Sprains and Strains

Question 1

Causes of sprains and strains?

Answer 1

• caused by excessive reaching, bending, lifting, gripping, squatting, or twisting of hands, shoulders or body
• caused by any work performed w/ high force, w/ many repetitions or in an awkward position

Question 2

What is a sprain?

Answer 2

• stretch or tear of a ligmanent (connects 2 or more bones at a jt), stretched too far from normal position
• 1 or more ligaments may be injured at same time
• MC: sprained ankle

Question 3

What is a strain?

Answer 3

• injury to muscle or tendon as a result of suddnely pulling them too far
• can be as simple as overstretching a muscle or tendon, or it can be a partial or complete tear
• MC: strained back

Question 4

Types of sprains and strains?

Answer 4

• back injuries, including pulled back muscles and ruptured discs
• compressed nerves causing severe pain, such as carpal tunnel in wrist or sciatic leg pain from back
• ligament sprains in upper body
• shoulder muscle sprains and dislocations
• abdominal hernias
• tendon injuries to the hands, forearms, and elbows (tennis elbow)
• ankle sprains and strains

Question 5

Where do sprains usually occur?

Answer 5

• MC site: the ankle
• frequentyl occur at the wrist
• sprain to thumb common in skiing and other sports

Question 6

Diff grades of sprains?

Answer 6

• 1: ligaments stretched or slightly torn
• 2: ligaments partially torn
• 3: ligaments completely torn, going to have max fxnl loss, and marked instability

Question 7

Where do strains usually occur?

Answer 7

• 2 common sites: back and hamstring muscle

- hand, forearm, elbow

Question 8

How do strains occur?

Answer 8

• carrying, holding or restraining items, people or animals
• lifting, pushing, holding or pulling loads
• working in a fixed position w/ back bent, sitting or standing continuously, or driving vehicles for long periods
• repetitive tasks such as reaching to lift or lower objects, or to grip tools continuously
• working in awkward positions involving bending or twisting your body to reach items
• vibrations through body like driving a truck or using a powered hand tool

Question 9

Jobs where strains fequently occur?

Answer 9

• construction
• agriculture
• trucking/transportation
• food services
• delivery services
• custodial services

Question 10

What are the signs and sxs of a sprain?

Answer 10

• pain, swelling, bruising, not being able to move the jt

Question 11

SIgns and sxs of a strain?

Answer 11

• pain, muscle spasms, muscle weakness, swelling, cramping, trouble moving the muscle

Question 12

1st stage tx for sprains and strains?

Answer 12

Want to reduce swelling and pain: NICER for 1st 24-48 hrs

1. rest injured area
2. ice injured area, 20 min at a time, 4-8x a day
3. compress injured area, using bandages, casts, boots, elastic wraps or splints to help reduce swelling
4. elevated injured area, above the level of the heart, to help decrease swelling while lying or sitting down

• if moderate sprain: may reqr use of mobility aids, such as cane, crutches, a walker or wheelchair
• if severe: may need surgery to repair torn ligaments, muscle or tendon

Question 13

Ottawa rules for ankle sprains?

Answer 13

• XR only reqd if there is any pain in the malleolar zone and any one of the following:
• bone tenderness along the distal 6 cm of the posterior edge of the tibia or tip of the medial malleolus, OR
• bone tenderness along distal 6 cm of posterior edge of the fibula or tip of lateral malleolus, OR
• an inability to bear wt both immediately and in ED for 4 steps

Question 14

2nd stage tx for sprains and strains - rehab?

Answer 14

1. PT/exercise program: designed to help reduce swelling, prevent stiffness and restore normal, pain free ROM (during 1st week after injury)
2. increase strength and flexibility (about 2nd wk after injury), usually more demanding exercises to improve fxn
3. return to full daily activities, including sports if appropriate, must work closely w/ PT to avoid re-injury

Question 15

Time needed for full recovery for a sprain/strain?

Answer 15

• mild: 3-6 wks
• moderate: 2-3 months
• severe: 8-12 months

Question 16

How can we prevent sprains and strains?

Answer 16

Can’t always prevent them from occurring:

• stretch b/f you workout w/ heavy items
• use proper footwear for activity you are doing
• warm up adequately b/f activities
• don’t run on ice/uneven surfaces