Sprain

Manifestations

Treatment of sprains

Sprain is one of the most pressing and common causes that limit the physical activity of people leading an active lifestyle.

The main causative factor of sprain is an acute traumatic injury, called a sprain, or an overload for a long time – overvoltage.

Manifestations

There are three degrees of sprain:

  • Grade I – slight pain due to the rupture of several ligament fibers.
  • Grade II – moderate pain, swelling and disability.
  • Grade III – severe pain due to rupture of the ligament and subsequent instability of the joint.

Stretching the muscle in turn is a traumatic damage to the muscle fibers themselves or to the joints of the muscle and tendon and is also classified according to three degrees of severity:

  • I – moderate.
  • II – the average degree of damage associated with the weakness of the affected muscle, its painful contraction.
  • III – complete rupture of the joints of the muscles and tendons, manifested by severe pain and the inability to reduce the damaged muscle.

Repeated movements during long-term work lead to the appearance of damage from “overvoltage” in people of some professions. Approximately 10–20% of musicians, typists, cashiers and conveyor workers complain of a relapse of sprains, among athletes this percentage ranges from 30 to 50.

Sprains due to overstrain (overtraining) are divided into four degrees:

  • I degree – pain only after physical activity.
  • Grade II – pain during and after exercise, not affecting the result of work.
  • Grade III – pain during and after exercise, affecting the result of work.
  • Grade IV – constant pain, disrupting daily physical activity.

It should also be noted that the defeat of the tendon apparatus can occur in the form of “tendinitis”, “tendinosis” and “tenosynovita.”

Tendonitis occurs because of a tendon injury and the associated destruction of blood vessels and inflammation.

Tendinosis  is a non-inflammatory lesion of the fibers inside the tendon, which can lead to a partial or complete rupture of the tendon.

Tenosynovitis is an inflammation of the lining of the stomach.

The most common types of sprain due to overvoltage (overtraining):

  • ligaments – “baseball player’s elbow”, “swimmer’s knee”, “jumper knee”;
  • tendons – inflammation of the Achilles tendon, upper knee tendon tendon, biceps tendon of shoulder, tendon of posterior tibial muscle, “tennis player’s elbow”.

“Tennis player’s elbow” occurs as a result of overtraining and is manifested by pain on the outer surface of the elbow joint. Patients usually associate his appearance with a game of tennis. The provoking movement — the forced extension of the middle finger of the hand against resistance — causes pain, as the muscle attaches to the base of the metacarpus of the middle finger.

“Golfer’s elbow” – occurs when over-training is damaged by the flexor muscles of the forearm.

“Baseball player’s elbow” – this type of stretching occurs with frequent movement of the hand along the curve of the throw of the ball. The injured have microfissures of the muscle tendons.

The friction syndrome of the oriotibial tract is pain on the external surface of the knee joint due to irritation and inflammation. Syndrome friction or tibia occurs when excessively intense running, running over rough terrain.

“Swimmer’s knee” – a condition that occurs in the knee joint due to sudden movements of the foot during swimming breaststroke.

“Jumper knee” – the so-called inflammation of the patellar tendon. Often found in high jumpers, basketball and volleyball players. It is characterized by pain in the lower pole of the patella, at the site of attachment of the patellar ligament. It develops due to permanent damage to this area, when there is no recovery and healing of the injury.

Inflammation of the biceps tendon of the shoulder is manifested by pain in the front of the shoulder joint, which is aggravated by movements in the shoulder joint.

The bursitis of the patella is accompanied by pain, swelling and local temperature rise in the patella pouch, which is located more superficially than the patella. Bursitis is caused by repeated trauma or exercise, as when kneeling. 

Inflammation of the Achilles tendon is manifested by pain in the heel, sometimes by pain on the back of the foot. Flexion of the foot increases pain, the area of ​​greatest pain is 2-3 cm above the junction of the tendon with the calcaneus. The tendon can be edematous and thickened.

It is also worth mentioning such a pathology as “split shin” – this is damage from overtraining. The pain arises in athletes at the start of the race, while running, subsides and re-intensifies after the end of the race. When palpation is determined by the pain on the posterior edge of the tibia, usually on the border of the middle and lower third.

Treatment of sprains

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Therapeutic treatment of damage to the ligaments, tendons and muscles includes primary and secondary therapy.

Primary therapy:

  • Load protection
  • Relaxation
  • Ice
  • Pressure bandage
  • Elevated position
  • Bandage support

Secondary treatment of sprains:

  • Physiotherapy
  • Rehabilitation
  • Injections
  • Physiotherapy
  • Anti-inflammatory drugs

The basis of treatment is early anesthesia and anti-inflammatory therapy of soft tissue trauma. Ice is effective as an anti-inflammatory agent only in the first hours after injury, then it is preferable to use heat. Immobilization with a splint or bandage can be used to enhance the protection of a injured limb or part of it from the load.

It is also necessary to use non-steroidal anti-inflammatory drugs in the form of tablets, and in these situations, drugs of different groups are approximately equally effective. Their prolonged use is recommended for chronic overvoltage states, in case of acute injury, they are effective for 72 hours.

A very effective method of treating traumatic soft tissue injuries and sprains is local therapy using ointments and gels containing nonsteroidal anti-inflammatory drugs (for example, efkamon). The ointment is rubbed into the skin of the affected area in an amount of 3-4 g. 2-3 times a day and covered with a dry warming bandage. The duration of treatment depends on the nature and severity of the disease.

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