Sprain

Sprain is a joint injury resulting from exceeding its natural range of motion (RoM). It involves pulling the joint capsule and ligaments, which may be torn or ruptured. The clinical classification system is based on the sprained structure. The diagnostic procedure to confirm the degree of damage to periarticular structures is an ultrasound. In some cases, MRI may also be needed. In some cases, articular cartilage may be damaged or avulsion fracture may occur (the ligament will remain intact, but the bone fragment will detach, where the ligament inserts in the bone). Sprains cause joint instability.

Signs and symptoms

Swelling, pain, bruising, subcutaneous haemorrhage, mobility limited by pain and swelling, pain more severe when lifting (arm) or standing (leg)

Treatment

If the sprain involves stretched ligament, the treatment is short (about a week) and conservative.  RICEMM protocol should be used.

If a ligament is torn, swelling is much bigger with blood accumulation under the skin (this may occur some time later).

Treatment is conservative, the recovery period is 3-6 weeks. RICEMM protocol should be used in the first week. The joint must be immobilised (e.g. in a splint) so as not to stretch the sprained ligament and create conditions to promote healing. After the recovery period, regenerative treatments will strengthen the cartilage and ligaments.

If a ligament is ruptured, surgery will be performed to suture or repair/ reconstruct it. This can be avoided only if a ruptured ligament is still perfectly aligned to its usual anatomical position. Then, it has a chance to heal without the surgery. Treatment efficacy is assessed by evaluating joint stability. If a joint remains unstable, ligament reconstruction surgery will be performed as an elective (scheduled) procedure.