Sprain: First aid

Overview

A sprain is an injury to a ligament caused by stretching the ligament too far or tearing it. A ligament can tear partway or all the way. Ligaments are tough, elastic-like bands that connect bone to bone. They help hold joints in place.

When to seek emergency help

Seek medical care right away if:

• You can't put weight on the injured leg, the joint feels unstable or numb, or you can't use the joint. This may mean the ligament was completely torn. On the way to see your healthcare professional, apply a cold pack.
• You have a change of color or streaks of color that spread out from the injured area. This may mean you have an infection.
• You have pain directly over the bones of an injured joint.
• You have re-injured an area that has been injured a few times in the past.
• You have a severe sprain. Delayed treatment might lead to ongoing pain and the joint not being stable.

Symptoms

Areas of the body most likely to sprain are ankles, knees and wrists. Sprained ligaments often swell quickly, are painful and might cause bruising. Often, the greater the pain and swelling, the worse the injury is. For most minor sprains, you can start treatment yourself.

Treatment

To treat a sprain, try the R.I.C.E. approach — rest, ice, compression, elevation:

1. Rest the injured area. Your healthcare professional may say not to put weight on the injured area for 48 to 72 hours. You may need to use crutches or not use the sprained area. A splint or brace also may be helpful at first.

   Even with an injury such as an ankle sprain, you can often exercise other muscles to keep from losing strength. For instance, you can use an exercise bicycle that has movable arm handles. This works your arms and the leg that isn't injured.

   You can rest the injured ankle on the footrest. That way, you still can get a good workout while letting the ankle injury heal.

2. Ice the area. Use a cold pack, a bath of ice and water, or a compression sleeve filled with cold water to keep swelling down after an injury. Ice the area as soon as you can after the injury.

   Ice the area for 15 to 20 minutes, 4 to 8 times a day, for the first 48 hours or until swelling goes down. Don't use ice for more than 20 minutes at a time. Use a dishcloth or thin towel between the ice and your skin. Putting ice right on the skin or icing for too long can damage tissue.

3. Compress the area with an elastic wrap or bandage. Keeping pressure on the area might keep swelling down.
4. Elevate the injured area. Keep it raised on a pillow or cushion above your heart whenever possible. This helps keep swelling down.

Sprains can take days to months to heal. As the pain and swelling improve, gently begin using the injured area. It should get better over time. Pain relievers available without a prescription, such as ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others), might help ease pain.

Prevention

You must restore strength and stability to the injured area before you go back to sports or fitness activities. A physical therapist or other sports medicine professional can show you exercises to help you heal and help keep you from injuring the area again.

When to call your doctor

The causes of sprains also can result in broken bones and other serious injuries. See your healthcare professional if your sprain doesn't get better after two or three days.