|ICD-10||T 14.3 14.3|
Sprain - A common type of injury. Stretching usually occurs with sharp movements in the joint, exceeding its normal amplitude. Most often, ligaments of the ankle and knee joints are subjected to stretching.
Sprain actually always represents their break, either at the microscopic level - with a slight stretch, or at the level of individual collagen fibers - with a moderate degree of injury, or - with a strong injury - break of the entire ligament. However, the ligaments have a high regenerative capacity, in most cases allowing them to grow together even after a complete rupture.
Ligament sprains are also often referred to as stretching the tendons, although this is not the same thing: ligaments are elastic joints between bones, and tendons are joints between muscle and bone.
Differences between stretching and fracture symptoms
When sprains are characterized by the following symptoms:
- pain when moving in a joint, which is much worse when trying to turn the joint in the direction in which it was stretched in case of injury,
- pain when pressing on the area of the stretched ligaments and their attachment to the bones,
- when stretching the leg ligaments - pain when stepping on the leg, sometimes (rarely) until it is completely impossible to step on it,
- the emergence and gradual growth of octastasis, sometimes reaching large sizes and giving the joint an “elephant” look,
- in some cases - hematoma (bruise), redness and fever in the area of injury, often a hematoma appears on the second day, and just below the injury site,
- in case of a moderate-force injury, a significant limitation of the mobility of the joint occurs, with a complete rupture of the ligament, on the contrary, the joint becomes excessively mobile and unstable, which becomes especially noticeable after the edema has subsided.
- with moderate and severe injuries, sometimes cotton can be heard - a sign of torn fiber in the bundle.
Differences between stretching and fracture symptoms What is stretching?
This ailment is a partial or complete rupture of the ligaments or muscles (connective fibers that strengthen the joints). Most often this occurs at the time of great physical exertion, which is disproportionate to the capabilities of the person. Also, this problem can occur with very active and awkward movements, when the muscles are not warmed.
Often stretching happens in children, people leading an energetic lifestyle, and athletes. Often there are problems with the knee, elbow and ankle joints.
At the time of stretching, pain, swelling and impaired joint function may occur. If to carry out a palpation, painfulness in places of an attachment of sheaves is defined. Most often, this problem is expressed when the intra-articular ligaments are damaged. An important symptom of stretching is dysfunction of the joint, which occurs due to hemarthrosis.
Pathology most often arises due to dislocation or awkward body movement, due to which the joint "falls" out of its usual position. In the future, the bundle that supports it is broken or stretched. Often stretching happens at the moment of falling or landing a person on an outstretched arm, with a hard lowering of the foot to the surface and sliding.
Symptoms of stretching tendons and muscles are generated as a result of strong tension. This problem can be of two types:
- acute occurs during a period of damage or injury, a blow, either due to weight lifting,
- chronic appears due to strong repetitive muscle movements.
About a million different injuries happen every year, and 85% of them are stretching.
- The most common problems with ligaments occur in the area of the ankle at the time of relaxation or sports, but this trouble can occur in other joints.
- This problem is often found in the wrists at the time when a person falls or falls on his outstretched arms.
- The ends of both shin bones and the ankle bone form the ankle and ankle. Stretching this area is very common, as this joint is supported by several lateral and middle ligaments. Most often, problems with the ankles occur at the moment when the foot turns in the opposite direction when running, unsuccessful touchdowns and during jump and turn.
- Another common frequency injury is the stretching of the calcaneofibular ligament. If there was a knee pathology or an unsuccessful fall, then dislocation occurs, and this also becomes a frequent cause of the problem.
- Everyone knows firsthand what stretching is, therefore, according to reviews, the most common place to get this pathology is the back and hamstring. A group of people at risk of injury is often involved in contact sports such as hockey, football, wrestling and boxing. Tennis, gymnastics, golf and other sports that imply strong setting skills increase the risk of stretching in the forearm and shoulder area. Elbow injury occurs in a group of people who are engaged in throwing and throwing.
