The most common clinical problem this week

Sprains, Strains, and Contusions

With the weather getting cooler and the fall sports seasons starting, there are a lot more injuries. Confusion remains over sprains, strains, and contusions. Excellent resources for these injuries can be found on the internet.

The bottom line is this: if you get injuried, immediately rest and immobilize, ice, compress, and elevate (RICE). Perhaps the most important is to immobilize. As a boy scout (or girl scout) we all recall using a rolled up magazine to splint a sprain. Pain arises as the injured tissues continue to be exposed to movement. By immobilizing a limb, the injured flesh is allowed to rest and begin healing.

Ice, compression, and elevation all help with the swelling but the immobilization is the only intervention that actually begins to help with healing. Contrary to what your buddies may say, dont try to walk it off. It may aggravate the injury.

If the pain is severe or its not improved with time, always seek medical opinion. Urgent care centers, emergency rooms, or a quick phone call to your primary care physician is never wasted time.

95% of all sprains and strains heal without any specialized treatment.

Sprains and strains always involve soft tissue structures such as ligaments or tendons. Contusions generally involve an impact injury and involve bruising of fleshy tissue and in severe cases involve bone bruises.

If the injury hasn’t resolved in a week, medical attention is definitely important. At this point, specialized immobilization may be required. Physical therapy may be required. X-rays at this time are important. Though unusual, there can be subtle fractures, broken bones, or even hairline stress fractures.

With modern advances, the rare 5% that do not heal now have opportunities for advanced sports medicine techniques. Ankle arthroscopy can heal ligaments through small minor punctures in the skin. Lasers and more advanced thermal probes can literally weld ligaments together. What used to take almost a year of recovery can now be repaired in just a few short weeks.

But the most critical time period is the first day after the injury. Remember, Rest and immobilize, Ice, Compress, and Elevate. RICE.