SPRAINS AND STRAINS

The goal during the first stage of treatment is to reduce your swelling and pain by using the R-I-C-E formula, rest, ice, compression, and elevation:

• Rest by reducing your regular exercise or activities of daily living. Your health care provider may advise you to put no weight on an injured area for 48 hours. If you cannot put weight on an ankle or knee, crutches may help. If you use a cane or one crutch for an ankle injury, use it on the uninjured side to help you lean away and relieve weight on the injured ankle.
• Ice the injured area. Apply an ice pack to the injured area for 20 minutes at a time, four to eight times a day. You can use a cold pack, ice bag, or plastic bag filled with crushed ice and wrapped in a towel. To avoid cold injury and frostbite, do not apply the ice for more than 20 minutes.
• Compression of your injured ankle, knee, or wrist may help reduce swelling. Examples of compression bandages are elastic wraps, special boots, air casts, and splints. Ask your health care provider for advice on which one to use and how tight to apply the bandage safely.
• Elevate the injured area. If possible, you should try to keep the injured ankle, knee, elbow, or wrist elevated on a pillow. Elevating the injured area above your heart can help decrease swelling.

Your doctor may recommend using RICE therapy for the first 24 to 48 hours after the injury. In addition to RICE, your doctor also may recommend:

• An over-the-counter or prescription medication to help decrease pain and inflammation.
• A hard cast for the injured limb, usually if you have a moderate or severe sprain of the ankle.
• Surgery to repair torn ligaments, muscle, or tendon usually seen if you have a severe sprain or strain. An orthopedic surgeon usually performs the surgery.

Stage 2 of your treatment is rehabilitation. The goal during the second stage of treatment is to improve the overall condition of the injured area and restore its function. Your doctor may prescribe an exercise program to:

• Prevent stiffness.
• Improve range of motion.
• Restore the joint’s normal flexibility and strength.

Once the acute pain and swelling are better, your doctor may give you exercises to do several times a day. The type of exercises you do, and how long you need to do them will depend on the type and severity of your injury. If your sprain or strain is more severe, your doctor may recommend physical therapy.

Once you begin to see some improvement of your injury, your doctor may recommend more demanding exercises to help increase your strength and regain flexibility.

Your final goal is to return to full daily activities, including sports when appropriate. You should work closely with your doctor or physical therapist to determine your readiness to return to full activity. You may be tempted to resume full activity or play sports despite pain or muscle soreness. Returning to full activity before regaining normal range of motion, flexibility, and strength increases your chance of reinjury and may lead to a chronic problem.

The amount of rehabilitation you may need and the time needed for your recovery after a sprain or strain depends on the severity of your injury and how quickly you heal. For example,

• A mild ankle sprain may require 3 to 6 weeks.
• Moderate sprain could require 2 to 3 months.
• Severe sprain can take 8 to 12 months to return to full activities.