This is a traumatic injury to the tendon and muscle joints or muscle fibers. Occurs as a result of significant loads for this particular organism. This problem can also appear in everyday life during serious physical activities, sharp weight lifting and a long stay in an uncomfortable and unusual posture.
Many people often pull the muscles of the neck or back. Stretching the legs can be obtained with a strong tension at the time of running, while jumping, walking or squatting with a heavy dumbbell without warming up before it. Often, the hind parts of the lower leg (calf) are stretched, often similar injuries go along with convulsions.
Especially often such troubles can be obtained at the time of performing various physical exercises and sports.
Problems sometimes result from the strongest muscle contraction due to abnormal muscle work. And also this trouble appears when performing stretching or exercises for flexibility.
The main factors that contribute to stretching the arms or legs are low daily activity and an underdeveloped muscle corset. If it is correct to warm up during classes, it is possible to significantly reduce the pathology.
This problem is accompanied by a rather painful muscle spasm. If this feeling is present, it indicates a significant damage, so you want to stop doing things in which the first appearance of pain is present.
This pathology is formed when several or one ligament is damaged in the knee joint. At this moment they are subjected to a very high load and as a result they stretch heavily. Quite often, the problem of this area is accompanied by a gap.
Ligaments in the knee joint perform the function of combining the bones of the tibia with the femur. Thanks ligamentous apparatus provided walking, the possibility of squats, turns and other movements.
There are four ligaments in the knee - two cross-shaped and two lateral, and a knee joint is also present. Everyone knows what stretching is and why it occurs, therefore damage to the knee joint is observed due to sports injuries and other active occupations.
It is a fairly common problem that happens to a person at least once. Often pathology accompanies athletes. In this case, the disease affects the shoulder and elbow joints, hands and even fingers. All these injuries are extremely unpleasant and difficult to heal. Stretching hands usually seriously limits a person in everyday life, and an athlete is not allowed to actively train. Therefore, the injury is a very serious pathology, which must be shown in time to the attending doctor for the diagnosis and prescription of drugs.
The problem occurs at the maximum tension of the ligaments of the muscles or tendons (fibers that connect the bones and muscles together). At the moment of excessive stress on the leg, its tissues do not withstand strong pressure, therefore, the pathology of the extremities occurs.
When the legs are stretched, a rupture of individual fibers is formed, which are assembled into bundles while keeping all the others intact.
The fibers that make up the tendons have a fairly high strength, but even they are designed for a certain directional voltage. In the case when the anomalous course of their movement occurs, they are damaged.
Quite often, stretching turns into a tear of tissues, which differs from the previous one in that it is a break in all the fibers of the muscles, tendons and ligaments at the same time.
Trauma may have varying degrees of severity. Most often these are minimal tissue breaks, which qualify depending on the site of localization and the magnitude of the deformation.
Stretching of the knee joints occurs with active cross-country and jump loads.
Problems with the ankle begin to become more active during the period of movement, if at this moment the heel is rather sharply turned inside.
As with any stretching, the cause of these injuries is a variety of active sports, jumping or falling from a height, as well as frequent violations of the warm-up rules before starting physical activity.
Another factor in which the treatment of sprains of the joints is necessary is diseases of an inflammatory nature, which affect the elasticity of the fibers, as a result of which stretching is formed (paratenonitis, tendonitis).
If there are traumatic injuries of the tendons, they often manifest themselves under various mechanical influences or with excessive force loading, most often during sports.
When stretching occurs, it can be felt as if something has exploded or has burst in the leg. In case of injury, there is always a strong and sharp pain that can be present for up to one and a half months. The acute phase in this case lasts 5-8 days. It should also be noted that the site of the lesion is significantly swollen, a hematoma is formed, and in the leg there are problems with movement.
It is necessary to emphasize that this pain can appear not only because of the stretching of the muscles, but also when the nerve is pinched. With this problem, redness and swelling can also be traced, which significantly limits the freedom of movement of the limb. If we compare these pathologies, the pinching often occurs without an initial injury, and after a serious illness (sciatica, osteochondrosis). Therefore, in order not to confuse diagnoses, it is not necessary to engage in self-treatment, but it is necessary to see the attending physician.
