Sprains and strains

Ankles are the most commonly sprained joint. One safe step you can take to help prevent sprains, is to always wear boots that give ankle support when walking on uneven ground.

Most of us have felt that sickening pain as we twist quickly or fall, twisting a joint. Ankles are the most commonly sprained joint, but for a speedy recovery, the same principles apply for any joint.

Strain or sprain - what's the difference?

Ligaments are the tough, non-stretchy tissues which connect joints and give them support. A sprain is an injury to a ligament. At its mildest, the ligament is slightly stretched but can still support the joint. At its most severe, the whole support to the joint is disrupted. A strain is an injury to a muscle.

How do I treat sprains and strains?

For the first two to three days, you need rest to give your muscles or ligaments the best possible chance of repairing. After that, you need to weigh up the risk of prolonging your recovery by doing too much, too soon against the risk of stiffening up if you keep the joint too still.

Contrary to popular belief, heat (such as hot compresses) can do more harm than good in the first three days after a strain or sprain. Don't be tempted to massage the area too vigorously, either - this can increase bleeding around the torn ligament or muscle.

The PRICE of successful recovery

If you want to get better quickly, think PRICE. That's:

P rotect the muscle or joint you've injured (how you do it will depend on which joint is affected - a sling might work for shoulders or elbows, or a brace or Tubigrip® for ankles or knees).

R est your joint or muscle for two to three days to give the healing process the best start. However, don't avoid moving a joint completely. You need to move your joint very gently in all directions, avoiding movements that cause a lot of pain. Avoid weight bearing fully for a few days and don't put undue stress on your joint with vigorous exercise for several weeks. For more severe sprains, physiotherapy can help to show you the exercises you need.

I ce - applied as soon as possible for 10-30 minutes. Don't let it touch your skin directly as it can damage the skin. Wrap ice in a plastic bag in a tea towel, or use frozen peas - you can always re-freeze and use them on the joint again! This cuts pain and inflammation by reducing the blood flow to the damaged area in the short term.

C ompression with an elasticated bandage will help reduce inflammation. You may be told to limit its use to two or three days to allow the joint to move freely and prevent stiffening up.

E levation cuts inflammation and pain. Blood needs to flow downwards away from the affected joint - that means a sling which keeps your hand above your elbow for hand or wrist strains, and keeping your leg above your hip level where possible for knees and ankles.

Avoiding sprains and strains

Whether you want to protect a joint you've sprained in the past, or to avoid injury in the first place, the same simple steps (or rather, safe steps!) will help keep risk to a minimum:

  • For ankles, always wear boots that give ankle support when walking on uneven ground. That includes everything from cross country rambling to going to the shops in snowy weather
  • In icy conditions, always wear flat shoes with a good grip
  • If you use a walking stick, make sure it has a rubber grip, and check the grip regularly to make sure it's not worn
  • Keep stairways well lit and clear of obstructions to prevent tripping
  • Avoid exercising if you're tired - your balance will be affected and your muscles will offer less support
  • Check heels of shoes regularly to make sure they aren't worn on one side. If they are, don't put them on until you've paid a visit to the cobbler!

With thanks to 'My Weekly' magazine where this article was originally published.

Dr Sarah is unable to provide medical advice or respond directly to questions concerning your health. If you have health concerns we recommend contacting your GP.