• A sprain occurs when the ligaments which hold the bones together around a joint are damaged (partially torn) by overstretching or twisting.


• A strain occurs when a muscle or tendon is damaged by overstretching or an excessive contraction and is also partially torn or “pulled”.

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What are the signs and symptoms?
Sprain and strain injuries present with:

• Pain.


• Bleeding into the tissues which causes swelling.


• Bruising around the injured area.


• Limitations and pain with movement due to tissue swelling and damage.

Tissues that are sprained or strained become swollen and inflamed, are painful and will present with bruising around the affected area. Movement of the injured tissues will be painful; for example, if you have strained your calf muscle, walking on the injured leg will be painful.

What to do?

• The most commonly injured tissues with sprains and strains are the ankle and knee ligaments, the leg muscles, the lower back, the wrist and the shoulders.


• If you suspect that the neck or back are involved do not move the person unless there is imminent danger from, for example, fire or water. Movement can cause spinal cord or nerve damage if the underlying sprain or strain injury is severe. If the person must be moved, then there should be one person controlling the neck and head to keep them in alignment, and at least two people on either side of the person to lift while supporting the spine.


• In children, it can be particularly difficult to distinguish a sprain from a break. This is because children have “stronger ligaments and tendons than bones” and the bones usually break before the ligament snap. If you are in any doubt, your child must go to an emergency facility for x-rays.


• First aid for sprains and strains includes:


• Rest for the injured part of the body


• Ice packs or cold compresses applied for 20 minutes a time every few hours in the first two to three days to lessen the swelling.


• Compression bandages for at least two days, also to reduce swelling.


• Elevation of the injured area above the level of the heart as much as possible which also reduces swelling and bleeding.
• Do not apply heat during the first week as this will only increase the pain and swelling.


• Consult your doctor who may prescribe painkillers such as paracetamol or an anti-inflammatory such as ibuprofen or diclofenac sodium (Voltaren).
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• If you visit a physiotherapist, treatment will be aimed at reducing the pain and swelling/bruising and improving your movement limitations. They will also rehabilitate your injury back to full health with the appropriate mobilising and strengthening exercises.

Any sprain still symptomatic after six weeks should be reviewed for instability, bone or cartilage damage.

Reviewed by Dr Sirk Loots, orthopaedic surgeon.

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