It should be noted that it is the ankle that takes on the pressure of the entire mass of a person and has a rather specific structure. Because of this, injuries of various kinds occur very often in it, especially in the muscular-ligamentous apparatus. Trauma to the ligaments of any degree can occur in every person throughout their lives at least once.
Problems with this joint are quite common, there are also partial injuries or sprains. According to experts, they can not stretch, but only burst. Therefore, ankle sprain is a complete or partial damage to the tendon fibers with simultaneous deformation of the nerves and microvessels.
Ligamentous apparatus of the ankle is represented by three groups of formations:
- ligamentum tibial syndesmosis: posterior lower, interosseous, tibial, anterior lower, transverse,
- external lateral,
Each of the ligaments, which is represented in the body, plays an important enough role, and at the slightest defeat of one of them significant problems with the ankle are formed. It should be noted that the anatomical part of this section has excellent blood supply and pronounced innervation (entry of nerve impulses into the tissue).
What is first aid for stretching? As with sprains and fractures, at the time of stretching the main task is to immobilize the injured limb. With any movement during the pathology period, the fibers break even more. It should be noted: what seems to be stretching does not always correspond to reality. This problem may be a veiled dislocation or even a fracture.
As advised by the doctor, you should not knead or rub the stretched hand or actively try to diverge the leg, because of these manipulations, you can make it even worse. The best thing that is recommended to do is to complete the workout and immobilize the limb. We also advise you to immediately apply cold, thanks to this, you can slightly reduce swelling and reduce pain at the moment and, what is also important, in the following ones.
Everyone knows what stretching is, so the formation of severe pain in a traumatized place is quite a frequent occurrence. Experts recommend applying a pressure bandage (fixing) or tire (as at the time of the fracture) and send the injured to a trauma center in this position. In the hospital, the doctors will perform an x-ray, after which it will become clear that the victim was injured.
If it was decided to do without medical care (there is some pain), then even in this case it is recommended to apply a fixing bandage and periodically apply cold during the first few hours. One day after the blood vessels recover, you can start rubbing the injury with a warming ointment to intonate the blood circulation and metabolism in the injured tissues.
What is a sprain?
A sprain is an injury, which is an tear of the ligament due to excessive tension. In this case, the overall anatomical continuity of the tissue is preserved. Both one and several bundles can be damaged at the same time. The most common places for sprains are the ankle, knee, or wrist joints. A complete rupture of the ligaments or even their detachment from the place where they attach to the bone can occur.
Causes of Sprain
The main cause of sprains are sudden movements in the joint, which exceed its physical capabilities. Such an injury can be obtained at work and at home, on the street or at home, at the stadium and in the gym. This can be a sharp, awkward body movement, slippage, dislocation, an unsuccessful landing after a jump, a fall on the arm or an extended leg. In such cases, the joint loses its normal position and the ligament that supports it may stretch or tear.
Often, sprain occurs during active sports, especially different types of wrestling, playing tennis, basketball, football.
The number of victims increases in winter due to ice.
Symptoms of sprains
Sprain can be recognized with the appearance of pain and redness at the site of injury. When touched or pressed, pain increases.
Swelling occurs in the area of stretching. It can intensify and turn into edema. From hemorrhage from small vessels under the skin sometimes a bruise appears.Due to the damage of the ligament in the joint, a sharp and tangible limitation of its mobility occurs. The danger of such an injury is that the symptoms worsen over time. If the injury immediately seemed easy, then after a few hours it becomes much more difficult to move.
It is customary to divide sprains into three groups according to severity.
A moderate degree is characterized by slight pain as a result of breaking several ligament fibers. With a moderate degree of damage, there is swelling and pain in the injured area, as well as disability of the joint. The third degree is a complete rupture with subsequent instability of the joint, which manifests itself in severe pain.
If you suspect a sprain is recommended to take action on the spot. To do this, restrict the movement of the affected joint, protecting the limb from possible more serious injuries. For this purpose, you can use various means - such as, for example, a tire or crutches. Fix the damaged area will also help elastic bandage or bandage. The compression tube bandage or compression bandage will be most effective.
