Sprains & Strains

Question 1

Sprains and strains are two types of MSDs, or musculoskeletal disorders
DEFINITION

Answer 1

MSD’s are injuries or disorders of the:
1. muscles, nerves, tendons, joints, cartilage, and supporting structures of the upper and lower limbs, neck and lower back that are

2. caused, precipitated, or exacerbated by sudden exertion or prolonged exposure to physical factors (e.g. force, repetition, vibration or awkward

Question 2

Causes of Sprains and Strain?

10

Answer 2

They are caused by 
1. excessive 
2. reaching, 
3. bending, 
4. lifting, 
5.  gripping, 
6. squatting, or 
7. twisting of 
  hands, shoulders or body

 Caused by any work performed 
8. with high force, 
9. with many 
  repetitions, 
10. or in an awkward 
  position

Question 3

1. What is a sprain?
2. One or more ligaments
   may be injured at the same
   time
   Most common: ?

Answer 3

1.  A sprain is a stretch or tear of a ligament (band of fibrous 
  tissue that connects two or 
  more bones at a joint); 
  stretched too far from normal 
  position

2. • sprained ankle

Question 4

1. What is a strain?
2. Descrbe its range of injury?
3. Most common?

Answer 4

1. A strain is an injury to a muscle or tendon (thick,
   tough fibrous cord of tissue that connects a muscle
   to a bone)
2. Can be as simple as overstretching a muscle or
   tendon, or it can be a partial or
   complete tear
3. Most common: strained back

Question 5

Types of Sprains and Strains

7

Answer 5

1. Back injuries, including pulled back muscles and
   ruptured discs
2. Compressed nerves causing severe pain, such as
   carpal tunnel in wrist or sciatic leg pain from back
3. Ligament sprains in the upper body
4. Shoulder muscle sprains and dislocations
5. Abdominal hernias
6. Tendon injuries to the hands, forearms and elbows
   (tennis elbow)
7. Ankle sprains and strains

Question 6

Three most common areas for sprains?

Answer 6

1. most common site: the ankle
2. frequently occur at the wrist
3. sprain to the thumb common in skiing and other sports

Question 7

SPRAINS: stretch and/or tear of a ligament caused by what?

Answer 7

a sudden pull

Question 8

Ankle Sprains

1. Inversion injury sprains what?
2. Eversion injury sprains what?

Answer 8

1. Lateral lig

2. Medial lig

Question 9

Describe sprains grade I-III?

Answer 9

I- Ligaments strecthed or slightly torn

II- Ligaments partially torn

III- Ligaments completely torn

Question 10

Severity of Ankle Sprains
Describe functional loss and instability for the following grades of sprains:

1. Grade I?
2. Grade II?
3. Grade III?

Answer 10

1. Minimum
   None
2. Moderate
   Moderate
3. Maximum
   Marked

Question 11

What is a strain? 2

Answer 11

1. injury to either a muscle or a tendon as a result of suddenlly pulling them too far
2. May be a simple overstretch of muscle or tendon,or a result of a partial or complete tear

(tendinitis example)

Question 12

Where Do Strains Usually Occur:

1. Two common sites?
2. Also in? 3

Answer 12

1. two common sites:
   - the back and
   - the hamstring muscle
2. • hand and
   • forearm,
   • elbow

Question 13

How Do They Occur?

6

Answer 13

1. Carrying, holding, or restraining items, people or
   animals
2. Lifting, pushing, holding or pulling loads
3. Working in a fixed position with the back bent,
   sitting or standing continuously, or driving vehicles
   for long periods
4. Repetitive tasks such as reaching to lift or lower
   objects, or to grip tools continuously
5. Working in awkward positions involving bending or
   twisting your body to reach items
6. Vibrations through the body like driving a truck or
   using a powered hand tool

Question 14

What are the Signs & Signals:

1. Sprain?
2. Strain?

Answer 14

For a sprain: Pain, swelling,
bruising, not being able to move the joint

For a strain: Pain, muscle
spasms, muscle weakness,
swelling, cramping, trouble
moving the muscle

Question 15

Treatments for Sprains & Strains

First stage?

Answer 15

1. to reduce swelling and pain
RICE therapy (Rest, Ice, Compress, Elevate) for the first 24 to 48 hours

Ice the injured area, 20 minutes at a time, four to eight times a day

Question 16

Treatments for Sprains & Strains
1. Health care provider may recommend a what to help decrease pain and
inflammation?

2. If moderate sprain, may require use of mobility aids, such as?
3. If severe sprain, may need what? 2

Answer 16

1. anti-inflammatory
   drug such as aspirin, ibuprofen (Advil, Motrin), or
   acetaminophen (Tylenol)
2. a cane, crutches, a walker or wheelchair
3. • surgery to repair torn ligaments, muscle or tendon
   • Short course of narcotic analgesic may be necessary if grade III sprain with severe pain

Question 17

Ankle Sprains….when to xray?
Ottawa rules
4

Answer 17

1. Ankle X-ray is only required if there is any pain in the malleolar zone and any one of the following:
2. Bone tenderness along the distal 6 cm of the posterior edge of the tibia or tip of the medial malleolus, OR
3. Bone tenderness along the distal 6 cm of the posterior edge of the fibula or tip of the lateral malleolus, OR
4. An inability to bear weight both immediately and in the emergency department for four steps.

Question 18

Treatments for Sprains & Strains
Second stage: Rehabilitation
What does this involve?
4

Answer 18

1. Physical therapy/exercise program: designed to help reduce swelling, prevent stiffness and restore normal, pain-free range of motion (during first week after injury)
2. Increase strength and flexibility (about second week after injury); usually more demanding exercises to improve function
3. Advanced stretching?
4. Return to full daily activities, including
   sports if appropriate; must work closely
   with physical therapist to avoid re-injury

Question 19

Time needed for full recovery:

1. Mild sprain/strain?
2. Moderate sprain/strain?
3. Severe sprain/strain?

Answer 19

1. three to six weeks
2. two to three
   months
3. eight to 12 months

Question 20

Although we cannot prevent all sprains and
strains from occurring, there are some tips on how
to avoid them?
4

Answer 20

1. Stretch before you workout with heavy items
2. Use proper footwear for the activity you are doing
3. Warm up adequately
   before activities
4. Do not run on icy/uneven
   surface