Strains And Sprains

A strain is an injury to a muscle or a tendon, possibly by being overextended or stretched.  A sprain is an injury to a joint with possible damage to, or tearing of ligaments.

Musculoskeletal injuries are usually associated with external forces such as falls or vehicle collisions.  The force applied to the body may cause injuries to the surrounding soft tissues (e.g., nerves and arteries), and even to body areas distant from the injury site.

Muscle strains are often caused by the improper lifting of heavy objects.  The back and spine are very susceptible to injury, and even minor strains in these areas can be debilitating.  Other commonly strained areas include the quadriceps, hamstrings, groin, and calf muscles.

A sprain can be very severe because of the damage it may inflict on the  connective ligaments in the area of a joint.  The pain may be minor or severe, and damage may include stretching or even tearing of these ligaments.  In the case of a torn ligament, medical aid must be sought to reconnect the tissues or permanent disability may result. The signs and symptoms of sprains and strains can include pain and tenderness at the sight of injury, discoloration of the injured area due to ruptured blood vessels in the region, loss of use or coordination, numbness or paleness of extremities (parasthesia), and deformity.

Basic first aid for the treatment of sprains and strains involve the implementation of several steps that are often remembered using the acronym RICE.  R-I-C-E stands for REST, ICE, COMPRESSION, and ELEVATION.

REST = This should be obvious to anyone suffering a severe strain or sprain, but should be observed even by those simply suspecting injury. Rest simply means, “Don’t walk on a sprain.” Repeated use of the injured area may mask the pain, cause further injury, or increase the time needed to heal.

ICE = This is perhaps the most important aspect in dealing with an injury of this type.  Applying ice to the injured area is necessary to control internal bleeding, reduce pain and swelling, and to facilitate the body’s natural healing processes.  Many people prefer the use of heat for sprain and strain injuries. Understanding the physiological changes that take place with each may prevent this mistake from being made.  A sprain or strain often involves the tearing of connective tissues, muscles, and often blood vessels as well. The application of heat will relax the muscles and dilate the walls of the blood vessels in the area.  While a warm spa may sound more inviting than a bucket of ice water, the heat will increase bleeding and swelling in the damaged area, slowing the healing process.  Conversely, ice constricts the blood vessels, slowing the bleeding and reducing painful swelling of the tissues.

CAUTION: DO NOT APPLY ICE DIRECTLY TO SKIN. IT MAY CAUSE FROSTBITE. ALWAYS PLACE A FABRIC BARRIER BETWEEN THE ICE OR COLDPACK AND THE SKIN.

COMPRESSION = A pressure bandage may be applied to restrict blood flow and swelling of the area. Be cautious not to apply a pressure bandage too tightly.  Check distal pulse, movement, sensation, and capillary refill before and after applying a pressure bandage to ensure that the extremities are receiving sufficient circulation.

ELEVATION = Elevation of an injured body part above the level of the heart is another method of controlling blood flow and reducing swelling of the injured area. Do not elevate any area if you suspect it may cause further injury.

The first aid for fractures generally involves immobilization of the injured area, treating for shock, and activating the EMS.  Sometimes, however, it may be necessary to move a patient yourself.  If you must move a patient even a short distance, a splint must be applied to immobilize the injury and prevent further damage.

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