Previous Page      Full Application Library 

Sprains (General)

Bryan Applications, S

A sudden overstretching of a muscle or of the ligaments of a joint is called a strain when it stops short of actually tearing the structure, but when there is tearing it constitutes a sprain. A strain is followed by little or no swelling of the part, but swelling follows a sprain. If it occurs immediately, it is due to the effusion of blood, if after the lapse of several hours, or a longer period, to inflammatory exudation. Even a strain, however, may cause very acute pain.

When there is effusion of blood into the tissues, there is a red or livid discoloration of the skin, the color changing to green and then yellow in the course of a few days. Inflammation in a joint may cause, in addition to local heat, pain and tenderness, a painful sense of pressure, or tension, in the joint.

It should be remembered that though an injury to a joint may cause no definite signs of fracture, or dislocation, and appear to be merely due to a sprain, nevertheless a small fragment of bone may be broken off,* or there may be slight displacement of the bones. An X-ray examination is desirable when there can be any possible doubt as to the extent of the injury. Sometimes also an important nerve may be damaged.

In the process of repair following a sprain, scar tissue may form adhesions which limit the movements of the joint. The risk of this happening is increased by keeping the joint too long at rest. Another possibility is that a sprain may be followed by osteoarthritis of the joint.

The first-aid treatment of a strain or sprain of a joint consists of rest and cold applications. If the injury can be treated as soon as it occurs, however, a firm bandage should be applied evenly and smoothly over the joint in order to limit internal bleeding, or if the accident has occurred out of doors the shoe should be left on, and a bandage applied over it and wetted. As it dries the bandage shrinks and increases the pressure.

A strain of a joint is often treated by strapping with plaster, but skill is required to do this properly. Strips of plaster long enough to go round the joint and overlap at the ends are put on from below upwards, each overlapping about one-third of the width of the one below it until the whole joint is covered in.

Sprains may be treated by putting a layer of cotton-wool about one inch thick over the joint, and for an inch or two beyond it on either side, and bandaging as firmly as possible, without causing discomfort, with a flannel bandage. The bandage is taken off once or twice a day. Heat may be applied to relieve pain.

The patient should be encouraged to move the joint gently from the outset, and after a few days the joint is moved by the doctor or nurse through its full range; this is to prevent adhesions. After four or five days massage may be started. Should there be symptoms of acute inflammation, as mentioned above, no movement or massage is permissible.

Strains or sprains of muscles are treated by rest and cold or hot applications. Movements that cause dragging on the injured muscle should be avoided, and by a skillful application of plaster this may be accomplished, although other movements of the limb can be carried out. See: Joint.

Application and treatment:

The rupture of a joint with partial injury of its attachments. The signs are rapid swelling, heat and disablement of the joint. Pain is increased by moving. Joint may have to be immobilized to heal. Remove pain with positive polarity on both sides for 5 to 30 minutes. Alternate with negative polarity 5 minutes.