Immediately after injury, try to cool the injured area. To reduce swelling and pain, apply a cold compress to your joint or immerse your limb for a short time in an ice bath. The cold will help narrow the vessels and reduce subcutaneous swelling or hemorrhage.
The damaged area should be kept raised, placing a cushion, pillow, or blanket.
A couple of days after the injury, you should start massage, physical therapy and thermal procedures (ozokerite, paraffin). Heat will accelerate the process of resorption of edema, increase blood flow to the affected area, and tissues will quickly recover.
An effective method for treating sprains is local therapy with anti-inflammatory drugs (nonsteroidal gels and ointments). In addition, it is important to maintain blood microcirculation in damaged tissues. For this, electrophoresis or special preparations that improve blood circulation are suitable.
In order not to repeat the sprain in the same place, it is desirable to adhere to the home mode at least a week.
With such damage, it is not at all necessary to give up physical activity, the main thing is to watch out for the load of the injured limb.
Training in the pool will be very useful. Swimming relieves the spine and accelerates the strengthening of the muscular system. If you add to the water brine (therapeutic agent, which is a waste product of microorganisms that live in the mud deposits of some lakes), the effect will increase. Rapa has an analgesic and anti-inflammatory effect on the damaged tissues of the joint.
Be careful! If the pain persists for several days, the joint is deformed, and there is a sharp pain when pressed (for example, when the injured person steps on the injured leg or leans on the straightened arm), there is a possibility of dislocation, fracture or rupture of the ligament. In this case, medical intervention will be required. The traumatologist will clarify the diagnosis, assess the degree of damage and prescribe a suitable treatment. X-ray examination and subsequent plaster cast may be required for reliable fixation of the joint.
When the ligament is ruptured, surgery is needed to treat wounds and to connect torn ligaments or tendons. In addition, you will receive comprehensive information about the rules of expansion of the motor mode, if necessary, safe painkillers and ointments, physiotherapy treatment will be prescribed. Exact adherence to medical recommendations will allow you to quickly return to work, to maintain normal physical activity.
Expert Editor: Pavel Alexandrovich Mochalov | D.M.N. general practitioner
Education: Moscow Medical Institute. I. M. Sechenov, specialty - “Medicine” in 1991, in 1993 “Occupational diseases”, in 1996 “Therapy”.
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Sprains are one of the most common traumatic injuries. Along with bruises is one of the first places in the list of the main causes of contact with emergency facilities. It can occur in patients of any age and gender, especially often seen in athletes and people leading an active lifestyle. Most often revealed sprains of the ankle joint, knee joint, shoulder joint and wrist joint. Usually active treatment lasts for 3-5 weeks, and for full recovery it takes 8-9 weeks.
In most cases, sprain is an isolated injury, but combinations with injuries of other structures, often located in the same anatomical region, are also possible. For example, with intraarticular fractures and dislocations, sprains and ruptures of ligaments in the area of the affected joint are observed. Less commonly, sprains are combined with injuries of other anatomical areas: fractures of the pelvis, spine and extremities, blunt abdominal trauma, TBI, chest damage, etc. The treatment of sprains is performed by traumatologists-orthopedists.
In everyday life, a sprain occurs most often as a result of tripping, tuck up of a foot or falling. For example, tugging of the leg when walking in high heels or moving on a slippery surface (ice, rolled snow, or too smooth floor) can cause damage to the ankle ligaments. A sprained wrist ligament is formed when falling on the arm in the same circumstances.
Athletes of ligament damage have their own specifics related to the sport. So, skaters and skiers often have injuries of the ankle joint, caused by a sharp internal rotation (rotation) of the foot when braking. Basketball players, volleyball players, ball throwers, and tennis players may develop sprains of the shoulder joint as a result of a sharp swing or throw. In people involved in powerlifting and bodybuilding, sometimes damage to the ligaments of the upper limb, caused by working with large weights, pressing or from the shoulders, is detected.
