A sprain is also known as a distortion in medicine. It is one of the most common and frequent injuries during sports, hiking and work. In this case, a sprain overstretches and injures the capsules and ligaments of the joint. This often happens due to a careless and unconscious over-movement of the affected joints. Typical signs include severe pain, especially with exertion, bruising (blue spots) and swelling of the affected areas.
What is a sprain?
A sprain, referred to by doctors as a distortion (Latin for twisting, distorting), is a joint injury that results from overstretching of the joint capsule and stabilizing ligaments. The joint capsule is a tight, connective tissue sheath that surrounds the joint and, like a pouch, prevents the joint surfaces from separating. Particularly stressed areas are also stabilized by ligaments. In extreme cases, ligaments or joint capsule can even tear. A sprain is usually accompanied by bleeding in and around the joint. Other possible associated injuries include: Dislodgement or displacement of articular cartilage, concomitant soft tissue injuries, nerve damage. A fresh sprain manifests as pain, swelling, tenderness, hematoma (this may appear up to 12 hours later).
Causes
The most common is a sprain of the foot. The classic injury scenario here: a bending of the foot over the outer edge with simultaneous outward rotation of the body. The bent foot cannot follow the rotation of the body, so that the joint capsule and the stabilizing ligaments, which prevent the joint surfaces of the foot and lower leg bones from separating, are pulled. Sprains are particularly common in sports such as tennis, basketball or soccer. The knee and hand are also frequently affected, but in principle a corresponding injury is conceivable in almost all joints. Risk factors for a sprain are: The practice of high-risk sports, especially at too high a level of performance or without sufficient warm-up, lack of coordination, a generally poor training condition with insufficiently developed muscles. But also previous injuries of the ligamentous apparatus at the corresponding joint. Even slight sprains, if they occur more frequently, can lead to pronounced instability of the joint – this is then referred to as a floppy joint. The worn-out capsule-ligament apparatus also impairs the joint mechanics, which exposes the joint cartilage to increased stress and can accelerate the wear process (arthrosis). Therefore, even in the case of seemingly insignificant injuries, it is better to see a specialist once too often to minimize subsequent damage.
Symptoms, complaints and signs
A sprain is a fairly painful and unpleasant affair that is usually accompanied by fairly typical and distinct symptoms. Affected individuals hear a sharp pain immediately after the sprain, which persists even at rest. Normal movement is therefore not possible with a sprain. In some particularly bad cases, there is swelling that is visible to the naked eye. Permanent cooling can eliminate these symptoms of a sprain. Those who immediately consult a doctor when these symptoms appear can expect a quick and complete recovery. However, those who do not seek medical and medicinal treatment can expect a considerable aggravation of the individual symptoms. The pain increases considerably and, under certain circumstances, inflammation of the nerve tracts is possible. In particularly bad cases, even permanent consequential damage is possible if a visit to the doctor is put on the back burner. A sprain usually has clear symptoms, so that a self-diagnosis can often be made. In order to bring about an improvement or elimination of the symptoms, appropriate treatment is essential. Otherwise, the complaints intensify and there is a risk of permanent consequential damage.
Course of the disease
The injury or sprain is followed by an initial phase in which the tissue swells, a bruise forms, and so on. After 48 hours at the latest, this phase is complete. A medical examination should be done as early as possible.After 6 hours, for example, a “held exposure”, i.e. an X-ray in which the joint is fixed in the same position in which the injury occurred, is no longer useful. The additional stress on the joint could lead to further injury. in the following 4-6 weeks, the destroyed tissue reforms, so the injury is usually considered healed after 6 weeks.
