Q: What's the difference between a strain and a sprain?

A: Simply put, one involves muscles and the other involves ligaments.

In a strain, the muscle tears from excessive use, stretching, or stress, which causes bleeding into the tissue. The patient experiences soreness or sudden pain with local tenderness when he uses the muscle or does an isometric contraction (meaning no shortening or lengthening of the muscle during exertion).

In a sprain, the ligaments that surround a joint are injured by a wrenching or twisting motion; blood vessels rupture and edema occurs. The patient experiences tenderness at the joint, and joint movement is painful. The degree of disability and pain increases during the first 2 to 3 hours postinjury due to cumulative swelling and bleeding.

Here's a Memory Jogger

To remember the treatment regimen for a strain or mild sprain, think of the mnemonic RICE:

[light shade square] Rest the affected area to allow healing.

[light shade square] Ice or dry cold should be applied intermittently for 20 to 30 minutes during the first 24 to 48 hours postinjury to decrease bleeding, swelling, and pain.

[light shade square] Compression bandage application controls edema and provides support.

[light shade square] Elevation of the affected area reduces swelling.

Caution the patient to avoid cold injury to the skin by layering a towel between the ice and his body. Also, teach him how to wrap the compression bandage so that it isn't too tight, which would interfere with blood flow.

After the acute inflammatory stage is past (usually after the first 48 to 72 hours), heat can be applied intermittently for 15 to 30 minutes four times a day to relieve muscle spasm and promote vasodilation, absorption, and healing.

With a mild or moderate injury, an over-the-counter nonsteroidal anti-inflammatory drug will generally suffice for pain control. In the case of a severe sprain, the patient's health care provider may order additional analgesia.

Easy does it

Strains and sprains may take weeks or months to heal completely. Advise your patient that excessive stress on the injured area can delay healing and cause reinjury. With a mild strain or sprain, gentle exercise can usually be started in a couple of days. A severe sprain may require 1 to 3 weeks of immobilization and, in certain cases, surgical repair.

Regular exercise, adequate warm-up before exercise, maintaining a healthy body weight, and proper lifting technique can help your patient avoid strain and sprain injuries-and they're good for him too.

memory jogger

Treating a sprain or a strain takes RICE:

R-rest

I-ice

C-compression

E-elevation

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