Factors contributing to damage to the ligaments in everyday life or in sports are overweight, uncomfortable shoes, clothing or sports equipment, as well as pathological changes in the structures of the joint as a result of arthrosis, previous traumas and infectious diseases. The probability of injury to the ligaments also increases with congenital or acquired anomalies that disrupt the normal anatomical relationships and the distribution of the load between individual segments of the limb (for example, with flat feet).
Ligaments - elastic dense connective tissue strands connecting one bone to another. It is necessary to distinguish the tendons from the ligaments, which also consist of connective tissue, but connect not only several bones, but bone and muscle. Ligaments strengthen the joint and "regulate" movement. They provide both the mobility of the joint and its fixation, allowing you to perform physiological movements, but keeping them from non-physiological. Depending on the main functional purpose, there are ligaments, strengthening joints, ligaments, guiding movements, ligaments that inhibit movement.
When stretched, the bond experiences a load that exceeds its strength and elasticity. As a result, some of the fibers break. The damaged ligament partially or completely loses the ability to perform its functions, the joint becomes unstable. There are a lot of small vessels and nerve endings in the ligament tissue, so when stretching, hemorrhages and severe pain occur. During the first three days, there is an increasing swelling, with multiple fiber breaks, the affected area acquires an “elephant” appearance - the contours of the joint are completely smoothed, the edema extends to the lower sections (for example, the foot if the ankle ligaments are damaged). Possible local temperature increase, cyanosis and hyperemia.
In traumatology and orthopedics, there are three degrees of sprain:
- 1 degree - breaks of individual fibers of the bundle while maintaining its mechanical integrity and continuity. Edema is not pronounced, hemorrhages are absent. Support and movement are somewhat limited, moderate pains.
- 2 degree - there are multiple fiber breaks, possibly partial damage to the capsule. There is moderate edema, often bruises are detected. Movement is limited, painful, support is difficult. Some instability of the joint may be determined.
- 3 degree - a complete break. Accompanied by severe pain, significant swelling and pronounced bruising. Movement is sharply limited, support, as a rule, is impossible. At attempt of passive movements instability of a joint comes to light.
If the ligaments are damaged in grade 1–2, in the absolute majority of cases, conservative treatment is required. Self healing occurs in a few weeks. With complete ruptures, despite the high regenerative capacity of the ligaments, self-recovery does not always occur, surgical intervention may be required. At the same time, the probability of self-healing depends on the localization of the ligament, concomitant traumatic injuries, timeliness and adequacy of conservative therapy.
The diagnosis is based on symptoms and, if possible, MRI, ultrasound of the joint, or arthroscopy. Ligaments are soft tissue formations, they are not visible on radiographs, so radiography can only be used to rule out a fracture, since fractures and sprains are accompanied by very similar symptoms and sometimes combine with each other. In addition, characteristic clinical signs are taken into account in the course of differential diagnosis with fractures.
With sprains, unlike fractures, there is no pain when pressing on the bone (with the exception of pressure in the area of the damaged ligament). Cotton is heard at the time of the injury, not a bone crunch. In a state of rest, as a rule, there is no pronounced pain syndrome that disrupts the patient’s sleep and rest. On palpation, crepitus is not determined, and the deformity is mainly due to edema, and not due to the displacement of fragments.
Unlike fractures, in which damage to the ligaments of the joint is observed only in some cases, dislocation is always accompanied by rupture or sprain. Dislocations are also excluded on the basis of radiography and the absence of typical clinical signs. When stretching, unlike dislocation, there is never a sharp and gross deformation of the joint, shortening of the limb and springy resistance when trying to passive movements.
Prognosis and prevention
The prognosis for sprains is favorable. Damage 1 degree, as a rule, heal without residual effects. When stretching 2 and 3 degrees, some patients in the long-term period have tingling and chronic pain in the joint. This can be due to the formation of small nodules, and the involvement of nerve endings in the process of scarring of the fibers. It must be remembered that the restoration of the ligament occurs due to the formation of scars, and, therefore, later this ligament will be less resistant to damage. To prevent re-injury during sports should use special calipers.