Complications
A simple sprain usually does not cause complications. However, the sprain often occurs as part of a combination injury – this slows the healing process. For example, if a completely torn ligament is present, it can take up to twelve weeks for the sprain to completely heal. If capsular ligaments are torn in addition to the sprain, they may grow together in a scarred fashion, resulting in poor posture and other complications. The sprain itself may also cause poor posture. As a result, joint wear and tear may then occur or chronic pain may result. If the sprain is not adequately treated, it can result in chronic joint instability. Sprains of the foot, in particular, always cause late effects, since the leg is exposed to extreme stress on a daily basis and healing of the injury is therefore often not fully possible. However, surgical intervention also carries risks. Nerve injuries, infections and wound healing problems can occur. The administration of painkillers and anti-inflammatory drugs carries additional risks, because side effects and interactions cannot be ruled out. In the worst case, severe allergic reactions occur after taking a medication.
When should you see a doctor?
If symptoms of the limbs appear after a minor accident or injury, the health impairments should be further observed. If there is already relief after a few minutes or freedom from symptoms within half an hour, a doctor is not needed. In these cases the self-healing powers of the organism have contributed in a sufficient form to an improvement of the situation as well as recovery. In case of increase of complaints or persistent irregularities, a doctor should be consulted. Swelling, changes in the appearance of the skin or impairment of mobility should be examined and treated. Of concern is a blue discoloration of the affected region. A loss of physical strength, a decrease in performance as well as sensory disturbances of the skin are further signs of an existing disease. A physician must be consulted so that various tests can be ordered and performed to clarify the cause. A diagnosis is often possible only after imaging techniques have been used and provide clarity about the condition of the skeletal system. If sporting activities can no longer be carried out as usual or if problems become apparent in coping with everyday life, the affected person needs help. Restrictions in the grasping function of the hands, problems with joint activity and disturbances in locomotion indicate irregularities in the skeletal system. They should be assessed by a physician.
Treatment and therapy
The first and most important measure after a sprain should be the application of the PECH rule. This refers to a total of 4 first aid measures:
1. immobilization to protect the joint and prevent further injury. 2. ice for cooling. Whereby the actual direct contact application of ice should be avoided. Mild cooling above freezing is advised to reduce swelling and dull the pain. Cold packs should be stored in the refrigerator rather than the freezer for this purpose. 3. compression (or compression), again to limit swelling. This can be done at the scene of the accident by simply applying pressure; later, a pressure bandage should be applied. 4. elevation. Another measure against swelling. Elevated body parts should be above the patient’s heart if possible.
Follow-up care
Mild sprains usually do not require a doctor’s visit. The affected body part should be spared and elevated as often as possible. Compression bandages on the injured joint help the body to speed up the healing process. Cooling compresses or warm compresses with essential oils or green tea also have a supporting effect to relieve the sometimes severe pain.Over-the-counter pain-relieving creams are available in pharmacies, also on a homeopathic basis, which also promote healing. It can take several months before the joint is fully loadable again after a sprain. For moderate sporting activities, supportive bandages should therefore be worn at first to protect the joint as far as possible. If severe sprains result in very severe pain or even bleeding, a doctor should be consulted without fail. He or she can use imaging techniques such as X-rays or ultrasound to detect a possible fracture or ligament injury, which usually requires surgical treatment. Of course, the measures the patient can take himself depend on the severity of the sprain. Rest is definitely advisable; supportive walking aids or special sports shoes can be used. Appropriate physiotherapy can also help the patient to mobilize the affected body part again as quickly as possible.
What you can do yourself
A sprain should be examined by a doctor to rule out serious fractures or nerve injuries. Mild sprains can be treated yourself by resting the affected body part. Regular elevation and the application of compression bandages support the healing process of the bone. Cooling compresses help with pain. In the later stages, warm compresses with essential oils or home remedies such as green tea can also be used to relieve the pain. Alternatively, pain-relieving creams from the pharmacy or homeopathy cabinet are a good option. After a sprain, it takes several months for the joint to regain full strength. Before that, gentle exercise is a good idea, and supportive bandages should be worn. If the sprain is severe, a visit to the doctor is recommended. This also applies if bleeding, intense pain or other injuries occur. If the ligaments are injured, surgery is often necessary. The measures that sufferers can take themselves in this case depend on the localization and severity of the sprain. General measures such as rest and supportive physiotherapy are indicated. Special running shoes or arm splints support the impaired limb and thereby also contribute to a rapid recovery.
