Treating sprains and strains

It's happened to the best of us — a casual walk through town turns into an embarrassing twist and tumble off the curb. It's especially humbling when our clumsiness turns into a painful sprain or strain.

Although many use the terms "sprain" and "strain" interchangeably, they actually mean two different things. A sprain is the stretching or tearing of ligaments, while a strain usually refers to the stretching or tearing of muscle or tendon.

Dr. Bradford Stiles, a board-certified sports medicine specialist with Sharp Rees-Stealy Medical Group, recently answered a few questions about these common injuries and how to treat them.

What is the most common cause of sprains and strains?
Honestly, bad luck is the most common cause, along with sports. Ankle sprains commonly occur when you walk or run on an uneven surface, like a cracked sidewalk or damaged sports field; making a quick pivot while playing tennis or soccer can cause you to sprain your knee; and you can sprain your wrist if you try to break a fall with your hand. A strain, often in the lower back or hamstring, is usually caused by suddenly slipping, running, lifting, jumping, throwing or chronic use during sports like tennis or golf.

Can you treat a sprain or strain at home, or should a doctor look at the injury?
You should see a doctor if you cannot use the limb or body as you normally would. For example, if you can't walk because your ankle is too sore, or your elbow or shoulder cannot make full-range motions, you should seek care. If you can use the body part without great pain, don't notice bruising and no skin has been broken, you may be able to treat it at home.

How can you treat a sprain or strain at home?
I add a P to the commonly used mnemonic device "RICE" to create "PRICE" for remembering how to treat a sprain or strain:

P – Protect the injured joint so that you don't do further damage
R – Rest the injured area to allow healing to begin
I – Ice every couple of hours, but never more than 20 minutes at a time
C – Compress the injured area to keep swelling to a minimum
E – Elevate the injury above the heart to help decrease swelling

It helps to have a few things on hand at home, such as an ice pack or bag of frozen peas; a compression wrap, which can be used to both protect the injured limb and also to secure the ice pack or bag of peas when icing; and a pain reliever like acetaminophen (Tylenol).

You should speak to your doctor before using a compression wrap or a splint to immobilize the limb because joints like to move and you don't want to cause them to stiffen and delay healing. This is also why we suggest that the "R" in "PRICE" should stand for relative rest so that you keep the joint moving a bit and redevelop strength in the injured area.

How long does a sprain or strain usually take to heal?
Some injuries can take a while to heal and you might benefit from physical therapy to build strength and regain use. Your doctor may order X-rays to rule out a fracture or other bone injury if the pain is severe or you are not healing in due time.

Use pain as your guide. If you can walk on an injured ankle or have full range of motion in an injured shoulder or elbow, then it might be OK to return to your regular activities. Your body is very good at telling you what you should and shouldn't do, and you simply have to listen to it.