Ligament Sprains

A sprain is an injury that damages the internal structure of a ligament, but the ligament remains intact. 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.

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 it were to come completely apart, the ligament 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

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• Sports with high speeds and risk of collision, such as:
  • Basketball
  • Football
  • Skiing
  • Gymnastics
• Joint looseness (rare)

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

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 ? to rule out other injuries such as a small fracture
MRI scan ? for determining recovery outcomes (rarely)

Treatment depends on the joint involved and the severity the injury. Pain, swelling and particularly lack of function determine whether you need to seek medical attention. For a major sprain, the sooner you receive attention, the quicker you will heal.
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 increases swelling.
Medications ? Pain medications such as aspirin and 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.

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. To avoid spraining a previously sprained joint, wear a brace or tape the injured joint. See a health care professional for advice on braces and taping.