A sprain is an injury to a ligament, which is a band of connective tissue that binds our bones together. The ligaments may be torn or stretched, or both in some cases. Strain also involves tearing or stretching. The difference is that strain involves the muscles or tendons. A tendon is a band of connective tissue that binds muscles to our bones. Whether the injury involves sprain or strain, the severity depends highly on the extent of the injury, meaning whether the injury sustained is complete or just partial. Seniors are at risk for sustaining sprains or strains due to limited mobility and difficulty in maintaining balance. Aside from seniors, people involved in heavy sports such as hockey, boxing and wrestling are also at risk.

Sprains may occur in both upper and lower extremities but the most common area is our ankle. In fact, over 25,000 Americans sprain their ankles every day. Sprains also frequently occur in knees and hands. Our thumb also gets sprained when it gets twisted during sports or when we perform daily activities. The ligament affected is the ulnar collateral ligament at the base of the thumb. A sprain may be mild (grade I), moderate (grade II) or severe (grade III). Mild and moderate sprains involve partial injury whereas severe sprain involve complete injury, as well as total loss of function.

Strain, on the other hand, is classified as acute or chronic. Acute strains are due to recent injuries of muscles and tendons, often encountered when we try to lift heavy objects. Chronic strains are due to continued and overuse of muscles and tendons. The muscles of our back and the back of the thigh are the two common sites of injury. Other areas include the elbow, hand and forearm.

Signs and Symptoms

Symptoms of sprain include pain, redness and swelling. A popping sound is sometimes heard. The injured area also appears to be distorted and seems to give way whenever it is used. Symptoms of strain also include pain and swelling but further includes muscle spasm, weakness and loss of motor function. Thus, strains can have a debilitating effect on our loved ones.

Causes

Events that cause sprain include sudden twist or blow, resulting to a joint being displaced and the ligament supporting that joint being torn or stretched. Our senior loved ones who have restricted mobility and balance problems are prone to falls and may land on an outstretched arm or on the side of one foot. They sometimes twist a knee or ankle as they try to stand firmly to regain balance.

Prognosis

Sprains and strains generally have good prognosis. Recovery depends on the severity of the injury. Mild sprains may need 3 to 6 weeks of recovery time whereas moderate sprain may take 2 to 3 months. Severe sprain, on the other hand, may require 8 months up to a year to fully recover.

Diagnosis

X-ray is performed to exclude the possibility of bone fractures. Imaging tests may also be done to rule out other events that cause pain and swelling. These include tumors or trauma to soft tissues.

Treatment

Treatment involves two stages. Stage I involves reduction of pain and swelling. Pain medications may be prescribed at this stage. Your loved ones who sustained mild sprains may also be advised to follow the RICE formula, which stands for rest, ice, compression and elevation during the initial 24 hours.

• Rest – Your physician may advise to place no weight on the affected area up to two days. Crutches or leg braces may be prescribed to assist walking.

• Ice – An ice pack may be applied for 20 minutes at a time, 4 to 8 times a day. Do not let the cold pack stay for more than 20 minutes to prevent frostbite, which may add further pain. You can make your own ice pack at home by simply filling a plastic bag with crushed ice and wrapping it in a cloth or towel.

• Compression – This is to lessen the inflammation or swelling, however consult with your doctor on the right tightness. Compression makes use of bandages, which may either be elastic wraps or casts.

• Elevation – Use pillow to elevate the affected area. The elevation should be above the level of the heart.

Moderate to severe sprains, on the other hand, requires assessment by your physician. A hard cast may be applied. Other cases require surgery. However, benefits are weighed over risks, especially the complications involving senior patients.

Care Plan

Most of the recovery time of sprains and strains are spent at home. RICE therapy may also be performed, in addition to the medications taken at home.

Rehabilitation may also be done at home. Rehabilitation is actually Stage II of the treatment plan. Consult with an orthopedic specialist for a rehabilitation program tailored to the needs of your senior loved ones. Special exercises done regularly may improve mobility and flexibility. Weight-bearing exercises may help increase strength and restore function. Remember to do warm-up exercises before proceeding to the main exercise program.

Advice senior loved ones to be patient. It generally takes a bit longer for senior patients to fully recover. Sometimes, they resume daily activities too soon. They may find recovery time too long. Therefore, help them cope during this difficult stage. Encourage them to engage in activities such as reading, listening to music or taking daily, leisure walks. This will keep their mind off their condition, and relieve boredom and depression.