What is a joint sprain?
Hi everyone, today we are talking about joint sprains, and what they are. Sprains are one of the most common injuries that occur to the body and happen when there is overstretching or tearing to a ligament that supports a joint.
A ligament is a band of strong connective tissue. They are most commonly found around joints and act to connect two bones together or more accurately prevent them from being pulled apart.
As ligaments reinforce all joints, a sprain can affect any joint in the body, however they are most commonly seen through the spine and in the distal joints of the upper and lower extremities including the ankle, knee, wrist and elbow.
It is important to note that a ‘sprain’ differs from a ‘strain’ which is an injury that involves the muscle or tendon. This is a different type of connective tissue which attaches muscle to bone.
A sprain is usually caused by trauma to a joint but in some cases may be caused by repetitive overuse and degeneration.
Large forces, particularly those that involve a twisting component, cause overstretching to the soft tissue which can result in tearing to the ligament fibres.
These tears are graded from mild to severe depending on the amount of the ligament that has torn and the subsequent instability in the joint. Sprains can occur when people twist an ankle or knee or fall on an elbow or hand.
The symptoms of sprains usually arise locally within the joint and surrounding area and in severe cases it is not uncommon to hear a pop or tearing sound. Pain is usually immediate and is accompanied by restriction in the ability to move the joint. Other symptoms of joint sprains include:
· Instability of the joint
· Decreased range of motion
Sprains are one of the most common musculoskeletal injuries and can occur in any population, however some people may be at a higher risk such as:
· Athletes (particularly people who are jumping, involved in contact sports and repetitively use the same area e.g: golf, tennis)
· People with history of sprains
· People who are overweight
· People just starting physical activity for the first time
· People with balance issues or other neurological dysfunctions
Most sprains can be accurately diagnosed by your healthcare practitioner by taking a thorough history of the injury and performing a physical examination of the area. This focuses on the mechanism of injury as well as looking at pain, weakness and instability in the joint.
If your practitioner is concerned about a potential fracture to the surrounding bone, an x-ray may be arranged to assess this, and in severe cases an MRI may be needed to assess the extent of the soft tissue damage as it does not appear on x-ray.
Sprains are graded into 3 different groups depending on the severity of the injury:
· Grade 1 (mild): limited pain and swelling to the joint and no instability – 0-10% of ligament torn
· Grade 2 (moderate): moderate pain and swelling with some bruising and mild to moderate instability – 10-90% of ligament torn
· Grade 3 (severe): severe pain with a lot of swelling and bruising and severe instability – ligament is ruptured completely.
Most joint sprains can be successfully managed with a course of conservative treatment, particularly in the case of grade 1 and low-medium grade 2 injuries. In some high grade 2 and grade 3 cases further examination and surgery may be needed to reattach the ligament.
A conservative treatment plan is quite consistent regardless of the joint affected and focuses on:
1. Pain management à Rest, ice, pain medication.
2. Minimise swelling à Compression, elevation
3. Prevent further injury à taping or bracing
4. Restore movement to the joint à release the surrounding soft tissue through massage techniques and mobilise the damaged and surrounding joints.
5. Restore strength and proprioception to the area à through a targeted rehabilitation program, which will differ depending on the joint.
The key to making a successful return to activity following a joint sprain is thorough rehabilitation. There is a high risk of re-injury for those people who have suffered a previous sprain and therefore strengthening the surrounding joints and muscles will reduce the probability of future injury.
Recovery times for sprains, varies greatly depending on the severity or grading of the initial injury. With general timeframes being:
· Grade 1 sprains - 2-4 weeks
· Grade 2 sprains - 6-8 weeks
· Grade 3 Sprains - 12 weeks – 12 months depending on whether surgery was required
Tips to prevent joint sprains include:
1. Always engage in a dynamic warm-up before you exercise or play sport.
2. Avoid the ‘too much too soon’ approach to returning to sport or exercise and instead progressively increase your training.
3. Wear correct protective gear when playing sports, especially ensuring you have the correct shoes for the surface you are playing on.
4. Always follow through with a complete rehabilitation plan and maintain adequate strength in an area that has had a previous sprain, as previous injury is the biggest risk factor for reinjuring.
So that’s an overview of joint sprains and how they occur. If you have any questions or comments, please email us at firstname.lastname@example.org and we will be happy to answer them for you.
If you suffer from joint pain or recurrent joint sprains, feel free to call us on (08) 9486 8653 and our therapists will be happy to chat with you.