swelling and fluctuation in the joint.
Mild to severe sprains can be treated quietly and healed after six weeks.
4. Symptoms of a ligament sprain
Signs and symptoms of ligament sprain can vary according to the sprain severity. Some include;
- Pain
- Swelling
- Redness
- Bruising
- Limit the ability to movement
- Hearing a pop in the joint
- Tenderness
- Instability
- Popping sensation
Causes
A sprain occurs when you stress the joint severely while overextending the ligament. Sprain often occurs in;
1. Ankle
Exercising or walking on a rough surface, jumping awkwardly. Common ankle ligament injuries are;
- Sprained ankle
- High sprain ankle
2. Knee
Twirling during athletic activity. Common knee ligament injuries are;
- ACL injury
- PCL injury
- MCL sprain
- LCL sprain
- Posterolateral corner injury
- Patella dislocation
- Superior tibiofibular joint sprain
3. Wrist
Arrival on an outstretched hand during falling. Wrist and hand ligaments injuries are;
- Wrist sprain
4. Thumb
Overextension when playing tennis (racquet sports). Thumb ligaments injuries are;
- Skier’s thumb
- Gamekeeper’s thumb
- Finger sprain
5. Shoulder
Shoulder ligament injuries are;
- AC joint injury
- Dislocated shoulder
Children have a growth plate near the ends of their bones. Ligaments around the joints are more potent than these growth plates. So, children are more likely to face fractures than sprain.
Risk factors
Risk factors of sprain include;
1. Environmental factors
Uneven or slippery surfaces can increase the risk of injury.
2. Poor equipment
Unfit or poorly maintained footwear, high-heeled shoes, and other sporting equipment can increase the risk of sprain. Poor flexibility and strength may increase the risk of sprain.
3. Fatigue
Tired muscles do not provide excellent or efficient support to the joints. Tired muscles cause stress to joints.
4. Other factors
A sprain can occur to anyone.
- History of sprain
- Overweight
- Participation in a lot of physical activities
- Tired muscles
Prevention
- Regular stretching
- Strengthening exercises
- Work activities
- Overall physical programs
- Don’t play sports to get in shape
- Give yourself a muscle brace
- Appropriate and stable exercise
- Warm up before doing anything
- Be careful while walking, running, or working on nonproper surfaces
- Minimize wearing high-heel shoes
- Eat a well-balanced or reasonable diet to keep muscles strong and healthy
- Maintain a healthy weight
Diagnosis
In a physical exam, the doctor will check the points of tenderness and swelling in the affected limb. The location and severity of pain can determine the nature and extent of the damage.
X-rays and MRIs can be used to determine or diagnose the extent of the injury.
Treatment
A self-care immediate first aid is given to the sprain: protection, Ice, Rest, Compression, and Elevation.
1. Protection
To restore the ligament, try to immobilize the affected area or stay away from weight-bearing substances for prevention. Use a brace to keep off the injured area.
2. Ice
Immediate help is to ice the area. Use an ice pack or cold water for 10 to 15 minutes and repeat this every 2-3 hours after waking up from injury. Don’t use ice directly on the skin; use an ice pack or wrap ice in a towel.
3. Rest
Avoid physical activities that cause pain, swelling, or discomfort. But don’t avoid all physical activities.
4. Compression
Compress the area of swelling with an elastic band to reduce swelling. Don’t wrap it too tightly because it hinders/stops circulation. Start wrapping from the end farthest of the heart. If you feel pain, then lose the wrap.
5. Elevation
Elevate the area of injury above the heart at night, allowing gravity to lower swelling. Doctors recommend avoiding painkillers during the first 48 hours of ligament sprain, which can increase the risk of bleeding, such as aspirin, naproxen, sodium, and ibuprofen. Acetaminophen can be helpful during this period in reducing pain. Apply heat to the muscles after three days; this will improve blood circulation, which increases the healing process. Slowly increase physical activity. Start stretching, which will reduce stiffness and weakness of the ligament. Make some effort to stay in shape. A physical therapist can also minimize injured joint or ligament strength and stability. Treatment requires anti-inflammatory medications, therapy, and pain relievers to reduce swelling and pain. Therapy restores movement. After two days, slowly use the affected area. You should see the slow and progressive improvement in the ability of a joint to move without pain and support your weight. Recovery from a ligament sprain takes days to months. The doctor will suggest moving the affected area with a brace.
Five methods may use according to the sprain’s severity;
- Reduce swelling
- Ligament injections
- PRP therapy
- Balance training
Best foods for ligament strength
The following foods are best to give strength, energy, and nutrients to the muscles, ligaments, and bones.
- Dairy products, green vegetables, kale, yogurt, cooked broccoli, kefir, bok choy, cheese, okra, and almonds are rich sources of calcium.
- Liver oil, sardines, salmon, tuna, raw milk, eggs, mushrooms, and mackerel are the best source of vitamin D.
- Leafy vegetables, broccoli, cucumber, asparagus, and cabbage are the best source of vitamin K.
- Spinach, pumpkin seeds, chard, almonds, black beans, avocado, figs, dark chocolates, and bananas are excellent sources of magnesium.
- Avocados, spinach, squash, sweet potato, salmon, beans, bananas, and beets are the best source of potassium.
- Fish is the most significant source of omega-3 fatty acids.
- Liver, carrots, kale, spinach, sweet potato, apricots, and broccoli are the best source of vitamin A.
- Guava, black currant, red pepper, kiwi, oranges, lemon, grapes, grapefruit, strawberries, papaya, kale, and pineapple are the best source of vitamin C.
The above foods are best for the fast recovery of the sprain.
References:
- https://www.mayoclinic.org/diseases-conditions/sprains/symptoms-causes/syc-20377938
- https://www.physio-pedia.com/Ligament_Sprain
- https://www.mayoclinic.org/diseases-conditions/sprained-ankle/symptoms-causes/syc-20353225
- https://my.clevelandclinic.org/health/diseases/15461-sprains-of-the-ankle-knee-and-wrist
- https://www.premierspineandsports.com/blog/5-treatment-solutions-for-your-ligament-injury
- https://spinehealth.org/eat-to-strengthen-your-bones-ligaments-cartilage-muscles/
