Sprains and Strains
A sprain refers to a stretch and/or tear of a ligament. Classifications of sprains:
- Grade I: Mild stretching of the ligament complex without joint instability.
- Grade II: Partial rupture of the ligament complex without joint instability.
- Grade III: Complete rupture of the ligament complex with instability of the joint.
This typically affects the thumbs, wrists, knees and ankles.
A strain refers to a stretch and/or tear of muscle fibres and/or tendon. Classifications of strains:
- First degree: Mild strain – only a few muscle fibres are stretched or torn. Although the injured muscle is tender and painful, it has normal strength, but power may be limited by pain.
- Second degree: Moderate strain – severe muscle fibres are injured, and more severe muscle pain and tenderness is present. There is also mild swelling, noticeable loss of strength, and sometimes a visible bruise.
- Third degree: Severe strain – the muscle tears all the way through, sometimes producing a ‘pop’ sensation as the muscle rips into two separate pieces or shears away from its tendon. There is a total loss of muscle function, severe pain and swelling, a visible bruise, and difficulty weight-bearing.
This typically affects the back, hamstring and foot.
- Sports
- Poor exercise technique
- Inappropriate footwear
- Inadequate warm up/cool down
- Deconditioned joints
- Increasing age
- Previous sprain/strain
- Sudden trauma - fall, twist, blow to the body
- Poor balance and postural control
Optimise soft tissue recovery through PEACE and LOVE – developed from RICE and POLICE Protocol
First 1-3 days – Acute phase
P: Protect
- Unload and/or restrict movement
- Minimise rest
- Let pain guide removal of protection and gradual loading
E: Elevate
- Elevate injured limb higher than the heart
A: Avoid anti-inflammatory modalities
- Avoid anti-inflammatory medications
- Avoid ice
C: Compress
- Use compression – taping or bandages
E: Educate*
*You will be provided with tailored education to your condition by the clinician you are seeing/may see
After a few days have passed:
L: Load
- Early mechanical stress is indicated
- Optimal loading without increasing pain
- Normal activities to continue as symptoms allow
O: Optimism
- Brain plays a significant role in rehabilitation interventions
- Stay realistic, but encourage optimism to improve the chances of an optimal recovery
V: Vascularisation
- Pain free cardiovascular activity is a motivation booster and it increases blood flow to injured structures
E: Exercise
- Tailored exercise therapy to restore mobility, strength, proprioception
A mild injury will usually heal within a few weeks with conservative management, with minimal risk of long-term complications.
A moderate injury should heal within a few weeks, but there is a high risk of re-injury in the first 4-6 weeks.
A severe injury may take months to heal fully, require surgical treatment, and result in complications.