A little anatomy of sprains
In medical terminology, ligaments are called formations that provide the binding of the skeleton and internal organs in the body. They are represented by a fabric of high elasticity, which consists of connecting cells of dense structure.
By elasticity, the ligaments in the joints differ, with which movements in different directions or inhibition of the motor process in the movable joints are possible. Compounds that hold all the internal organs in the correct position, have a fixed structure to ensure a stable arrangement of the heart, kidneys, liver and other organs.
Violation of the integrity of the ligaments leads to the loss of the ability to perform their main function in the body. The joints become pathologically mobile, the internal organs are displaced from their anatomical position, changing the overall physiology.
Pathogenesis of injury
A sharp jerk in the joint with a movement unusual for this joint amplitude exceeding all permissible values, leads to a sprain. The knee and ankle are most susceptible to trauma.
Stretching is always accompanied by mechanical tearing of the connective tissue. With a slight degree of stretching, microdamages are formed, a jerk with great force leads to a complete rupture of the ligament. The damage is accompanied by severe pain with the formation of edema and hematoma.
Bundles tend to self-heal, having a high degree of regenerative capacity. Connective tissue grows together without therapeutic help even after a complete break. To do this, it is necessary to ensure rest and subsequently dosed exercise.
Causes of sprains
The risk of stretching is every person, regardless of gender and age. Injury is possible with falls, intense physical movements, trivial tripping or tucking of the foot. People who are actively involved in sports, as well as people working in heavy work occupations.
In professional athletes in each sport can be noted the injury that occurs as a result of movements in a particular joint, which is most involved in this sport. The probability of falling during ice, a wet road after a rain increases. Workers at high-altitude jobs, porters and other professions associated with lifting or moving weights, put themselves at risk of injury.
There are a number of diseases that are provoking factors to be able to get a sprain:
- the omission of the arches of the foot,
- degenerative processes in the tissues of the joint,
- anomalies of the development of the musculoskeletal or ligamentous apparatus,
- relapses after previous injuries.
Extent of damage
There are three degrees of severity of sprain:
- With a slight injury appear microscopic tears of connective fibers. The joint swells a little, pain is present, but without pronounced manifestations, deformation is not observed. The victim can move independently, limping a little, but leaning heavily on the injured leg.
- With an average form of stretching, collagen fibers are broken, which increases the flow of fluid at the site of stretching, a bruise is formed, and the pain syndrome is felt more acutely. Stiffness and contracture appear in the joint, all attempts to step on a limb with the ligaments stretched end with sharp pain, movement requires crutches or a cane.
- Severe form is manifested by complete rupture of the ligament. The place of stretching strongly swells, an extensive hemorrhage appears, the pain syndrome becomes brighter. The joint, the ligaments of which have burst, becomes hyper-mobile, a noticeable pathological change in the direction of the bones with respect to each other, which are included in the mobile joint.
Symptoms of sprain
Sprains happen instantly, careless movement and the victim feels a sharp pain of high intensity. The place where the ligament stretches, swells before your eyes. The victim does not have the ability to rely on the injured joint, if there is damage to the ankle, the foot can change its position relative to the lower leg, the front part is directed inward.
If the movement was very sharp, a moderate or severe degree of injury is possible. In this case, at the time of injury, you can hear a distinct click in the joint, resembling the sound of a broken string. This phenomenon indicates a violation of the integrity of the ligament.
The pain syndrome present in the injured joint increases if you try to turn the limb in the direction of the damaged ligament. Unpleasant pain will be felt if you try to gently press on the place where the connective tissue attaches to the bone.
The place of the sprain is swollen, often accumulated fluid increases the leg in the ankle area to the size of the thickest part of the calf. The skin on the second day may be hot to the touch. If subcutaneous hemorrhage occurs, the hematoma will gradually appear a couple of centimeters below the injury.
When the damage of individual fibers joint becomes constrained, the movement in it is significantly hampered. A complete rupture is characterized by the opposite state: movements in the joint are no longer limited to ligaments, therefore characteristic instability appears even when attempting passive movements.
