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Sprains, Strains & Automobiles

Ok so the automobiles bit is a red herring, (if you're old enough you'll know the film that inspired this heading!) but I will be talking about sprains and strains and the difference between the two!!

Sprains refer to injuries to ligaments, which are the tough fibrous bands of connective tissue that connect bone to bone and provide stability to joints. Such injuries result from the wrenching or twisting of the ligaments from falling or getting hit, causing pain and swelling but not dislocation. The ankle is the most common location for a sprain.

Strains refer to injuries to muscles, tendons or both. These are injuries are very common and occur most in the lower back, shoulders, neck and hamstrings. Such injuries result from overuse, excessive force or overstretching and are often called a 'pulled muscle'.

Both strains and sprains are graded according to severity. Grade 1 being the least serious, generally causing a local inflammatory response and some mild pain at the injury site.

Whereas Grade 3 will require medical attention and may require an x-ray to check for any associated fractures. You should always seek medical attention if you heard a crack when you had your injury, the injured body part has changed shape or the injury is numb, discoloured or cold to touch. This could indicate a broken bone. You should also see a doctor if the symptoms worsen. If you're not sure you can always ring 111 for advice first.

Massage in the day or two following an injury is not advised as this can interrupt the healing process. Focus at this stage should be on the RICE protocol (Rest, Ice, Compression, Elevation) to support healing.

Rest - you should rest the injured joint from any painful movements. In particular, load bearing movements that may aggravate the injury. Ice - apply an ice pack, wrapped in a cloth, to the joint for around 15 minutes. This can be done up to once per hour. Compression - use a bandage or support to provide stability to the joint and to help reduce swelling. This should be worn during the day but removed at night. Elevation - elevate the joint, preferably above the level of the heart, to help fluid drain away from the injury and help with the healing process.

An important point to note on rest is that this should be ‘active’ rest. The intention is to avoid movements that are painful and aggravate the injury. However you should still try and move the joint within pain free limits. For example small passive movements may be comfortable or perhaps active movements in certain planes of motion. These movement stop the joint from seizing up and encourage movement of lymph which helps support the healing process. As healing progresses the amount of mobilisation should also increase (but only within pain free ranges).

Kinesiology taping may be useful for oedema reduction (to help reduce swelling and bruising) or to give support (e.g. with ankle sprains). After the acute stage then massage can be helpful to deal with compensatory issues, and promote healing, proper tissue alignment and optimal range of movement.

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