SPRAINS

A sprain occurs when sudden twisting or wrenching of a joint tears ligaments and/or tendons. Ankle and knee sprains are common in the outdoors. They range in severity from very mild to requiring surgery and a long rehabilitation. Even a moderate sprain can take up to 6 weeks to heal.

ASSESSMENT

A person with a sprain will exhibit some or all of the following signs and symptoms:

• The joint is swollen and discoloured (dark red or bruised).

• The joint is painful and tender.

• There may be loss of function of the joint.

MANAGEMENT Use the RICE treatment:

• Rest:

Stop any movement to prevent further injury.

• Icy cold:

Apply something cold to the area as soon as possible to help reduce swelling and to relieve pain. Apply a cold compress, such as a cloth soaked in icy water or cold mud in a plastic bag, or immerse a sprained ankle in a stream. Do not use ice or anything frozen as it can damage the tissues. Keep the area cold for 20 minutes. Cold cloths warm up quickly, so keep changing them or adding more cold water

• Compression:

Move the foot and ankle, or hand and wrist, into the neutral position and apply a compression bandage that covers the injury site completely. The aim is to help reduce swelling and to provide support. The neutral position is the most comfortable position, because it requires no muscle strength to hold. If the foot is turned inwards, start the bandage from the inside, bringing it over the top of the foot towards the outside. This helps support the foot in its neutral position. The bandage needs to be firm but not too tight, allowing circulation past the injury. A sprained joint may continue to swell, so remove any jewellery and check circulation. Use a combination of icy cold and compression if you can, removing the cold after 20 minutes and reapplying a dry bandage.

• Elevation:

Elevate the limb to help reduce swelling. The aim is to reduce swelling, not prevent it. Swelling is the body’s natural reaction to trauma. It brings extra blood and tissue-healing materials to the area to help healing, and it immobilises the area. However, too much swelling can cause circulation and nerve problems.

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