Behind the bright clinic of stretching one can overlook the signs of complications that can accompany the damage of the connective tissue. For example, when the leg moves inward, a fracture of the dome of the talus may be concealed, in which stretching the anterior talus-fibular ligament is a concomitant complication. Turning the foot in the opposite direction may result in a tear-off fracture of the medial ankle.
How to distinguish a fracture from a ligament rupture:
- severe pain when pressing the bone in the area of stretching above or below the attachment to the bundle,
- pain remains constant, not passing even during sleep,
- the toes or hands on which the injury occurred, do not move,
- at the moment of injury, the crunch of a broken bone is heard,
- deformation with displacement in an unnatural way.
Therapeutic measures for sprains
In the first minutes after the injury it is important to provide first aid with the subsequent delivery of the victim to the trauma center:
- put the patient on a hard surface, put a rolled roller under clothes or improvised materials under the leg or arm, which made a sharp movement,
- to provide immobilization of the limb by applying a tire,
- give anesthetic - Baralgin, Ketanov.
After determining the degree of sprains, treatment is prescribed. A mild injury can be successfully treated at home, and the victim with a full rupture can be hospitalized in the hospital.
In the first two days, a limb with damaged ligaments should not be stressed. Full rest is provided due to easy fixing by elastic bandage or a compression orthosis. With multiple breaks in collagen fibers, a rigid fixation bandage is assigned, in exceptional cases, when complete immobilization is indispensable, a plaster bandage or a splash of polymeric bandages is applied.
The first two days are applied cold compresses every 3 hours for 15 minutes to reduce pain and swelling, warming procedures are allowed only on the third day. The patient should be the main time, in the prone position, creating a raised position for the injured limb.
To relieve pain and inflammation nonsteroidal anti-inflammatory drugs are prescribed - Diclofenac, Indomethacin, Ibuprofen. Short-term symptom relief will provide non-narcotic analgesics - Baralgin, Pentalgin, Analgin.
Local treatment can be provided with ointments and gels - Dolobene, Voltaren, Fastum gel, but only during the period when warming is allowed. At first, you can use a niz anesthetic gel that does not have a warming effect. If the pain can not be eliminated by taking pill forms, lidocaine or novocainic blockades are performed.
In severe cases, when the ligaments, in spite of the regeneration function, do not grow together for a long time, surgery is prescribed. Two parts of the connective tissue suture or attach to the adjacent ligament.
When the pain and swelling disappears, therapeutic loads are assigned during exercise. The time period after injury is divided into several time stages. For each stretch of recovery a complex of therapeutic exercises is drawn up, taking into account the specifics of a particular case.
In the first week, classes are conducted sparingly, exercises are performed slowly and smoothly. Control over compliance with the recommendations on the load and the technique of performing the movements is performed by the physician physician. In the second week of classes, more difficult exercises are added, the number of repetitions increases.
For each subsequent period is added for 2 weeks, and the exercises are strength in nature for training ligaments. Gradual rehabilitation allows you to abandon the cane, to restore the full range of motion in the damaged joint.
Modern methods of physiotherapy treatment of stretching are an excellent complement to the basic therapy. Magnetotherapy promotes the regeneration of connective tissue ligaments. Penetrating to a depth of 7 cm, a pulsed magnetic field has a therapeutic effect on the cells, normalizing metabolic processes.
Local cold therapy is called cryotherapy. The response of the body to cooling in the form of the launch of recovery functions during stretching of the ligaments. During the procedure, the injury site is blown with cold air two degrees below zero.
Prevention of sprains
You can partially protect yourself from sprains by following these guidelines:
- make a menu of the daily ration based on the products included in the list of healthy food to maintain a normal weight and provide the connective tissue with the necessary amount of vitamins and minerals,
- do exercises from simple physical exercises to train the ligament apparatus,
- choose comfortable shoes with low heels for everyday wear,
- avoid intense physical exertion
- wear protective orthopedic products for the prevention of sprains,
- contact a traumatologist if there was a sharp jerk in the joint for a detailed examination, in time to respond to concomitant injuries.