Ligament Sprains
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Ligament Sprains

En Español (Spanish Version)

Definition

A sprain is an injury that damages a ligament. A ligament is a firm, fibrous band of tissue that connects two bones across a joint. There are ligaments crossing all of the joints in the body. Grade 1 and 2 sprains damage only the internal structure of a ligament, but the ligament remains intact. Grade 3 sprains (sometimes called “torn” or “ruptured” ligaments) result in complete tears of the involved ligament.

Sprain: Grade 2

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Causes

A sprain occurs when an external force pushes two bones of a joint apart. If the force continues, the ligament holding the joint together has to give. Most of the time, it gives only partially and is sprained. If the ligament were to come completely apart, it would be torn, or ruptured. Sprains occur commonly as the result of sporting activities, but can occur from accidents during everyday activities.

Forces that may cause a sprain include:

  • A fall
  • Contact with another person (especially in sports)
  • A misstep

The most common joints involved include:

  • Ankle
  • Knee
  • Thumb
  • Finger
  • Shoulder (acromioclavicular joint)

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for ligament sprains include:

  • Sports with high speeds and risk of collision, such as:
    • Basketball
    • Football
    • Skiing
    • Gymnastics

Symptoms

Symptoms include:

  • Pain immediately after the sprain—Without treatment, the pain becomes worse over the next 24 hours.
  • A "popping" sound
  • Local swelling, often within minutes
  • Bruising (black and blue)
  • Trouble moving the joint
  • Increased pain when putting pressure on the injured area

Diagnosis

The doctor will ask about your symptoms and how the injury occurred. The doctor will also examine the injured joint for:

  • Tenderness
  • Swelling
  • Bruising
  • Damage to the ligament

Tests may include:

  • X-ray—a test that uses radiation to take a picture of structures inside the body; in this case, to rule out other injuries (such as a small fracture)
  • MRI scan—a test that uses magnetic waves to make pictures of structures inside the body for determining recovery outcomes (rarely used)

Treatment

Treatment depends on the joint involved and the severity of the injury. Pain, swelling, and particularly lack of function determine whether you need to seek medical attention. Treatment may include:

Rest

Stop doing the activity and protect the joint.

Decrease Swelling

If the leg is involved, elevation will help. Compression of the area with an elastic bandage helps to control swelling. Do not pull the elastic bandage tight. Release the bandage if fingers or toes become numb.

Ice and Heat

Apply ice to the area for 15 minutes, 4-6 times a day for the first 36 hours. Do not apply heat until you are ready to start being more active. Check with your doctor before applying heat because it may increase swelling.

Medications

Pain medications, such as aspirin or Tylenol, may be needed. Some doctors recommend anti-inflammatory medications.

Rehabilitation

As sprains begin to recover, rehabilitation exercises are often helpful. Exercises include strengthening muscles and increasing range of motion. Medical guidance is often needed at this stage.

Prevention

It may be difficult to avoid sprains, because various joints are at risk during athletic activities. Proper athletic technique can help avoid awkward motions and missteps that may lead to a sprain. Thorough professional rehabilitation of a sprained joint under the supervision of a certified athletic trainer or physical therapist may reduce the likelihood of a later resprain. To avoid spraining a previously sprained joint, you may also wear a brace or tape the injured joint. See a healthcare professional for advice on braces and taping.

RESOURCES:

American Academy of Orthopaedic Surgeons
http://www.aaos.org

American Orthopaedic Society for Sports Medicine
http://www.aossm.org/tabs/Index.aspx

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org/

Canadian Orthopaedic Foundation
http://www.canorth.org/

References:

American Orthopaedic Society for Sports Medicine website. Available at: http://www.sportsmed.org .

Human Tendons. Human Kinetics; 1997.



Last reviewed October 2007 by Robert E. Leach, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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